[lbo-talk] Medicare Advantage plans cherry-picking the healthy via extra benefits

Mark Rickling mrickling at gmail.com
Mon Oct 5 13:05:34 PDT 2009


Wasn't aware this was a key element in the "extras" private insurers offer in MA plans. Nice to see privatized Medicare siphon off the healthy, leaving gov't-run Medicare with sicker pateints. Tell me again why we should be paying the inscos a fat premium over traditional Medicare to run these plans? More generally, see also Maggie Mahar on this:

http://www.healthbeatblog.com/2009/09/medicare-advantagebig-advantage-for-insurers-little-advantage-for-seniors.html

http://www.washingtonpost.com/wp-dyn/content/article/2009/10/03/AR2009100302483.html?sub=AR

Discrimination by Insurers Likely Even With Reform, Experts Say Economic Pressure Could Give Rise to New Biases Against Prior Conditions

By David S. Hilzenrath Washington Post Staff Writer Sunday, October 4, 2009

[ . . . ]

There are myriad ways health plans can attract healthier members, from the messages they advertise to the overall level of coverage they provide and the smallest enticements they add to their benefits packages.

[ . . . ]

At the other end of the age spectrum, ads for private health plans serving senior citizens on Medicare seldom feature people who are sick, said Tricia Neuman, who has studied the ads for the Kaiser Family Foundation. Many of the plans have offered benefits such as health club memberships, help buying eyeglasses, and preventive dental care, which may be more likely to sway healthy seniors than seniors who have severe and complex medical needs.

Some private Medicare plans have offered relatively inexpensive enticements while requiring members to pay more out of pocket than they would under conventional Medicare for major expenses, said the Medicare Rights Center's Precht. In 2008, a quarter of the private Medicare plans charged members more out of pocket for Part B medications, which include chemotherapy drugs for cancer patients, according to a March study for the AARP Public Policy Institute.

The government has been cracking down on those practices. As a Medicare official put it in a March 2008 letter to health insurers, charging beneficiaries more out of pocket than conventional Medicare for Part B drugs, dialysis and time spent in skilled nursing facilities "may be considered discriminatory."

[ . . . ]



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