General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region Forums'End the Scam': Democrats Unveil Bill to Change Name of Medicare Advantage
In an effort to crack down on the misleading practices of Medicare Advantage providers, Democratic Reps. Mark Pocan, Ro Khanna, and Jan Schakowsky reintroduced legislation Tuesday that would ban private insurers from using the "Medicare" label in the names of their health plans.
The legislation, titled the Save Medicare Act, would formally change the name of the Medicare Advantage program to the Alternative Private Health Plan, an attempt to make clear to seniors that the plans are run by private entities such as Anthem, Humana, Cigna, and UnitedHealthcare.
"Only Medicare is Medicare," Pocan (D-Wis.) said in a statement. "It is one of the most popular and important services the government provides. These non-Medicare plans run by private insurers undermine traditional Medicare. They often leave patients without the benefits they need while overcharging the federal government for corporate profit."
Khanna (D-Calif.) declared that "it's time to call out 'Medicare Advantage' for what it is: private insurance that profits by denying coverage and the name is being used to trick seniors into enrolling."
"That's not right," he added. "This bill will end the scam by preventing private insurers from profiting off the Medicare brand. Our focus should be on strengthening and expanding real Medicare."
The bill, which faces long odds in the Republican-controlled House, was introduced as GOP lawmakers push for cuts to traditional Medicare as part of their broader austerity campaign.
https://www.commondreams.org/news/democrats-bill-medicare-advantage

marybourg
(13,553 posts)introduce it every session until it passes!
peppertree
(22,915 posts)Anything that gets in the way of a scam of any kind will be royally blocked by Kevin's cacas.
soldierant
(9,029 posts)when it is Republicans.
GreenWave
(11,782 posts)from a song. "the was it way"
Rebl2
(17,089 posts)Yo_Mama_Been_Loggin
(129,749 posts)
PoindexterOglethorpe
(28,157 posts)I have an Advantage Plan with Humana and I'm very happy with it, thank you very much.
Maybe someone should go after ones which are actual scams, and not paint them all bad.
ShazzieB
(21,771 posts)Last edited Wed Feb 1, 2023, 05:27 PM - Edit history (1)
99+% of the advertising I see from these plans is deliberately misleading to one extent or another. For that reason alone, I support this law.
Don't try to sell me something by calling it something it's not. That's dirty pool.
PatSeg
(51,122 posts)I hate that for profit private insurance companies can use the name "Medicare".
dmr
(28,705 posts)they mail out look as if it is officially Medicare. That is not right, nor fair to the consumer.
And I've found them to be INTENTIONALLY confusing so that people really aren't sure what they are getting. Then later if you realize you've made a mistake, you are locked in for an entire year.
pazzyanne
(6,730 posts)I have a PPO Advantage plan through BC/BS that I love. It is not a Scam.
As you said, "Maybe someone should go after ones which are actual scams, and not paint them all bad."
I would not get an HMO Advantage plan, as most of them are scams.
https://th.bing.com/th/id/R.42e9ede528de6a659ffaaa4bee1ec141?rik=N6e%2fJhT7KY7klg&pid=ImgRaw&r=0
BlueIdaho
(13,582 posts)And at the lowest price I have paid in my entire life. Thanks Blue Shield.
DownriverDem
(6,914 posts)BCBS of Michigan PPO Medicare Avantage
Habibi
(3,603 posts)My understanding is that MA plans are great if you don't have a serious illness, like cancer. Many plans are $0 premium, and come with perks like gym memberships. You'll likely be limited to a network, however, which can change yearly.
If you choose an MA plan and later develop a serious illness such as cancer, you may be on the hook for a lot of money in copays/coinsurance. With original Medicare (Part A & Part B), plus a medigap plan (that covers the 20% of costs that original Medicare doesn't cover), those costs will be paid for. With an MA plan, possibly not.
And (again, my understanding), if you want to switch from an MA plan to an Original Medicare w/ Medigap plan, you'll have to go through medical underwriting. That is, you'll have to answer health questions, and you may be disqualified from the OG Medicare system depending on your answers.
I live in New York, and I believe we don't have that particular requirement here, which I'm grateful for.
colorado_ufo
(6,157 posts)And you will need approval for many procedures. And if they decide to no longer participate in your state, you may be scrambling for coverage. And they offer no coverage abroad and in some cases, even when traveling out of state. And you may not be able to keep your doctors, as they offer a network.
I looked at possibly switching to Humana and found out that my hospital does not accept it (I think they may now). Plus, I was told that I would be denied anyway because of my cancer history.
They promote all the "shiny things" and don't encourage you to "peak under the hood."
pazzyanne
(6,730 posts)I also have a PPO Advantage plan through BC/BS that is wonderful. You mention medigap plans which are more expensive than I can afford. If this bill passes I will be hurting in a big way.
See other posts on this forum for details.
Habibi
(3,603 posts)And yeah, medigap plans aren't cheap. But as a cancer patient, it's worth it to me to know what my medical expenses will be every month, and that nothing approved by Medicare will be denied me, so I'm willing and can afford to pay (for now).
I hope that, whatever changes are made, you continue to receive great care.
pazzyanne
(6,730 posts)Medical care is so important as we age! We still need a Medicare for all in some form.
obamanut2012
(28,915 posts)It, at best, muddies the waters, but the at worst is what the truth is. They want folks to think they are Medicare. You can't do that.
DBoon
(24,377 posts)... but that doesn't mean it can be sold as canned prime rib
JohnnyRingo
(20,214 posts)But they're relatively healthy. They get check ups, breast exams, and treated for minor ailments.
The way to rate an insurance policy is what happens when things go south. As inflicted as I am I was advised to stay away from Advantage companies that would limit my care, insist on generic meds, and dictate where I can get treatment.
Peregrine Took
(7,583 posts)greatauntoftriplets
(178,410 posts)With the name "Medicare" in them, it sound government sponsored, even though it isn't.
former9thward
(33,424 posts)All Medicare Advantage plans are approved by the Department of Health and Human Services. Which reports to President Biden.
Phoenix61
(18,589 posts)Everything you eat and drink is approved by a government agency but none of it is sponsored by the government.
former9thward
(33,424 posts)And part C is just as much Medicare as part A and B.
Phoenix61
(18,589 posts)It is private insurance.
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
former9thward
(33,424 posts)Medicare Advantage plans are part of Medicare. It is called Medicare Part C. Their elimination would mean a slash in Medicare benefits for those on them.
Just Jerome
(365 posts)It is private insurance.
It is a scam.
It is a Trojan Horse.
This bill is absolutely needed before real Medicare is destroyed.
Please learn the facts.
KS Toronado
(21,546 posts)

former9thward
(33,424 posts)Have you ever read Medicare Part C? You need to learn the facts.
Just Jerome
(365 posts)Yes, it is Part C, but it is not Medicare as Medicare was originally established. The scam lies in the very existence of part C. Its there to sow confusion and it works. Private insurance is being passed off as Medicare.
Call it MINO if you like: Medicare in name only.
To that end, it is not Medicare.
And yes, Biden needs to be apprised of these facts before its too late.
area51
(12,481 posts)GoodRaisin
(10,583 posts)https://www.medicalnewstoday.com/articles/how-is-medicare-advantage-funded
It is, as was stated, a trojan horse.
former9thward
(33,424 posts)Medicare is administered through private companies. The claims and health care. `When you call Medicare you are calling employees of a private company. It has been that way since 1965.
GoodRaisin
(10,583 posts)The part of which costs are not covered we purchase supplemental insurance for, not called Medicare.
former9thward
(33,424 posts)Just as much as Part A and B. Take it up with President Biden if you don't like it. Part A and B are also private companies. Your monthly Medicare fee for Part B goes to private companies. Part A health care is administered by private companies and the health care is paid by a private company.
GoodRaisin
(10,583 posts)that government funding for medical care is being shifted away from the public sector to the private insurance industry; therefore, privatizing the publics medicare dollars. I liken it to charter schools, in which government funds are taken from public schools and given to privately owned charter schools. Its really no different at all. The law allows both, but both are trojan horses to larger scale privatization.
GoodRaisin
(10,583 posts)obamanut2012
(28,915 posts)former9thward
(33,424 posts)If you are interested in the actual facts. And President Biden's HHS Department approved them if you think they are "scams".
pazzyanne
(6,730 posts)Traditional Medicare does NOT include prescription coverage. My PPO Advantage plan covers prescriptions as well as dental, a break on copays and more for $80.00 a month more. My Mom has a stand alone prescription plan that she pays $50.00 a month.
If this bill passes I and others like me will be paying more for services not covered by Traditional Medicare.
KPN
(16,951 posts)for ending Medicare at which time private insurance will simply call itself Medicare and once again fully control premiums, deductibles, co-insurance and out-of-pocket costs for subscribers themselves without interference from government.
. Rs have been working at doing the same thing with SS and public education for decades. Create and support enough attractive alternatives to SS and public education and in the process reduce the number who value publicly funded and administered programs so they can ultimately pull the rug entirely out from under those programs
and thereby make money offering such services themselves. Why pay taxes? Just give us your money.
OMGWTF
(4,929 posts)dchill
(42,660 posts)Inquiring minds want to know.
montanacowboy
(6,611 posts)How did this abomination ever come about?
former9thward
(33,424 posts)That was the Clinton administration.
phoenix75
(291 posts)Respect and dignity for human life are more important than dividends for stockholders.
TygrBright
(21,227 posts)obamanut2012
(28,915 posts)former9thward
(33,424 posts)It is Medicare Part C. Approved by the Department of Health and Human Services.
Phoenix61
(18,589 posts)insurer its not Medicare. You can argue semantics all you want but its doesnt change that fact.
Bird Lady
(1,996 posts)Unfortunately there is no way to get the sharks to quit calling. I have made a recording on my machine
telling them I will blow their ear drums out with a whistle if they continue and still they persist.
murielm99
(32,415 posts)I am so tired of these calls!
Ligyron
(7,981 posts)Think of the incredible amount of money they must be pulling in from our government to have people calling 24/7 even if the sweatshop is located in India.
I tell them I'm 48 when they call. click bzzzzz
KS Toronado
(21,546 posts)"Hello, I'm Harry with your Alternative Facts Private Health Plan calling" CLICK, CLICK, CLICK, CLICK
Martin68
(26,544 posts)Raine
(30,973 posts)too many people get fooled by the name alone.
usedtobedemgurl
(1,859 posts)If the government passed legislation providing dental and eye care for everyone on Medicare and Medicaid. Then, they companies could not fraudulently sign you up for junk they will not reimburse for. It will all be provided in the first place!!!!!!!!
Phoenix61
(18,589 posts)There are we limited providers in the area and its created some real problems for him.
spedtr90
(720 posts)https://jacobin.com/2022/03/joe-biden-administration-privatization-medicare-health-insurance-direct-contracting-entities

Skittles
(168,075 posts)so tired of people falling for this scam and assisting in efforts to PRIVATIZE MEDICARE
ymetca
(1,182 posts)for our overall health, just like everything else about our absurd healthcare "system", if you could even call it that.
All the ridiculous hoops we have to jump through just to preserve the sacrosanct belief that profit is god, above all else.
We've made shareholder value the ultimate authority over everything, with that class writing all our laws, then wonder why everything has to be so complicated.
It's by design.
Rhiannon12866
(244,815 posts)How many seniors have fallen for this?? My doctor didn't even know...
Straw Man
(6,908 posts)I have an Aetna "Advantage" PPO plan, which I took because my employer pays for it as a retirement incentive. I have two cards: A Medicare Part A & B card, for which I pay through a deduction from my Social Security, and an Aetna Part C & D card, which my former employer pays for. I am partially covered by Medicare, am I not?
Deuxcents
(24,370 posts)Once you opt out of the medigap, you are out of Medicare n covered by private insurance.
Straw Man
(6,908 posts)Once you opt out of the medigap, you are out of Medicare n covered by private insurance.
... why did I receive a Medicare card, and why does Social Security take a Medicare deduction out of my monthly payment?
Deuxcents
(24,370 posts)Im under the impression that private insurance companies are allowed to offer part C due to a law change but that once you opt out, youre not in Original Medicare, youre in their Medicare plan. Im sure there are taxes to be paid but I dont have an answer as to what or why. Im retired n my employer health benefits will be only offering Advantage plans next year so..I have a lot of questions, too
Progressive dog
(7,543 posts)and was happy with the previous ones I have had with several insurance companies. I have never been denied benefits that I would have had through original Medicare. In fact, I have benefits beyond what medicare offers.
Everyone who has one knows that they are run by private insurance companies. You can research them along with medicare drug plans (all private} and medicare supplements ( Medigap)(all private) on the medicare web site.
Many medicare advantage plans provide drug coverage for free. All have a maximum out of pocket cost for care covered by parts A and B. Most provide drug coverage at no cost. Many provide some OTC medicines at no cost. Many have no extra cost to the insured, some even refund part of the part B premium.
Every plan can be compared with each other and with original medicare on the medicare.gov website.
News Junkie
(312 posts)is more appropriate.
Emile
(38,263 posts)for profit insurance.
louis-t
(24,490 posts)
grantcart
(53,061 posts)1) Medicare Advantage aka Medicare part C is largely funded by government funds. 70% of Medicare Advantage clients (like me) pay zero premiums. Some MA plans offer additional prescription coverage and charge a premium.
Some of those clients are sold a plan where the benefit doesn't match the needs of the client and are abuse. This would be the fault of the agent. This abuse could be eliminated by eliminating commissions on up charge premiums.
2) Before Obama health insurance companies generated a profit by subtracting costs from revenues and could profit from denial of care. That was changed so that the insurance companies gross profit is fixed (between 15 to 20% termed Medical Loss Ratio) to a percentage of revenue (or total sales). As a result companies can no longer profit from denial of care.
RobinA
(10,449 posts)Now, since my retirement medical plan is an Advantage plan not Medicare, I won't have to pay into Medicare when I retire. Right? Oh, wait... I still have to pay into Medicare and can't even get the Advantage plan if I'm not enrolled in Medicare? Sounds kind of Medicareish to me.