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question everything

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98. This is how the story started

Wed Nov 20, 2024, 05:25 PM

Nov 20

Patricia Greene had spent a month recovering from a devastating stroke when her Medicare Advantage insurer, a unit of UnitedHealth Group, decided to stop paying for her nursing home.

The 85-year-old was so weak and fragile, her son said, that she couldn’t even get herself out of bed. Her family felt she wasn’t ready to leave the facility in New York City’s Queens borough.

So she dropped her UnitedHealth coverage and enrolled in the traditional version of Medicare run directly by the federal government.

That decision saved UnitedHealth tens of thousands of dollars in the months that followed, billing records show, and shifted onto taxpayers the cost of later hospital and nursing home care in what turned out to be the final months of her life.

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Not a matter of paying premiums a matter of life and death, really.

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rampartd flamingdem

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The Sickest Patients Are Fleeing Private Medicare Plans--Costing Taxpayers Billions [View all] question everything Nov 19 OP

THAT'S when they find out what a fucking scam it is Skittles Nov 19 #1

You can warn them Hope22 Nov 19 #2

"too good to be true" seems lost in the wind Skittles Nov 19 #4

Just recently turned 65 Babajida Nov 22 #109

um - young pup Skittles Nov 22 #114

lol Babajida Nov 22 #120

I agree Skittles Nov 22 #121

Your primary care office cannot refuse Medicare patients Ms. Toad Nov 22 #132

Are they quitting or are they intentionally being kicked out? ... aggiesal Nov 19 #50

either way it's more proof what a fucking scam they are Skittles Nov 19 #52

I agree, but if they were kicked out, if I was running the government ... aggiesal Nov 19 #53

LOL Skittles Nov 19 #54

I agree with that too. It's what I would do. n/t aggiesal Nov 19 #55

My wife was on Medicare Advantage plan until the end of her life at140 Nov 19 #56

of course there are always the exceptions Skittles Nov 19 #57

you are right about the goal of MA at140 Nov 19 #60

it is odd that they do not specify in the article Skittles Nov 19 #61

The first paragraph- which I snipped to keep the allowed ones -mentioned United Healthcare question everything Nov 19 #71

Humana isn't much better Skittles Nov 19 #72

No complains with Humana MA HMO using now for 7 years at140 Nov 22 #106

yes they do make it seem nice for now Skittles Nov 22 #107

A friend recently received notice that her Advantage care was being cancelled. Lonestarblue Nov 20 #101

B-I-N-G-O, this is what I'm referring to. ... aggiesal Nov 20 #104

She will still be covered by traditional Medicare Voltaire2 Nov 22 #131

Yep. Medicare Advantage was great for my mom -- until she really needed it. W_HAMILTON Nov 19 #62

I am sorry about that. She should have been able to switch during open enrollment question everything Nov 19 #74

She could have switched, but wouldn't have been able to afford... W_HAMILTON Nov 19 #82

We've had this discussion here repeatedly. Voltaire2 Nov 22 #133

When you go back to original medicare Henry203 Nov 20 #103

self deleted Babajida Nov 22 #111

Medicare "Advantage" was George W. Bush's attempt to privatize Medicare. OMGWTF Nov 19 #3

it's an ONGOING EFFORT Skittles Nov 19 #5

That would be because he's basically a pimp. dchill Nov 19 #48

Part C started in Clinton. Silent Type Nov 19 #27

Exactly! surfered Nov 19 #46

Another GOP grift of the public and especially their MAGA base. Jit423 Nov 19 #59

This is an important article. Thanks. spooky3 Nov 19 #6

not only the "free stuff" rampartd Nov 19 #11

And all the admin costs, and profit for the insurer, etc. nt spooky3 Nov 19 #13

i can't even fit this into "capitalism." rampartd Nov 19 #15

Seniors had better be ready to push back hard if spooky3 Nov 19 #16

i am a cancer survivor rampartd Nov 19 #19

Hang in there! I have a relative whose care in the last two years has spooky3 Nov 19 #20

i've seen the numbers paid out by medicare and my supp. blue cross rampartd Nov 19 #24

Totally agree. Nt spooky3 Nov 19 #28

there is NO REASON a session of chemo should cost that much Skittles Nov 19 #65

And the fact that we as a country allow it to happen. spooky3 Nov 19 #79

My wife has had, and survived, cancer twice DFW Nov 19 #29

Wow! I hope she is ok now. nt spooky3 Nov 19 #64

Amazingly, yes, she is. DFW Nov 20 #87

I'm happy for her and your family. Nt spooky3 Nov 20 #88

Thanks. We were extremely lucky, and never forget it. DFW Nov 20 #89

Congratulations! Nt spooky3 Nov 20 #90

oh my god what a beautiful family. I have had open arthritisR_US Nov 22 #108

Thanks, you're very kind! And it sounds like you've been through the wringer more than most! DFW Nov 22 #116

Ralph Reid was doing his shit and it was illegal but our conservative arthritisR_US Nov 22 #117

I live in Germany DFW Nov 22 #118

Canada? So many of us are looking at the Canadian system as an example.. question everything Nov 22 #124

Alberta is extremely conservative but other provinces in the arthritisR_US Nov 22 #142

I have advanced emphysema from a genetic condition misanthrope Nov 20 #97

This message was self-deleted by its author Skittles Nov 20 #85

? Skittles Nov 20 #105

In economic theory it is called 'rent seeking'. Voltaire2 Nov 22 #134

kickbacks for the people who add people to these scams Skittles Nov 19 #63

Unless they are in a guarantee issue state how do they do it? Tadpole Raisin Nov 19 #7

They aren't switching to another private plan; they spooky3 Nov 19 #10

I know they aren't switching to another M.A. plan. That wouldn't help at all. Tadpole Raisin Nov 19 #17

So your earlier post was commenting about supplemental plans? spooky3 Nov 19 #18

If they were in an Advantage plan they didn't have a supplement. Tadpole Raisin Nov 19 #23

If their income is low enough... littlemissmartypants Nov 19 #45

True! Although when over 65 sometimes the asset test knocks you out Tadpole Raisin Nov 19 #51

Already there... littlemissmartypants Nov 19 #58

Sorry about that. Can the manufacturer help? They often do for expensive drugs question everything Nov 19 #70

Thanks for the suggestion. There's a manufacturer discount card. ... littlemissmartypants Nov 19 #83

A system that makes it normal for people to stress out over this DFW Nov 20 #100

yeah, not just income, assets. Voltaire2 Nov 22 #135

Dr Ozis gonna fix it 🙃 Deuxcents Nov 19 #8

there are youtube videos with the hack Oz pimping for Advantage Skittles Nov 19 #9

Social Security Advantage. The Musk/Swarmy Plan Traildogbob Nov 19 #12

Once you really need care.. Macrophylla Nov 19 #14

I work in Neurosurgery Horse with no Name Nov 19 #32

What would you recommend? Babajida Nov 22 #112

steer clear of any doctor office pimping for Advantage Skittles Nov 22 #119

Agreed n/t Horse with no Name Nov 22 #123

I would recommend doing your homework Horse with no Name Nov 22 #122

There will be no more traditional Medicare mnhtnbb Nov 19 #21

no Skittles Nov 19 #25

You'll be wheeled into the alley behind the hospital awaiting doom. erronis Nov 19 #38

That's what I mean. mnhtnbb Nov 19 #39

it will all eventually be turned over to private insurance Skittles Nov 19 #40

This is exactly what I think, too XanaDUer2 Nov 20 #93

They're already screwed by then. If you join Advantage you will likely be locked out of traditional Medicare supplements tritsofme Nov 19 #22

Hubs and I would pay 800 per month on original Medicare. And I have had excellent care... Demsrule86 Nov 19 #33

What plan do you have? Babajida Nov 22 #113

The concept of a plan has always been the same... Moostache Nov 19 #26

Sadly, original Medicare covers only 20 days of nursing home care, after that you pay $204 or so for next 80 days. Silent Type Nov 19 #30

Not all Medigap policies pay this...most folks go on Medicaid. Demsrule86 Nov 19 #34

This is why we need long term insurance except they are getting so expensive question everything Nov 19 #78

Unfortunately, I see no chance of nursing home coverage in next 20 years at least. Good point about those who are Silent Type Nov 19 #80

This is bullshit. You can't go back to orginal Medicare after Advantage...unless you Demsrule86 Nov 19 #31

You can go back to original Medicare, buy you'll pay 20% out of pocket unless you qualify for a Medigap policy, which Silent Type Nov 19 #35

That is false. totodeinhere Nov 19 #68

Better go read that again. 63-day window applies to the FIRST YEAR you go on MA. After that, underwriting applies Silent Type Nov 19 #73

Thanks for the correction. n/t totodeinhere Nov 19 #75

It's overly complicated. I don't see how anyone keeps up with it. Silent Type Nov 19 #77

That is not true! Liberal In Texas Nov 19 #36

If your advantage plan is canceled that may set up a special circumstance Tadpole Raisin Nov 19 #66

Wall Street Journal Cirsium Nov 19 #37

Switching? Jill Hanson Nov 19 #41

So did I, though in some case you can IF you have a lot of money. Auggie Nov 19 #42

During open enrollment as is right now question everything Nov 19 #44

You can definitely go back to original/heritage Medicare. But, there is no guarantee you can get a Medigap policy, Silent Type Nov 19 #76

Medicare alone (Parts A/B leaving you with a 20% copay) is a permitted switch. Ms. Toad Nov 22 #141

False fact upstream..... Granny Blue Nov 19 #43

I think... littlemissmartypants Nov 19 #47

For 2025, Medicare Advantage plans have cut benefits and raised premiums and copays, across the board dlk Nov 19 #49

Kick dalton99a Nov 19 #67

I'm so damn sick of this crap soandso Nov 19 #69

I thought wryter2000 Nov 19 #81

You can during open enrollment see 44, above question everything Nov 19 #84

no you CAN go back Skittles Nov 20 #86

I don't know why everyone is so worried Zorro Nov 20 #91

Humana is terminating 560,000 members because they are not profitable enough dalton99a Nov 20 #92

This happens with for profit companies. Their fiduciary is for their shareholders who expect them question everything Nov 20 #94

With Dr. Oz sabbat hunter Nov 20 #95

I don't get it. The premium for my plan is $36/month. milestogo Nov 20 #96

This is how the story started question everything Nov 20 #98

I'm enrolled in both milestogo Nov 20 #99

GOP evil julmur Nov 20 #102

Anyone here old enough to have Medicare? Babajida Nov 22 #110

that's the issue Skittles Nov 22 #115

There are professionals who help individuals through the labyrinth of enrolling question everything Nov 22 #126

Most if not all are paid a commission by the insurer dalton99a Nov 22 #128

Look for State Health Insurance Assistance Programs ie: SHIP CousinIT Nov 22 #139

100% elder abuse Babajida Nov 22 #140

I always assume a slick commercial indicates a weak or bad product. lindysalsagal Nov 22 #125

Problem is once they sign up for an advantage plan, transferring JohnSJ Nov 22 #127

VERY Misleading article. I'll explain why. Typical of the WSJ though, siding with private insurers CousinIT Nov 22 #129

You may want to read the whole story again. I have no idea where you got your conclusions question everything Nov 22 #136

The headline is badly written then. CousinIT Nov 22 #138

Neither MA or Medicare cover long term nursing home costs. Voltaire2 Nov 22 #130

Medicare covers some stay when one is released from the hospital. Go read the original stroy question everything Nov 22 #137

'long term' nt. Voltaire2 Nov 23 #143

300,075 over 6 years doesn't seem high considering 30+ Million are insured by MA plans. Silent Type Dec 6 #144