Tag: Insurance

8 Million And Counting

What is the scoreboard for you might question….this is just to let the world know what Donny and those slugs that are in his employ are doing to the health of this nation.

The unprecedented healthcare cuts that President Donald Trump and the Republican Party enacted last summer have impacted people in all 50 US states, stripping insurance coverage from around 8 million Americans total and wreaking havoc on hospitals and other providers nationwide.

The advocacy group Protect Our Care on Tuesday released state-by-state fact sheets detailing how many people have lost Medicaid, Children’s Health Insurance Program (CHIP), and Affordable Care Act coverage due to Republican policy decisions, including the party’s roughly $900 billion in cuts to Medicaid and decision to let enhanced ACA subsidies expire, sending premiums skyrocketing.

“Eight million Americans have lost their health care because Donald Trump and Republicans decided they would rather hand out tax breaks to billionaires than protect working families,” said Brad Woodhouse, the president of Protect Our Care. “Every day that healthcare becomes more expensive, a family is forced to make an impossible choice between putting food on the table and staying covered, a senior is forced to ration their medication, and an expectant mother has to travel farther to access maternity care.”

(commondreams.org)

I still say let’s give Medicare For All (M4A)…..what have we to lose?

To be honest I want to give you an opposing view….this is from the website Reason….keep in mind their slogan is “Free Minds and Free Markets”….so with that in mind they are basically on the side of for profit healthcare…

“Free healthcare is cool,” comedian Shane Gillis recently said on The Joe Rogan Experience. “We should have that.”

“You should treat the entire country like it’s a community,” Rogan replied. “If you had a community, would you want the sickest person to fucking die who could be very valuable if you could take care of them, and do you have the resources to take care of them?”

While support for “free” healthcare in the United States is not new—Harry Truman campaigned on universal health insurance in 1948, and Sen. Bernie Sanders (I–Vt.) has popularized the “Medicare For All” slogan in recent years—the policy has received renewed interest of late. The Democratic Socialists of America have made universal healthcare “at no cost to individuals” a key component of their party’s expensive platform.

But it is not just political hopefuls who like the idea of universal healthcare; academics seem to as well. A recent study by the Yale School of Public Health claims that single-payer universal healthcare would save more than 100,000 lives a year, and would supposedly cost $1 trillion less than the system it would replace. The study, which has not been peer-reviewed yet, appears to come to its conclusions by modeling a scenario that assumes cheaper pharmaceutical prices, less administrative overhead, reduced fraud, and fewer emergency visits.

…

The U.S. healthcare system has plenty of problems. While the promise of “free stuff” may sound tempting, the experience of countries with universal healthcare should make Americans deeply skeptical of the idea that putting the government in charge of the entire system is a panacea.

https://reason.com/2026/08/19/universal-healthcare-sounds-great-heres-whats-happening-in-countries-that-have-it/

The part about long waits for treatment….when I needed a gastro doctor it took me 14 weeks to get an appointment….we have those long waits, maybe not as stark as others but they are there.

If they are against M4A then how about giving Americans the same coverage as Congress people?  It is free and their waits are shorter and their drugs are mostly free….how about that for a solution?

In case there are those that still do not know what M4A is….let me help….here are the basics….

Medicare for All would transform the program into a single-payer health insurance program that would provide all Americans with healthcare coverage.

Single-payer healthcare systems, also called universal healthcare, are currently in place in various countries worldwide. These healthcare systems can have differing elements, such as:

  • how the health insurance is paid for
  • how the healthcare is delivered
  • how the health facilities are owned and operated

So yes I support M4A and will do so as long as I kind breathe on my own.

How about you?

I Read, I Write, You Know

“lego ergo scribo”

Want To Save Lives?

If so then Medicare For All would be the road to travel….I have been a supporter of the idea since its inception….and now a new study has shown just how effective it could be….

Previous research has shown that shifting the United States to a Medicare for All system could save roughly 68,000 lives and $650 billion per year, but a new study by experts at Yale University suggests the savings would likely be even greater on both fronts.

In a Tuesday statement, Sen. Bernie Sanders (I-Vt.), lead sponsor of the Medicare for All Act in the Senate, highlighted the findings, published recently on medRxiv, a server for preprints, or research that hasn’t yet been peer reviewed.

…

“We estimate that such a system would reduce national health expenditure by $1,041 billion annually,” they explained. “Sources of savings include reductions in administrative overhead, pharmaceutical prices, fraudulent billing, and avoidable emergency care. Combined with the reversal of recent retractions, universal coverage would save over 114,000 lives annually.”

Specifically, as Sanders’ office detailed in a statement, Americans would save:

  • $377.5 billion by paying no more than other major countries for prescription drugs;
  • $286.3 billion by eliminating bureaucracy and waste;
  • $285.7 billion by curbing fraudulent billing;
  • $100 billion by preventing costly emergency room and hospital visits; and
  • $295.6 billion by reimbursing providers fairly for the care they provide.

https://www.commondreams.org/news/medicare-for-all-savings

I would say that is good news, right?

But not to worry….health insurance and other corporate donors will be fighting hard to defeat any chance of M4A having any success…

The investigative outlet Sludge published an analysis on Monday showing that the health insurance industry is among the corporate donors to Third Way, a think tank that is reportedly preparing to pour $15 million into an effort to combat the rise of candidates who support Medicare for All and other progressive policies.

Third Way, which has long been hostile to the progressive wing of the Democratic Party and Medicare for All in particular, does not publicly disclose its donors. But Sludge’s David Moore uncovered some of the group’s benefactors by examining corporate tax filings, which revealed that the private insurance industry group Better Solutions for Healthcare (BSFH) donated $50,000 to Third Way’s advocacy arm in 2024.

Among BSFH’s members are the Blue Cross Blue Shield Association and the health insurance industry trade group AHIP. Moore noted that BSFH is “run out of the offices of leading Republican digital and strategy firm Targeted Victory in Arlington” and was founded by GOP operative Alexander Schriver.

Sludge’s review of corporate tax filings showed other healthcare industry donors to Third Way, including CVS Health and Johnson & Johnson.

“Another corporate lobbying heavyweight, the Business Roundtable (BRT), gave $50,000 to Third Way in 2024, up from the $25,000 it gave in 2023 and down from the $75,000 it gave in 2022,” Moore reported. “Each year in 2019, 2020, and 2021, BRT gave $50,000 to Third Way. The CEO group’s health insurance members include the heads of UnitedHealth, Cigna, Elevance (formerly Anthem), CVS Health—all members of AHIP (formerly America’s Health Insurance Plans), save for UnitedHealth—as well as healthcare company Centene and many Big Pharma firms like Johnson & Johnson.”

https://www.commondreams.org/news/third-way-medicare-for-all

Again not to worry the chance of getting good healthcare is small because the Congress is owned by the people that are fighting this attempt.

This is a little something for you to mull over while enjoying your morning coffee…..

Your medical records are private, right?  But for how long?

You might assume that what you tell a doctor stays between you, your physician and perhaps your insurer. But the reality is more complicated.

The Health Insurance Portability and Accountability Act, the federal privacy law that governs health information and is commonly known as HIPAA, is narrower than its reputation suggests. It regulates hospitals, physicians, insurers and their business associates, but not the health data you generate everywhere else: not the period-tracking application on your phone, the internet search you ran about a diagnosis, the DNA you mailed to a genealogy company or the wearable that counts your heartbeats.

Even the records HIPAA does cover can be shared, sold or handed to the government in ways that might surprise you.

This gap in protection matters more than ever because the U.S. government is pushing hard to gather health data domestically and abroad. This is happening even as a growing body of research shows that the safeguard which these efforts to collect data lean on – anonymizing data by removing identifying information to make it difficult to trace back to an individual – is far weaker than officials claim.

https://theconversation.com/us-government-is-pushing-to-gain-unprecedented-access-to-your-medical-records-as-data-protections-are-weakening-287021

Americans need to wake up and smell the manure in the road.

I Read, I Write, You Know

“lego ergo scribo”

Retirees And Their Money

As a retired old fart I keep my eyes on news that would impact new retirees and those near retirement….just my way to impart some FYI to help them navigate the complexities of retirement.

Regardless how attractive the ads are for some of these Medicare plans they are most likely a money trap that provides little in the way of help.

Plans like ‘Zero’ premiums and free dental, vision and hearing…..they are a trap and should be avoided….but here is why….

Choosing the right Medicare plan is one of the most important financial and health decisions older adults make. With so many plans promising lower premiums, free perks, and wide coverage, it’s easy to get drawn in by attractive marketing. But all too often, these plans hide critical limitations in the fine print, from unexpected out-of-pocket costs to restrictive provider networks. Knowing which plans to approach with caution can save retirees from serious financial and medical headaches. Here’s a look at 10 Medicare plans that seem helpful at first glance but often leave enrollees feeling misled.

https://www.savingadvice.com/articles/2025/06/03/10157823_10-medicare-plans-that-look-helpful-until-you-read-the-fine-print.html

It is common knowledge that I do not support these so called Medicare Advantage plans because to me they are a money trap and provide little…..but I am not alone….many retirees dump these plans once they see just how bogus they are….

Medicare coverage doesn’t just mean signing up for government insurance. In fact, more than half of Medicare recipients now get their coverage through a Medicare Advantage plan, or Medicare Part C plan, which is offered by a private insurer.

Advantage plans are an alternative to original Medicare, replacing Part A (hospital coverage), Part B (outpatient care coverage), and sometimes Part D (prescription drug coverage).

Enrollment in these plans is expected to grow to 60% of the eligible population by 2030, with many people drawn to them because they’re often marketed as “zero premium” plans with out-of-pocket limits, while Medicare Part B has uncapped spending and charges premiums. The Trump administration strongly favors the expansion of Medicare Advantage plans.

Yet, while Advantage Plans seem like a good alternative, a substantial number of older Americans who sign up for them don’t stick with them. In fact, among those who signed up between 2011 and 2022, around half left their plans within five years.

Recent research published in the journal Health Affairs helps demonstrate why so many are opting out of their Advantage Plan during open enrollment, either by switching to a different Part C plan or by returning to traditional Medicare instead. Since these Advantage plans are less likely to attract beneficiaries over the long term, the study warns that such plans will likely have less incentive to cater to participants with chronic conditions.

https://www.kiplinger.com/retirement/medicare/should-you-ditch-your-medicare-advantage-plan-most-people-do

Please do not fall for the BS do your research before you retire and do not be swayed by promises that will not be fulfilled.

The way things are going you will need all your retirement to just exist so do not fall for the BS that could eventually put you into the poor house.

I Read, I Write, You Know

“lego ergo scribo”

United Healthcare In The News (Again)

Can you remember awhile back when the CEO of United Healthcare was shot on the streets of NYC?

Well United Healthcare is not through with being the target of investigation….

It seems that the insurance giant may have committed Medicare fraud….(was this on the list of fraud that Elmo had compiled?)

UnitedHealth Group is facing another government investigation, this one reportedly centered on possible criminal Medicare fraud. Since at least last summer, the Justice Department has been investigating the health insurance company for fraud related to its Medicare Advantage business, reports the Wall Street Journal. Medicare Advantage insurers receive extra payment for covering especially sick patients, meaning there’s an incentive to document patients’ diagnoses. Previous reporting by the Journal revealed “questionable diagnoses by UnitedHealth added billions to taxpayers’ costs,” the outlet notes.

Earlier reports described a DOJ civil fraud investigation related to UnitedHealth’s Medicare billing practices. In a statement, UnitedHealth says it wasn’t informed of the “supposed criminal investigation reported” and stands “by the integrity of our Medicare Advantage program,” per Reuters. It previously disputed the Journal‘s reporting as “inaccurate and biased,” saying Medicare Advantage “provides better health outcomes and more affordable healthcare for millions of seniors” than traditional Medicare. But the criminal probe based in New York presents another headache for a company that has seen its stock fall almost 50% in the last month.

The greedy bastards were not deterred by this investigation and continued abusing the people that depended on them for help….

UnitedHealth Group, the healthcare conglomerate facing a criminal investigation over possible Medicare fraud, secretly paid nursing homes thousands of dollars in bonuses to cut hospital transfers for ailing residents, risking patient health while it saved millions, per a Guardian investigation. The outlet identified numerous cases where nursing home residents needed immediate hospital care but failed to receive it after UnitedHealth’s intervention. In one 2019 case out of Washington state, a nursing home resident was showing textbook symptoms of a stroke, indicating immediate hospitalization was needed. But a remote UnitedHealth employee wanted a less-serious condition ruled out first and asked for an update in, not minutes, but four hours.

In a similar case that year, a remote UnitedHealth employee delayed requesting a hospital transfer for a patient with stroke symptoms, forcing facility nurses to bypass the system. It took an hour and the patient suffered permanent brain damage, per the Guardian. Other UnitedHealth nurses say they faced pressure to persuade Medicare Advantage members to adopt “do not resuscitate” orders—an effort to prevent costly hospital stays—even when the patients had expressed a desire to seek all available treatments.

“A lot of times the [facility] nurses want to send people out and we have to go in and try to stop it,” a UnitedHealth nurse tells the outlet. “And if we don’t … they take us out onto the carpet.” “The sense is: ‘Well, they’re medically frail, and no one lives for ever,'” says another nurse. “No one is truly investigating when a patient suffers harm.” Though internal emails reference “budgets” outlining how many hospital admissions a nursing home had “left,” UnitedHealth denies that its employees prevented hospital transfers or inappropriately pushed patients to change their DNR status. It says nursing homes receive bonuses for preventing unnecessary hospitalizations that are harmful to patients. The company’s shares fell almost 7% Wednesday following the report, per Reuters.

These incidents are disgusting and illustrate just how uncaring these greedy bastards truly are….

Not to worry though the consumer will be protected…..oh wait the Consumer Protection part of government has been mostly shuddered by the Trump administration and DOGE.

What to do now?

I Read, I Write, You Know

“lego ergo scribo”

The ‘Advantage’ Con

This is post for all my senior readers.

Daily we are bombarded by ads telling us all the ‘advantages’ of having Medicare Advantage plans….the problem is as I keep pointing out they are full of crap and are little more than a con job.

These plans taunt that we can get special coverage for hearing, vision and dental with these plans…..so how true is that?

As the privatized form of Medicare, Medicare Advantage plans advertise dental, vision, and hearing benefits not covered by traditional Medicare, but a recent analysis found that Medicare Advantage beneficiaries do not typically receive more of these supplemental services than traditional Medicare beneficiaries. Additionally, out-of-pocket spending was similar for most supplemental services.

The research led by a team from Mass General Brigham is published in JAMA Network Open.

“Medicare Advantage plans receive more money per beneficiary than traditional Medicare plans, but our findings add to the evidence that this increased cost is not justified,” said first author Christopher L. Cai, MD, who conducted this work as a resident in the Department of Internal Medicine at Brigham and Women’s Hospital.

For their study, Cai and his colleagues analyzed 2017–2021 data from two continuous surveys, the Medical Expenditure Panel Survey and the Medicare Current Beneficiary Survey. In total, the investigators assessed information on 76,557 Medicare beneficiaries.

Only 54.2% of Medicare Advantage beneficiaries were aware of having Medicare Advantage while just 54.3% were aware of having vision coverage. Medicare Advantage enrollees were no more likely to receive eye examinations, hearing aids, or eyeglasses than traditional Medicare enrollees.

Out-of-pocket expenses for supplemental benefits were similar or modestly lower for Medicare Advantage. Medicare Advantage and traditional Medicare enrollees paid $205.86 and $226.12, respectively, for eyeglasses (9.0% less for Medicare Advantage); $226.82 and $249.98, respectively for dental visits (9.3% less for Medicare Advantage); and no differences for optometry visits or durable (a proxy for ), after adjusting for demographics.

Nationwide, Medicare Advantage plans’ annual spending on vision, dental services, and durable medical equipment totaled $3.9 billion, while enrollees spent $9.2 billion out-of-pocket for these services and other private insurers covered $2.8 billion.

In contrast, Medicare Advantage plans received $37.2 billion dollars annually more than taxpayers would have spent if beneficiaries had enrolled in traditional Medicare, a cost that is partially intended to fund supplemental benefit use.

“Supplemental benefits are a major draw to Medicare Advantage, but our findings show that people enrolled in Medicare Advantage have no better access to extra services than people in traditional Medicare, and that much of the cost comes out of their own pockets,” said senior author Lisa Simon, MD, DMD, assistant professor in the Division of General and Internal Medicine at Brigham and Women’s Hospital

(medicalexpress.com)

These are profit generating cons…..yes I said ‘cons’….

The federal agency now headed by former television host Mehmet Oz announced Monday that it is substantially boosting payments to privately run Medicare Advantage plans, a boon for an industry notorious for overcharging taxpayers and denying patients necessary care.

The Centers for Medicare and Medicaid Services (CMS) said it is jacking up payments to Medicare Advantage (MA) plans by more than 5% for 2026—an increase of over $25 billion. That’s more than double the increase proposed by the Biden administration.

Health insurance company stocks jumped in response to the news of the Trump administration’s payment hike, with shares of UnitedHealth Group—the largest provider of Medicare Advantage plans—rising more than 6% following the CMS statement.

Oz, whom the Republican-controlled Senate confirmed in a party-line vote last week, previously reported holding tens of millions of dollars worth of stock in companies with interests before CMS, including UnitedHealth.

Social Security Works, a progressive advocacy group that campaigns against Medicare Advantage, said Monday that “privatized Medicare plans are denying patients the care they need, while defrauding the government of billions a year.”

“Trump is giving them even more taxpayer money,” the group wrote on social media. “Trump-Musk don’t care about ‘efficiency.’ They care about stealing our money.”

https://www.commondreams.org/news/trump-medicare-advantage-payments

Please research these plans if you are considering taking one…..arm yourself with information before you talk to the fat cat behind the insurance desk.

Do not fall prey to these vultures……it will cost more of your money and provide little coverage…..you have been warned.

I Read, I Write, You Know

“lego ergo scribo”

Where The Money Went

Just another FYI from your friends at IST….

The money you pay your insurance companies with….

One is ‘on your side’ and another tells you are in ‘good hands’….etc etc….you have heard all the claims and BS from them…..

Are you getting your money’s worth out of these companies?

As Americans grapple with rising healthcare costs, a revealing new study shows where much of that money is going — and it’s not necessarily toward better patient care or medical research. According to research just published in JAMA Internal Medicine, major healthcare companies listed on the S&P 500 have been directing massive amounts of their profits to shareholders, with these payouts more than tripling over the past two decades to reach $170.2 billion in 2022 alone.

To understand the scale of this financial shift, consider that healthcare represents 17% of America’s entire gross domestic product, with total U.S. healthcare spending reaching $5 trillion in 2023. Of this enormous sum, approximately 70% comes from taxpayer dollars through various channels, including tax breaks for employer-based health insurance and direct government funding via Medicare and Medicaid.

Behind the staggering medical bills and insurance premiums that many Americans face lies a financial system that includes substantial payouts to investors. “When shareholders expect greater payouts year in and year out, that has an impact on affordability,” notes lead author Dr. Victor Roy, in a statement. “One of the ways that [health care companies] make money is to keep prices high — or raise them.”

Between 2001 and 2022, 92 major healthcare companies distributed an astronomical $2.60 trillion to shareholders through two main mechanisms: direct dividend payments and share buybacks.

Dividends, of course, are profit-sharing checks sent directly to investors who own shares in these companies. Share buybacks, on the other hand, are more like a company reducing the number of slices in a pie; when a company buys back its own stock, each remaining slice becomes worth more, benefiting the shareholders who still hold shares. Both strategies effectively channel money to investors rather than reinvesting it in healthcare services or innovation.

https://studyfinds.org/healthcare-company-profits-shareholders/

These companies challenge most claims in a way to weasel out of paying out….there must be a way us peasants can come out with our savings intact….

There is and it is called Medicare For All…..

Medicare For All

The time has come and the time is ripe as more Americans are being screwed out of the homes because of outrageous medical expenses.

Any thoughts?

I Read, I Write, You Know

“lego ergo scribo”

Is United Healthcare Evil?

Since the CEO of United Healthcare was popped on the streets of NYC there has been scrutiny over what drove the assassin to commit murder.

There have been several stories of people that were screwed over by the big insurance giant…..this is the one that stuck with me….

A month after the killing of UnitedHealthcare CEO Brian Thompson prompted many Americans to share personal horror stories of the company’s coverage denials and other practices, a doctor in Austin, Texas on Wednesday shared her own experience that she said exemplified how the for-profit health system “just keeps getting worse.”

In a video posted to TikTok, Dr. Elisabeth Potter said she recently received an unprecedented phone call from UnitedHealthcare about a patient—one who was already under anesthesia and having surgery.

Potter, a plastic surgeon who specializes in reconstructive surgery for breast cancer patients who have had mastectomies, said she was performing a bilateral deep inferior epigastric perforator [DIEP} surgery when UnitedHealthcare called her in the operating room.

The call was urgent, she was told, and needed to be returned right away.

“So I scrubbed out of my case and I called UnitedHealthcare, and the gentleman said he needed some information about her,” said Potter. “Wanted to know her diagnosis and whether her inpatient stay should be justified.”

Potter found that the person calling wasn’t aware that the patient whose care he was questioning had breast cancer and was in the operating room—that information was known by “a different department” at UnitedHealthcare.

Potter’s account, said Nidhi Hegde, managing director at the American Economic Liberties Project, was “another horror story from a doctor dealing with United Healthcare’s terrible authorization process.”

https://www.commondreams.org/news/united-healthcare-surgery-coverage

This is horrific but it is not an outlier…

Then there is news about their and others drug pricing…..

The Big 3 companies acting as intermediaries between drugmakers and insurance providers made billions by needlessly jacking up the prices of lifesaving drugs, according to the Federal Trade Commission. In its second interim staff report on pharmacy benefit managers (PBMs), released Tuesday, the FTC said CVS Health’s Caremark Rx, Cigna’s Express Scripts, and UnitedHealth Group’s OptumRx “marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent,” generating $7.3 billion in revenue in excess of the acquisition costs of the drugs over five years beginning in 2017.

In theory, PBMs act as middlemen, negotiating fees with drugmakers on behalf of employers and reimbursing pharmacies for prescriptions, per Reuters. But the FTC’s earlier report on PBMs, released in July, found they are “vertically integrated” with healthcare conglomerates, which “exercise vast control over huge swaths of the healthcare sector.” That report analyzed two specialty generic drugs, flagging markups over 1,000%. This report expands the analysis to 51 specialty generic drugs. For these, the Big 3’s price-markup revenue climbed from $522 million in 2017 to $2.1 billion in 2021. “Cancer drugs alone made up nearly half of the $7.3 billion” in revenue over five years “with multiple sclerosis medications accounting for another 25%,” per NBC News.

The companies—found to have “reimbursed their affiliated pharmacies at a higher rate than they paid unaffiliated pharmacies on nearly every specialty generic drug examined”—also generated an additional $1.4 billion over five years through the practice of billing plan sponsors more than they reimbursed pharmacies for the drugs, the report notes. A rep for Express Scripts says the report is misleading, with the analyzed drugs accounting for less than 2% of what health plans spend on medications in a year, per Reuters. An OptumRx rep said the company lowers drug costs and saved patients $1.3 billion last year. But the report found patients’ out of pocket costs for the 51 drugs totaled $279 million in 2021, “an annual compound increase of 14%-21% since 2017,” per Reuters.

To my way of thinking this is evil and all the industry needs to be held to a higher standard than it is today….but sadly if that happens it will be after this next 4 years.

These companies are just sick as well as greedy and evil…..period.

I Read, I Write, You Know

“lego ergo scribo”

The $600 Billion Swindle

Before I begin I want to wish all my Dads out there…..

Happy Father’s Day!

I am an old fart and retired and most people I know are retired or close to retirement and I keep a watch on what is going on with Medicare and the insurance giants.

I have been trying to warn my readers of the dangers and the scams run under the guise of “Medicare Advantage” tag.

Since last year I have been warning my readers that are considering one of these ‘plans’ to beware and why….

Medicare Advantage Plans

A new analysis of these plans illustrates just how bad and how deep these swindles go.

A new academic analysis published Monday in JAMA Internal Medicine details the enormous sums that privatized Medicare Advantage plans have cost U.S. taxpayers in recent years and calls for the abolition of the program, which has been massively profitable for the insurance giants that dominate it.

Citing the nonpartisan Medicare Payment Advisory Commission, the paper notes that Medicare Advantage (MA) plans have overcharged the federal government to the tune of $612 billion since 2007—and $82 billion last year alone.

MA plans—now used by more than half of the eligible Medicare population—utilize a range of tactics to reap larger payments from the federal government, which provides insurers a lump sum for each Medicare Advantage patient. The size of the payment depends on the enrollee’s health, which MA plans are notorious for portraying as worse than it is in order to receive heftier government payments.

“Paradoxically, despite those overpayments, MA plans spend 9% less on medical services than [fee-for-service] Medicare spends for comparable enrollees,” reads the new study. “If MA plans pay for less care, where do the overpayments go? Some pay for supplementary benefits, although plans do not disclose how much they spend on them, and MA enrollees do not get significantly more dental care or incur lower out-of-pocket dental costs than those in FFS Medicare. Instead, overhead and profit eats up the lion’s share.”

The study’s authors estimate that MA plans’ overhead from 2007 to 2024 was $592 billion, which is “equivalent to 97% of taxpayers’ $612 billion overpayments to them during that period.”

Dr. Adam Gaffney, an assistant professor of medicine at Harvard Medical School and the lead author of the new study, said in a statement that “Medicare Advantage is a bad deal for taxpayers.”

“Money that could be used to eliminate all copayments or shore up Medicare’s Trust Fund is instead lining insurers’ pockets,” said Gaffney. “And the private insurers keep Medicare Advantage enrollees from getting needed care by erecting bureaucratic hurdles like prior authorizations and payment denials.”

https://www.commondreams.org/news/medicare-advantage-cost

Please read all the information if you want to save your cash….do not listen to the hype….ask questions and arm yourself with facts not promises.

Be Smart!

Learn Stuff!

I hope the Dads have a great day and as always….Be Well and Be Safe….

I Read, I Write, You Know

“lego ergo scribo”

Closing Thought–08Mar23

Scamming our seniors.

My regular visitors know that since I am an old fart I try to keep an eye on the scams and policies that will effect most people as they retire.

The insurance industry is getting worse by the year….they have been scamming seniors for decades and it just gets worse with the passing of time.

Democratic Sen. Elizabeth Warren released a report Wednesday highlighting the splashy incentives—from luxury vacations to cash bonuses—that private insurance companies offer agents and brokers for enrolling seniors in potentially higher-cost Medigap plans.

Medigap is federally regulated supplemental health insurance offered by for-profit companies such as UnitedHealthcare, Humana, and Aetna.

According to Warren, the Medigap marketplace is rife with “incentive trips and other perks for brokers and agents” who—in pursuit of such rewards—could be motivated to “push seniors into the most expensive Medigap plans, regardless of whether those plans meet their needs.”

The senator found that the estimated 32 private companies that entice agents with vacations and other incentives to boost Medigap sales provided the supplemental insurance to around 6.6 million people in the U.S. in 2021 and raked in nearly $16 billion in premiums from beneficiaries that year.

Warren acknowledged that her report “may underestimate the prevalence of incentives and rewards in the Medigap insurance industry” given that insurers and third-party companies are often not transparent about their incentive practices.

In a statement, Warren lamented the weak federal and state regulations that are giving insurance giants “free rein to scam millions of seniors in Medigap, offering agents lavish vacations to steer unknowing beneficiaries into more expensive plans.”

“Regulators must act to make sure seniors aren’t getting fleeced,” said Warren, who noted that around 40% of Medigap enrollees had less than $40,000 in annual income in 2018.

https://www.commondreams.org/news/warren-insurance-medigap-scam

I have always thought that these so-called “advantage’ plans were nothing more than a scam to screw seniors out of what money they have….these insurance toads are unfeeling ass wipes…..and that includes the senior’s best friend, AARP….which pushes their own brand of ‘advantage’ policies.

Keep an eye on your finances there are slugs that will come for your money.

I Read, I Write, You Know

“lego ergo scribo”

Let’s Defraud Seniors

This is post is for all those Americans that have had their 50th birthday surely they have received their official letter inviting them to join AARP (where did they get your birthday info)……

The big deal these days is that Medicare Advantage plans for us pre-dementia seniors….to me they seem like a scam and not worth the cash they cost….seems I am not the only one with such thoughts….

I recently wrote about the deceptions that insurance companies are pulling on seniors…

Those MediCare Advantage Plans

Now further info has been given to help seniors know what is being done to rip them off…..

Insurance giants are exploiting Medicare Advantage—a corporate-managed program that threatens to result in the complete privatization of traditional Medicare—to capture billions of dollars in extra profits, Saturday reporting by The New York Times confirmed.

The newspaper’s analysis of dozens of lawsuits, inspector general reports, and watchdog investigations found that overbilling by Medicare Advantage (MA) providers is so pervasive it exceeds the budgets of entire federal agencies, prompting journalist Ryan Cooper to call the program “a straight up fraud scheme.”

Nearly half of Medicare’s 60 million beneficiaries are now enrolled in MA plans managed by for-profit insurance companies, and it is expected that most of the nation’s seniors will be ensnared in the private-sector alternative to traditional Medicare by next year. Six weeks ago, Sen. Ron Wyden (D-Ore.) launched an inquiry into “potentially deceptive” marketing tactics used by MA providers to “take advantage” of vulnerable individuals.

As the table below shows, almost every major player in the industry has been accused of fraud by a whistleblower or the U.S. government. In addition, the vast majority are engaged in rampant upcoding, or exaggerating patients’ illnesses in order to reap more money from taxpayers—something they do while refusing to provide necessary care for tens of thousands each year.

https://www.commondreams.org/news/2022/10/09/straight-fraud-data-confirms-private-insurers-use-medicare-advantage-steal-billions

Seniors should research this before they commit to a monthly deduction to their Social Security benefits.

Remember if something sounds too good to be true then it probably is just that….too good to be true.

Please do not fall for the glowing promos….you need to be more vigilant for these parasites will suck you monetarily dry.

I Read, I Write, You Know

“lego ergo scribo”