![]() A major complaint, said Mike Chaney, the Mississippi Insurance Commissioner: “Consumers are not aware their doctors are likely to change under the Medicare Advantage plans.” ‘We can’t pay our bills’ State insurance commissioners told NBC News they, too, receive many complaints from customers saying they were sold Medicare Advantage plans without understanding their limitations. ![]() Medicare payments to the plans will total $27 billion more in 2023 than if patients were enrolled in traditional Medicare, the report projected.Ī new enrollment period for the plans began this month. Medicare pays the plans 6 percent more than it would spend if plan enrollees were covered under regular, fee-for-service Medicare, the MedPAC report found. If the government hoped Medicare Advantage plans would reduce the costs of care, that has not been the outcome. Former New York Jets quarterback and Super Bowl champion Joe Namath, pictured in 2019, is one of Medicare Advantage's celebrity pitchmen. government pays most of beneficiaries’ premiums to the insurers offering the plans. Many plans add services such as dental and hearing care and wellness programs not offered under traditional Medicare, for which beneficiaries pay extra. Medicare Advantage plans are sold assiduously by celebrity pitchmen - one is Joe Namath - as a better way for Americans who qualify for Medicare to get insurance coverage. The Alliance HealthCare System clinic in Holly Springs, Miss., last month. Coverage denials from Medicare Advantage plans killed the program, Williams said. Still, this spring he had to shut down a long-time geriatric psychiatry program that had served the community for over eight years. Alliance serves a county with 38,000 people. When the area hospital was in danger of closing in 1999, he marshaled resources and bought it to keep it open. Williams is something of a local hero in Holly Springs. “They are taking over Medicare and they are taking advantage of elderly patients.” Kenneth Williams, CEO of Alliance HealthCare, said of Medicare Advantage plans. “They don’t want to reimburse for anything - deny, deny, deny,” Dr. Kenneth Williams at the Alliance HealthCare System clinic. ![]() While the number of older Americans who rely on Medicare Advantage in rural areas continues to rise, these denials force the hospitals to eat the increasing costs of care, causing some to close operations and leave residents without access to treatment. As for the quality of care, the Medicare Payment Advisory Commission, a non-partisan agency of Congress, said in a March report that it could not conclude Medicare Advantage plans “systematically provide better quality” over regular Medicare.Įven worse, because the plans routinely deny coverage for necessary care, they are threatening the existence of struggling rural hospitals nationwide, CEOs of facilities in six states told NBC News. Last year, a federal audit from 2013 was released showing that 8 of the 10 largest plans had submitted inflated bills to Medicare. Problems are emerging with the plans, however. Just over half of Americans on Medicare are enrolled in one of the plans offered by large insurance companies, including UnitedHealthcare and Humana. Some 31 million Americans have Medicare Advantage plans, private-sector alternatives to Medicare introduced in 2003 by Congress to encourage greater efficiency in health care.
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