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Not quite scam insurance

March 7, 2023

Both Humana and UnitedHealth Group own primary care clinics in my area, targeted at those 65 and older. Which they use to funnel patients into their Medicare Advantage plans.

Medicare Advantage plans, also called Medicare Part C, bring large revenues and profits to the companies that provide them. They are aggressively marketed as a one-stop decision for those who qualify for Medicare. You don’t need to find a Medigap insurer. You don’t need to find a Part D insurer for drug coverage. Instead of paying premiums for each of Part B, Medigap, and Part D, you pay one premium, often lower. And the honey-tongued agent will enroll you now. What’s not to like?

Quite a bit, actually. Each plan comes with its own network of providers. They require pre-approval for a variety of procedures. They may not cover medical care you need or want out of state. There are a variety of co-pays and deductibles. They often don’t cover needed nursing care after a medical event. Aging patients get the burden of navigating that maze of requirements and accounting. And in the future, if you want to go back to the route of traditional Medicare, getting Medigap insurance may require medical underwriting.

Unsurprisingly, insurance brokers say they would choose traditional Medicare for themselves. Informal questioning of my now-retired engineering colleagues show they reached the same conclusion, mostly opting for a Medigap plan G.

If you go the traditional route, you may want to sign up for Part D drug coverage as soon as you can, since there are permanent penalties when you sign up in later years.

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