Day: August 17, 2019

What Does “Covered” Mean?

Every year I go through training for the Medicare Annual Enrollment Period.

It usually takes around a week to take the courses and pass the tests required to verify that I know what I need to know to help people who are going on Medicare understand how Medicare works and what their options are with Medicare.

This year one phrase in the training stood out because it discussed a very deceptive part of Medicare Advantage plans.

As you probably know if you have read any of my writings, I strongly believe Medicare Advantage plans are one of the most deceptive and harmful ideas the government has ever allowed to be perpetrated on the American people.

2019-08-16 Charles Bradshaw
Charles Bradshaw

Medicare Advantage plans such as Humana Gold Plus and Kaiser Permanente are private, for-profit, restricted access plans in which the managers of the plans have a fundamental conflict between providing the health care their members need and minimizing health care costs in order to maximize their profits.

Medicare Advantage plans routinely say “no” to expensive but needed health care services such as MRIs, skilled nursing stays, expensive cancer treatments and joint replacements when regular Medicare would say “yes”.

The phrase that stood out to me said

“Medicare Advantage plans are required to cover all health services available under Medicare Parts A and B.”

In this case, the word “cover” is the key.

What does “cover” mean in this situation?

It does not mean that a person on Medicare who has left regular Medicare for a Medicare Advantage plan will have the same access to expensive treatments they may need as they would with regular Medicare.

The reason for this is Medicare Advantage plans use a much more restrictive set of guidelines before they will approve expensive care.

If two people have identical degenerative bone disease conditions and need a hip replacement – but one is on regular Medicare and the other has left Medicare for a Medicare Advantage plan – the one on regular Medicare is much more likely to be approved for the hip replacement than the person on the Medicare Advantage plan.

The only way Medicare Advantage plans make a profit is by spending less on their members’ health care than if those members were still on regular Medicare. And they make a lot of profit!

Every time a Medicare Advantage plan says “no” to expensive medical tests such as an MRI, they are saying “yes” to more income for the Advantage plan and more bonuses for their executives.

It is somewhat like the old question “If a tree falls in the forest and no one is there to hear, does it make a sound”.

Accordingly, if a Medicare Advantage plan “covers” MRIs, joint replacements and expensive cancer treatments but says “no” when they are needed, do the plan’s members really have the health care they need?

Unfortunately, the answer is “no”.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.

Who Is Managing Your Health?

There is only one acceptable answer to this question and that answer is “you.”

However, if you make the wrong decision about how to receive your Medicare, your health could be managed by an insurance company’s budget analyst often more concerned about the profits of his employer than your best health outcome.

When you first go on Medicare – usually at age 65 but often later if you are still working – you can choose to receive your Medicare benefits through regular Medicare combined with a Medicare Supplement and a Medicare Part D drug plan.

Or, you can instead assign your Medicare benefits to a private, for-profit, restricted-choice Medicare Advantage plan such as Humana Gold Plus or Kaiser Permanente.

When you choose to stay with regular Medicare,

2019-08-16 Charles Bradshaw
Charles Bradshaw

you can go to any doctor or hospital anywhere in the country that accepts Medicare as almost all do. This includes such noted medical facilities as Mayo ClinicJohns Hopkins, M.D. Anderson and Cancer Treatment Centers of America.Importantly, with regular Medicare combined with a Medicare Supplement, all or almost all of your costs are covered 100 percent regardless of your health situation now or in the future.

This scenario allows you, along with the doctors you choose, to make the best decisions for your health.

On the other hand, if you choose to receive your Medicare through a private, for-profit restricted-access Medicare Advantage plan, your health care decisions are often made by a budget analyst who is more focused on managing the costs of your care than working to deliver the best health outcome for you.

With a Medicare Advantage plan, you have a limited choice of doctors and hospitals and you are not fully covered when you travel.

Even worse, because a Medicare Advantage plan is focused on its own profits, it will often say “no” to treatments and tests your doctor may think is right for you when regular Medicare would have said “yes.”

A Medicare Advantage plan can even say “no” to a cancer treatment most likely to save your life and require you to take a less expensive but less effective treatment.

With today’s internet, you have access to a wealth of information about your health and the health care providers you can choose with regular Medicare. You have more control and input into the decisions about your health than any generation before.

You should never give up this benefit by assigning your Medicare benefits to a private, for-profit, restricted-choice Medicare Advantage plan.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.

Why Medicare Answer Center Doesn’t Ask For Your Phone Number

When I started helping people with Medicare more than ten years ago, I was dismayed at how many people did not fully understand their Medicare options when they first went on Medicare.

Importantly, they did not understand the potential negative consequences on their access to health care and their finances from making a poor Medicare choice.

Finally, far too many people going on Medicare did not understand that the initial choice they made about their Medicare could become a permanent choice they could not change if they had or developed health issues.

I started Medicare Answer Center with the goal of helping as many people as possible fully understand how Medicare works and what their options were with Medicare. By fully understanding their choices, more people could make a better choice and receive better access to health care when they needed it most and not be financially disrupted by thousands of dollars in unplanned if and when they became sick.

2019-08-16 Charles Bradshaw
Charles Bradshaw

At Medicare Answer Center, we take a very different approach than the thousands of high-pressure Medicare sales people who bombard you with unwanted phone calls when you are turning 65.

We provide helpful information about Medicare without asking for your telephone number.

We will only contact you if you request and schedule a no-obligation appointment with us.

Most important, we are not desperate for you to enroll with us. In fact, we only enroll about half of the people we help.

The reason for this is many people already have the coverage that is their best health insurance option and we will tell them this.

We also will continue to help you after you have started Medicare whether that means answering questions you may have or helping you change your Medicare Part D drug plan if your medication needs change.

This is not the case with the Medicare sales people who call you from high-pressure call centers. If you enroll with a high-pressure Medicare call center you are likely to never talk with your agent again.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.