31 million people are on Medicare Advantage plans, a private alternative to traditional Medicare. The plans are often cheaper and promise better benefits. However, the CEOs of rural hospital systems in six states told NBC News that Medicare Advantage routinely denies reimbursements for necessary care. NBC News’ Sam Brock reports.
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#MedicareAdvantage #Hospitals #Medicare
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This is a nightmare!😮
I tried United Healthcare Nedicare Advantage in 2023….they denied claims for in network provider services….traditional Medicare is now my choice
The 3 D of the insurance industry Deny, delay and defend!
I’ve had no problem with my plan, I couldn’t afford the things without it being on Sadi, if they take it away, they better give us a bigger raise, and not make us pay for everything
I am a disabled RN (had license for 35 years). I also worked doing Medicare assessments for reimbursement for a nursing home rehab program. I got an advantage plan thinking it was a good deal (first red flag) and ended up with leukemia. I ended up with thousands of dollars in bills. When I switched back to regular Medicare, a supplement (now dropped, because I can only be billed for %20 of what Medicare ALLOWS, not the actual hosipital bill), and a part D plan, one of the chemo pills I needed for 20 months was $450/MONTH CO-PAY on the advantage plan…. with part D, it was $0/month. Always shop around during open enrollment… you can find significant differences between Medicare options.
It’s all about the money, not about helping the sick people. It’s shameful
How scary is this! And why no one fix that problem? I don’t know maybe the government?😢
Surprise, surprise. The fastest way for insurance to profit off really sick people is to “insure” that their demise is as quick as possible. For profit health insurance is always, always going to be a scam.
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I am so glad I opted for original Medicare and a Plan G supplement 3 years ago when I became eligible. I was less than a year out of a cancer diagnosis at the time, and I'd spent so much energy (that I didn't have to give) on arguing with my pre-Medicare insurance to get the necessary treatments during that time. The day I started my Medicare coverage all of that fighting for care and network and pre-approval nonsense vanished. The premiums and LOW deductible I pay are far less than what I paid for my other insurance, and worth the security of knowing that should the cancer bug bite again, I won't have to wait or jump through hoops to get the care needed.
I struggled to afford original Medicare the whole first 15 months I had it because I wasn't yet old enough for my own SS retirement benefits and was struggling on my deceased husband's SS survivor benefits. Didn't matter: I pinched pennies and did everything I could to pay for original Medicare, because there was NO WAY I was going to take a Scamvantage policy. Now I'm on my own benefits. It's a little more comfortable, and I am so glad I made the decision I did, even though I could barely afford it.
⛔⛔ why is this a SURPRISE! when the CEOs, their executive teams, and investors main priority is PROFITS….your health is LAST! the executive team at Bcbs, United, Cigna, Humana, Kaiser earn BILLIONS in BONUSES every year to deny your procedures. PROFITS PROFITS PROFITS PROFITS! WAKE UP AMERICANS!
Medicare advanage is a scam.
They need to investigate my detainment against my will TWICE since 2019. Upward around $50K taxpayers $ going for unnecessary treatments which are actual illegal holds on innocent people. WAKE UP AMERICA!
so does Medicare. Fake news.
I wonder if these companies are scamming medicare as well by getting paid a percentage by medicare for the treatment then turning around and denying any coverage of that treatment to the hospital or clinic that preformed it. The reason I am asking is because I live in Illinois and a few years ago the state automatically switched my healthcare from origianal medicare/medicaid to Medicare-Medicaid Alignment Initiative with meridian. Then followup visit with provider that was usually covered i was suddenly billed for in full came in the mail and I had to call around "clinic,new insurence, state aid, medicare" to find out why and get straightened out. It took over a year for "medicare" to be the ones to finally get to the bottom of that and medicare suggested to switch back to original medicare/medicaid for the time being while they investigate what was going on. Because they said they paid their share for that.
I'm just wondering about the timing of this story. Did it not occur to them to get this out BEFORE open enrollment (when people choose or change their Medicare plans) closed? That was Dec. 7th.WTAF??!!
Each Medicare Advantage plan is different. It takes a lot of research to find out what each one covers. They're not all bad. Get good advice from your state and spend a lot of time comparing. And good luck. You also need that.
Apparently, the "Advantage" is for the managers, not the patients with the coverage.
Medicare Advantage should be illegal
peddling lies to seniors who dont know the system
i handle my hubbys care as i was an adminstrator for a state health agency and i keep him from making mistakes but not everyone has an advocate like me in their corner,,
sad sad,, all lies..;;den of thieves
Glad I have the public health service in Spain 🇪🇸🇪🇺🌹👍
Contact your state insurance commisioner for further assistance! Former claims adjuster
If you are denied ,demand an appeal. It is not a healthcare person making that decision.
How many different ways do you need to prove that the system you’re a slave to is CORRUPT and has almost nothing to do with the patient. Good luck.
Oh yes! Infact, in Florida, alot of people don't know how to utilize the coverage. Well because they don't make it easy to understand. I was hardly able to move because of my back. My orthopedic dr said I would need to get authorization from the insurance company before I got the mri. More days went by, and Ever Core who contracted with Aetna said NO. I had to appeal, more time went by. This is the 2nd orthopedic I saw because the 1st Dr said I need to go pick up the RX for the prescription and give them a specialist copay, when I couldn't see the Doctor! I was an All Lines Claims Adjuster and this makes no sense to me! Then that had to go to EverCore and was denied! Why? No idea! You can't even get ahold of a knowledgeable worker to explain! I have talked to several people at Aetna and got different answers. If you get transferred to offshore customer service, your out of luck. Those women in another country are so nice, but it's obvious they haven't had training! Let's hold these insurance companies to a better standard! All I could do was to contact the State Insurance Commission to help me! Good grief!
This is critical issue affecting millions of Americans deteriorating their necessary medical care forcing them to suffer despite of their hard working and paying for Medicare entire lives
I was told many years ago to say no to an Advantage plan and yes to a Supplemental plan. I've had no problems.
I have United healthcare and Optum through my union. Optum requires pre authorization and still deny deny deny. Although advantage plans take money from our hard earned medicare contributions. It's all about profit for the advantage plans they don't care about the people they are suppose to serve. Someone needs to make them accountable.
The way to reduce Midicare expenditures is to reduce treatment.
2:55. That’s why they call it the ADVANTAGE plan. Thats what they take of you!