Medicare Advantage Company Ejected From Program For First Time

[cal04]

http://www.huffingtonpost.com/2010/03/09/medicare-advantage-compan_n_492010.html

One of the central GOP objections to health care reform is that the Democratic plan cuts "half a billion dollars from Medicare." That's a reference to cuts to Medicare Advantage, the privatized Medicare delivery system -- reform aims to reduce the plan's excessive costs. Medicare Advantage plans are currently paid roughly 14 percent more than what it costs to cover the average Medicare patient.

Now, for the first time since the program was enacted, an insurer is being ejected from the program for denying medication to seniors and otherwise failing to live up to Medicare obligations, say three people briefed on the decision made by the Centers for Medicare & Medicaid Services (CMS).

The timing of the decision gives a boost to Democratic reform efforts, as the party can point to the behavior of the Fox Insurance Company of New York as the type that would be reined in by reducing the role of private corporations in Medicare.

A call to Fox was not returned. A CMS spokesman couldn't be reached immediately.

[Selatius]

1. All of Medicare Advantage should be shut down. It can be done more cheaply by Medicare itself.

No need to outsource the services to a private company to perform the same tasks. The only difference is now that the private company is in the loop, it's going to tack on a profit mark-up on the service it provides.

[Cleita]

3. LOL!

Minds thinking alike. We were posting just about the same thing at the same time simultaneously.

[Bitwit1234]

8. I have Medicare and I agree agree agree that is what is fueling

the high cost of Medicare. Bush and company got this privatization plan thru congress when he stole office. He wanted to do it to all Medicare but couldn't. Most clinics and hospitals won't accept the Advantage Plans.

[Cleita]

2. The program needs to be ended. It's breaking the Medicare bank along with

Medicare Part D. They need to end the copayments and prescription drug benefit which puts money in the private sector. That money could make Medicare cover everything and prescription drugs. There would be no need for Medicare Advantage, Medigap nor Medicare Part D if that happened, just one plan that covers all the basic health needs of old people. Those programs were put in place by Republicans to make the elderly think they were doing something for them but that in fact were cynically done with the idea that they would shoot holes through the programs and eventually destroy what they call an entitlement.

[gleaner]

6. I agree ...

Part D, the prescription coverage is a particularly bad deal. Medicare should be a straight fee for service plan, with the medical facilities and doctors required to take it as payment in full, by law if necessary.

It is a good program. I have it, regular plain vanilla medicare and I have never had any problems with it. Some of the doctors I see tell me they prefer it, because it pays and provides better coverage for the patients than private insurance.

One of my doctors told me that AARP which everyone thinks of as an independent advocate for seniors and senior services is not truly independent. They are affiliated with Pacificare which was acquired by United Health care in 2005. At the time the AMA was highly critical of United saying it delivered bad patient care and would not be a good provider for seniors. They accused United of "re branding" bad plans under Pacificare's name. I checked and they are not anxious to advertise the affiliation, but I found a link off the Pacificare website, www.pacificare.com, which might be of interest. It is https://www.securehorizons.com/ , page 2 off the Home Page of Pacificare. It discusses Secure Horizons and Medicare Advantage plans in the most glowing terms but never mentions United at all that I could see.

A lot of people trust AARP implicitly as a non profit organization which acts in the best interests of seniors as an advocate. They may have done so once but they don't anymore. Now they act in the best interests of United Health Care.

[Cleita]

7. Secure Horizons wasn't such a prize when my husband got it.

They convinced him to sign his Medicare away for it. Did some fibbing and bait and switch too. We found out what a bad deal it was when he had a stroke. It's then that one of the doctors told me that I should get him back on traditional Medicare with a medigap policy ASAP. Also, he told me that they had stopped accepting Medicare Advantage programs for their poor payment habits. When I became eligible for Medicare that is what I took. A pox on Medicare Advantage programs as far as I'm concerned. I hope with Obama cutting that extra 13% out that they will just get out of the business.

[gleaner]

10. It really is a terrible program ..

They convinced a relative of ours that they could not withdraw. Once enrolled, they were told you can't leave. We were finally able to get through to them that they could leave and they are much better off now with fee for service Medicare.

Once I found out about United, I understood why Secure Horizon and other Medicare advantage programs were such crap. United is one of the biggest crooks in the health insurance industry. We should stop dancing around and let the government run it.

My husband worked for Social Security for 30 years before he retired and they do a good job running their programs. The thought of them or Medicare being privatized makes my blood run cold.

[notadmblnd]

4. I've never known anything that was privatized to be cheaper or more efficient

I don't know why everyone buys into that myth?

[denverbill]

5. And it had to be 'Fox Insurance Company'. How appropriate. n/t

[Lugnut]

9. I have a Medicare Advantage plan for the dental and eyeglasses.

It's a huge ripoff. Coverage for one's entire body including teeth and eyes in traditional Medicare would make these plans useless. I'd gladly see them go to the trash bin.