The investigators urged Medicare officials to strengthen oversight of these private insurance plans, which provide benefits to 28 million older Americans.
Report: Medicare Advantage Programs Routinely Deny Needed Care
Credit: Wikimedia Commons
April 28, 2022

Federal investigators released a report yesterday that concluded every year, tens of thousands of people enrolled in private Medicare Advantage plans are denied necessary care that should be covered under the program. Via the New York Times:

The investigators urged Medicare officials to strengthen oversight of these private insurance plans, which provide benefits to 28 million older Americans, and called for increased enforcement against plans with a pattern of inappropriate denials.

Advantage plans have become an increasingly popular option among older Americans, offering privatized versions of Medicare that are frequently less expensive and provide a wider array of benefits than the traditional government-run program offers.

Enrollment in Advantage plans has more than doubled over the last decade, and half of Medicare beneficiaries are expected to choose a private insurer over the traditional government program in the next few years.

Federal investigators say there is troubling evidence that plans are delaying or even preventing Medicare beneficiaries from getting medically necessary care.

Read the entire story. Much like in the pre-Obamacare days, insurance companies are denying and delaying needed care in hopes that doctors and patients will simply give up and stop appealing. The report found that many Medicare Advantage patients did not even know they could appeal these decision.

They also found that many patients suffered serious medical consequences from the delays.

If you or your relatives are on Medicare Advantage and would like to switch to regular Medicare, here's how.

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