Be careful signing up for Medicare Advantage

We are right in the Medicare plan change window until Dec. 7. So lately, I have asked quite a few people about their Medicare plan, and it is really shocking how little a lot of people know, even though their decisions can have far reaching financial consequences in their lives. A lot of people don’t even know the first thing about the difference between original Medicare and “privatized” Medicare Advantage, or the socalled Part C Medicare.

Original Medicare was and is relatively simple; you sign up for Medicare and you probably buy one of a few supplemental policies that pays most of what Medicare does not pay, and you buy a part D drug plan. Your doctor and hospital send bills directly to the Medicare Trust fund, (the trust that you paid in about 2.9% of your wages to your whole life). Then Medicare (government employees) settles the bills with the doctors cheaply and efficiently, with no costly private insurance involved, except for the supplemental part. And best of all you can go to any doctor, or for that matter the Mayo Clinic, in the whole country without even a referral from your doctor or the necessary permits from an advantage plan.

Of course, mainly the Republicans, could not leave such a simple plan alone, since they hate anything efficient government and love everything expensive and inefficiently private. So about 20 years ago, they created a different plan where The Medicare Trust Fund pays private “Advantage” insurance companies in the neighborhood of $12,000 per year as your advantage plan premium (and a lot more if they can convince Medicare that you have more health issues than average) to take over managing and paying for your health care. Make no mistake thinking they are not a for-profit company; they will pay as little of your medical bills as they can get away with, just like the private insurance you probably had the rest of your life. To lure you in, it looks good with low upfront cost for you, but never forget that if you get seriously sick, you may have to pay as much as $7,500 out of pocket per year, an amount you are not allowed to take out insurance to cover.

On Oct. 8, the New York Times had a big article about how nearly all the Medicare Advantage Insurance Companies committed massive fraud claiming their insured participants were much sicker than they really were, to get paid billions more than they should have been from the Medicare trust fund. This is very typical of big private companies. You know they make lots of money on it, otherwise why would they bombard you with ads?

It is my conviction that as more people sign up for Medicare Advantage, it will eventually be much easier to suddenly completely privatize health insurance for seniors, especially as Medicare may not be able to pay 100% of what they pay today, as the Trust fund is diminished, partly due to the fraud the Advantage companies committed.

Just hope Democrats are in control when the Medicare fund runs low in as little as four years. Or how would you like to suddenly have to pay the insurance company the $12,000, (or $24,000 per couple) they get from Medicare now, or even a percentage of that? I can’t begin to explain Advantage plans that often, on the surface, look better and cheaper than original Medicare. You are lucky you live in Democratic N.Y. since they look out for people, and make it easier than in most other states to change back to original Medicare, even after the Advantage companies keep the money they made on you in your healthy years.

The best website I have found that gives reasonably clear information on most of this is www.verywellhealth. com. Study it very well and then decide.

Jorgen Overgaard, agricultural economist, professional tax preparer Keuka Park

EDITOR’S NOTE: Letter writers are responsible for making sure the information they submit is accurate and factual.

Be careful signing up for Medicare Advantage

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