Medicare’s open-enrollment period is here, meaning millions of older Americans and people living with disabilities can compare plans and make changes to their healthcare coverage. If recent trends hold true, more than half of all enrollees will choose a Medicare Advantage (MA) plan — the private alternative to traditional Medicare.
What many enrollees don’t understand is that their “choice” has effectively been made for them.
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‘I don’t want to spend my remaining days living hand to mouth’: I divorced my husband and remarried. Can I claim his Social Security?
‘No one writes about “rich guy” early retirement’: My wife and I earn $300,000 a year and have $3.75 million. We have 3 kids. When can I quit working?
The U.S. government now pays MA plans at least 22% more per enrollee than it would cost to cover the same person under traditional Medicare. But more money doesn’t mean enrollees get better care. MA plans perform no better and in some aspects are worse than traditional Medicare. Nor does the money appear to provide enrollees with meaningful control over their coverage decisions. Instead, MA plans bombard enrollees with a complicated array of options so overwhelming that almost 70% of people don’t even try to compare what’s available to them.
Most alarmingly, in spite of massive federal subsidies, MA plans are erecting more and more barriers to patient care, including arduous prior authorization requirements that can delay necessary procedures, and narrow networks that may exclude higher-quality providers — all while often failing to save enrollees money on care.
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Nevertheless, the MA program continues to grow because for many enrollees, traditional Medicare — with its 20% coinsurance and lack of an out-of-pocket spending limit — isn’t financially viable. For an older American living on a low or fixed income, making the choice between a zero-dollar-premium MA plan that claims to cover all the necessities, or paying upwards of $200 a month for a supplemental Medigap policy to guard against financial catastrophe — plus additional premiums for a supplemental prescription-drug plan and any dental, vision and hearing services — isn’t really a choice at all.