Why Medicare Advantage Plans Are a Scam
INTERVIEW ON THE PRICE OF BUSINESS SHOW, MEDIA PARTNER OF THIS SITE.
Recently Kevin Price, Host of the nationally syndicated Price of Business Show, interviewed Dr. David Wilcox.
Health Transparency: The Real Truth with Dr. David Wilcox
Have you ever played the shell game at a local or state fair? Do you remember the game where an object of value is placed under a cup and you try to guess where that object will be after the fair employee moves it around? Why is it that you can never seem to win at this game no matter how many times you play it? The answer is simple. It’s a scam meant to make the administrator of the shell game money. The same is true with Medicare Advantage Plans.
A scam is defined as a dishonest scheme, a fraud by Dictionary on the internet. They even use the example of “an insurance scam”. That’s pretty telling. So let’s explore why Medicare Advantage Plans are a scam.
Medicare Advantage Plans lure you in with the promise of extra benefits and out-of-pocket limits. What they don’t tell you is that you have to stay inside their smaller network of hospitals and providers and can only obtain prescription drugs that their formulary covers. They also use prior authorizations which can delay or in some cases, deny your healthcare. Medicare Advantage Plans place more restrictions on you than traditional Medicare does.
When you turn 65 you will start receiving many offers to sign up for Medicare Advantage Plans. The insurance brokers have a financial incentive to encourage enrollment in Medicare Advantage plans because commissions are higher for Medicare Advantage than for Medigap and Part D plans that are purchased to complement traditional Medicare.
Although you can drop a Medicare Advantage Plan and switch to traditional Medicare during an open enrollment period, the damage may be done. If you initially elect traditional Medicare you won’t be denied a Medigap policy for existing conditions. This means someone with diabetes, heart conditions, high blood pressure, and other co-morbidities will be able to obtain Medigap insurance as traditional Medicare only covers 80% of your costs. Medigap insurance is used to cover the additional 20%. If you are switching from a Medicare Advantage Plan to traditional Medicare you can be denied coverage for pre-existing conditions by a Medigap Insurer.
Another consideration is that many physician offices and hospital systems won’t take certain Medicare Advantage Plans as they find it administratively hard to deal with all the prior authorizations and delays in payment. This means that you may have to drive many hours to find a provider network to obtain your care.
While Medicare Advantage Plans may offer a lower premium than traditional Medicare, there is always a price to pay and many rules you have to follow. The insurance company’s model is they want you to pay in, stay healthy, and die fast. They are a business beholden to their investors. If you do get very sick and have to have expensive treatments chances are they will delay or deny your care.
With any business, there are highly paid executives such as CEOs that run it and command millions of dollars in salaries. That money comes from your insurance premiums. Traditional Medicare does not have this additional expense.
Anytime you can remove an insurance company from your healthcare you should do it. With traditional Medicare, no insurance company will interfere with you and your provider’s prescribed treatment plan. You will be able to obtain care anywhere and won’t be limited in your prescription drug choices. Choosing traditional Medicare is a much better choice.
According to a statement, “Healthcare is complex and that is not an accident. It is complex by the healthcare entities vying for your healthcare dollars. Covid has exacerbated the American Healthcare System, which was fragile, to begin with. Many clinicians are leaving healthcare due to burnout. How does the average layperson navigate the complexities of the American Healthcare System where a prescription could cost you $5 at one pharmacy and $500 at another? What does the average layperson do when their insurance company rejects their claim? Proactive education of the American Healthcare System prior to accessing it is the key to safely navigating the healthcare system. Until now, little information has been available to provide the layperson with the knowledge they need to be a better partner in their health care. Dr. David Wilcox’s book How to Avoid Being a Victim of the American Healthcare System: A Patient’s Handbook for Survival” is a game-changer and will provide you with the skill set you need to navigate the American Healthcare System.
Website: https://drdavidwilcox.com/
Dr. Wilcox is a Doctorate prepared nurse who also holds a Masters in Health Administration and is Board Certified in Nursing Informatics. Dr. Wilcox has 28 years of healthcare experience in which he worked as a bedside nurse, hospital administrator, and in healthcare information technology which has helped him to develop his unique perspective on the American Healthcare System.
Dr. Wilcox is the author of the book “How to Avoid Being a Victim of the American Healthcare System: A Patient’s Handbook for Survival (2021)” available at https://www.amazon.com/dp/0578878364
Dr. Wilcox currently resides in North Carolina with his wife and their three dogs.
Dr Wilcox’s website: Dr. David Wilcox – Healthcare, American Healthcare System (drdavidwilcox.com)
Connect with Dr. David Wilcox on social media:
LinkedIn: https://www.linkedin.com/in/david-wilcox-48631113/
X/Twitter: @DrDavidHelps
