Tag Archives: medicare advantage

Journalists expose significant problems with Medicare Advantage plans

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Majority report from US Senate Finance Committee finds seniors subject to marketing scams from health insurers.

Seniors signing up for Medicare Advantage (MA) during open enrollment (which ends Dec. 7) have more reasons to worry now that reporters at Kaiser Health News, MedPage Today and elsewhere have continued to uncover significant problems with these private managed care plans. 

During open enrollment, reporters have a responsibility to explain the problems seniors may face with MA plans and to warn them about deceptive marketing practices.

And health care journalists should ask officials at the federal Centers for Medicare and Medicaid Services (CMS) why it sets higher rates for health insurance brokers selling MA plans than the rates it sets for brokers to register seniors in Medicare Supplement (also called Medigap) plans that might be more appropriate for their needs.  Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Help your audience by explaining the nuances in Medicare Advantage and Medigap plans

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In 2015, 25% of people with Medicare had a Medigap supplemental policy.

Source: Medigap Enrollment and Consumer Protections Vary Across States, KFF report, July 11, 2018.In 2015, 25% of people with Medicare had a Medigap supplemental policy.

Reading the news about COVID-19 vaccine distribution efforts in recent weeks, I learned that my home county of Barnstable (better known as Cape Cod) is the oldest in Massachusetts by residents’ age. The average age of the county’s 213,000 residents is 53.3 years — among the highest in the nation.

That fact helps explain why we see so many television advertisements for Medicare Advantage (MA) plans all day every day during certain times of the year.

Regardless of where these ads run, the problem for senior citizens is that the spots do not tell the whole story about MA. Like most advertisements, they highlight the good news and leave out the bad. Health care journalists have an essential role to play during enrollment season in reporting on how each eligible individual can choose the most appropriate Medicare coverage, despite the advice from aging celebrities on TV. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Tip sheet offers story ideas when reporting on Medicare Advantage

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Photo: John Jacobi via Flickr

Medicare Advantage plans may not be all they’re cracked up to be and often mislead consumers, according to a new MedPage Today story by reporter Cheryl Clark, who also is AHCJ’s new patient safety core topic leader. As Clark puts it, “getting out is a lot harder than getting in.”

Anyone turning 65 has several months on either side of their birthday to choose to enroll in traditional Medicare, the government-run health insurance for older adults and certain people under 65 with disabilities. Medicare includes Parts A (hospitalization), B (physician services) and an optional Part D (prescription drug plan). As of November, Medicare covered nearly 39 million people. Continue reading →

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.

CMS initiatives may be good news for some beneficiaries

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Photo: moodboard via Flickr

This post was co-written by Joseph Burns (@jburns18), a Massachusetts-based independent journalist and AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

You may have seen the April 2 press release from the Centers for Medicare and Medicaid Services that highlighted the steps it is taking to, among other efforts, advance a more patient-centered approach, reinterpret standards for supplemental benefits under Medicare Advantage plans, lower prescription drug prices and address the opioid crisis. While that’s a lot to promise in a page and a half, more details are available in CMS’ 2019 Medicare Advantage and Part D Rate Announcement and Call Letter. Be forewarned, however, that many journalists may need experts to interpret the implications of what CMS calls its call letter. Continue reading →

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.

FOIA lawsuit uncovers audits showing 35 health plans overbilled Medicare Advantage

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Fred Schulte

A federal review of health insurers operating Medicare Advantage plans shows that 35 health plans overbilled the federal Centers for Medicare & Medicaid Services, the Center for Public Integrity reported on August 29.

Fred Schulte, a CPI senior reporter, said the center obtained 37 MA plan audits through a Freedom of Information Act lawsuit. The documents indicated that 35 of those health plans were overpaid in 2007. The typical overpayment was several hundred thousand dollars.

“Among the insurers charging the government too much: five Humana, Inc. health plans, three UnitedHealth Care Group plans and four Wellpoint, Inc. plans,” Schulte wrote. None of the plans would comment for Schulte’s article. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.