Medicare Advantage plans are in crisis. Will seniors pay the cost? Of course we will.
Medicare Advantage enrollment is up but profits are down.
This is the inevitable problem when private for-profit healthcare is taking over more and more of the system that is supposed to serve older folks like me.
Older folks need a lot of medical care.
The smart thing isn’t to put the folks who need a lot of medical care into one insurance group.
The result of the private healthcare industry massive marketing campaigns for Medicare Advantage plans is that now more than half of Medicare recipients have enrolled.
MA plans work for some of us and not for others.
New York teachers were fine with the system of healthcare insurance that they had until the head of the city’s teachers union, Michael Mulgrew, and the mayor decided to try to force them into a Medicare Advantage plan.
CVS Health got walloped at the outset of 2024 as older adults in its Medicare plans continue to get a lot more medical care than the company expected.
CVS’ operating income fell by 34% — roughly $1.2 billion — in the first quarter compared with the prior-year period, according to results released Tuesday. The company, which absorbed the health insurer Aetna in 2018, marketed its Medicare Advantage plans aggressively last year and expanded its geographic reach more than any insurer. Now, that strategy is proving a detriment to its bottom line. (Statnews)
The other giant Medicare Advantage players are reporting the same profit declines.
The way the private insurers have tried to reduce costs is by using prior authorizations, often farmed out to a third party company which simply says no to necessary drugs or treatments.
Although 80% of appeals to rejected drugs or treatments eventually win, the business model is to wear us down in hopes we will forego the medical care we need.
What we can look forward to is steep price increases in our Medicare Advantage plans in the coming period.
Retired Illinois teachers (outside of Chicago) are covered by TRAIL and a Medicare Advantage plan negotiated with Aetna, a subsidiary of CVS.
When the current agreement between Illinois Central Management Services and Aetna expires I imagine we will be facing a major premium increase.
After all, a profit driven healthcare system can’t survive without profits.