The Little-Recognized Cost of Medicare Advantage

Medicare Advantage is all about collecting your data.     It’s how your health system and insurer gets paid by the government.     It’s also how they generate revenue from vendors looking to sell you something—especially things that the government, not you, has to pay for.     Health systems and insurers sell your data to these vendors.       That’s why, as soon as you sign up, you get drowned in marketing....

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If You Think Robocalls are Bad Now. . .

Medicare Advantage has released more rules allowing your doctor to obtain more information from you without being seen in the office.       The health systems which employs your doctor and your insurer have a lot of money riding on the collection of this information.       Prepare for Pestering.         You will be getting phone calls, texts and emails asking you to put on your remote sensor so they...

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Your Insurance Home Can Turn Your Benefits On and Off

Didn’t get the plan with dental benefits but now wish you had? Or wish you had a different drug plan?     All is not lost.     Contact your insurance home. See what they can do for you.     You might be surprised by how easily you can change your benefit.     Your insurer has only one goal—to retain you on their plan. If you approach it correctly, you might be able...

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A New Resource to Help You Shop for Medicare Advantage Plans

The consumer advocate watchdog Medicare Web Watch has released its picks of the best Medicare Advantage websites in the 4 and 5-star categories.       The picks are about the websites, not the overall product. But if the usability of your Medicare Advantage plan’s website is important to you, this may be one shopping site you don’t want to miss.       It’s updated every year, so bookmark it for when it’s time...

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Compliance Week: Beware of False Diagnoses

Under Medicare Advantage, the government pays your doctor and health system based on how sick you are.     The government knows how sick you are based on the diagnoses your doctor and health system submit to them when you seek care.     There is no effective way to check to see if your doctor or health system are being honest.     The may be telling the government you have illnesses you don’t...

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Did Your Insurance Deny You a Medicare Advantage Service? Appeal it. Here’s How.

If you’re denied a service under your Medicare Advantage plan, appeal it.     90% of the time, you’ll win.     Medicare Advantage Organizations (MAOs) like your insurance company routinely deny claims to save money.     Sometimes they have a reason, other times they do it at random.     Why?     Because they know that fewer than 10% of the time, you’ll appeal.     Show them who’s boss. When you’re...

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Is Cancer a New Side Effect From Treating Your Blood Pressure?

As we covered here last here, the government will soon begin to punish your doctor financially if your blood pressure is too high—even if you never had problems with your blood pressure before. Tens of millions will be put on medication in an effort to save millions of lives—and at the costs of hundreds of thousands suffering injuries like falls, strokes and renal failure. The guidelines were never meant for universal application; they’re designed to...

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Medicare Advantage Fraud is Dangerous to Your Health

Under Medicare Advantage payments are based on information the insurance company sends to the government.     The more information, the more money.     Your insurer, health system, or clinicians may tell the government you have a sickness that you don’t have in order to get paid more.     That information may end up on your medical record.     And if you need medical care and can’t speak, that information may change...

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How Much Does Your Insurance Agent Get Paid

Ever wonder how much your insurance agent gets paid to sign you up with or keep you enrolled in a Medicare Advantage plan?   It’s probably less than you think.   There are two approaches agents can take.   They can provide great service as your insurance home.   Or they can churn through sign-ups, getting signatures on the bottom line and moving on,   Which approach did your agent use?

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You Can Change Your Drug Plan, Too

After the first of the year, you can get a “do-over” on your Medicare Part D plan, too.     This year, with all the new charges and prior authorizations and step edits required to get your meds, you’re more likely to find out that your drug benefit is not what you thought it was.     You can change it with little to no hassle in the first three months of the year.  ...

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