What we should be asking is how do MA plans provide all they claim, may charge no premium and thus are able to make a profit based only on the federal payment to them for each patient.
A dozen U.S. Senators and three witnesses sharply criticized Medicare Advantage (MA) marketing schemes during a Senate Finance Committee yesterday.
Participants blasted the “unscrupulous,” “deceptive,” and “rip-off” tactics and high commissions that enroll seniors in plans that don’t meet their healthcare needs.
With the 2024 Medicare re-enrollment window in its fourth day, committee chairman Sen. Ron Wyden (D-Ore.) pointed to federal investigators’ findings that “marketing middlemen are the latest set of sleazy private-sector scoundrels targeting seniors on Medicare Advantage.”
Wyden said these “big marketing companies … [are] hijacking personal information from as many seniors as possible, and then funnel the personal information to health plans that pay the sleazy marketers the most money.”
Rapidly increasing MA sales commissions were a theme throughout the hearing. Hearing witness Krista Hoglund, who is the CEO of a small MA plan in Wisconsin covering 60,000 lives, said MA companies now pay $1,300 or more to an agent for enrolling a new beneficiary — far above the CMS-approved cap of $611.
This aggressive practice of rewarding brokers with a variety of “add-on” bonuses resulted in two-thirds of the people who enrolled in MA plans during re-enrollment last year signing up for just two large national for-profit companies instead of smaller plans like hers, she said.
“Unfortunately, we know some large firms and third-party marketing organizations leverage their influence for financial gain rather than what’s in the best interest of the consumer,” Hoglund said. While many plan agents are trustworthy, many are not, she said.
Wyden said insurance experts have estimated those commissions cost the Medicare program $6 billion in 2022 n. Those dollars “line middlemen’s pockets … who may have sold your elderly parents, your grandparents, or your neighbors the wrong plan,” Wyden said. “It’s outrageous. It’s a rip-off and it’s got to stop.”
Christina Reeg, director of the Ohio Senior Health Insurance Information Program — one of a network of 54 federally funded unbiased counseling programs — said MA sales pitches often stress benefits that are of minimal importance to a person’s healthcare.
Seniors are “more apt to join a plan for the added benefits, specifically the over-the-counter allowances and other cash rewards” and debit cards, but ignore more important plan offerings like who is in the provider network, Reeg said.
Reeg would rather beneficiaries look at things like daily copays for inpatient hospitalization or maximum out-of-pocket costs.
Source: medpagetoday.com
QUINNSCOMMENTARY 
“Pay me now or pay me later”. Critical thinking in this country seems to have gone down the drain. Many people over 65 aren’t taking a critical look at MA plans before buying them. Just because Broadway Joe or “Martha” tells you it’s a good deal, doesn’t mean that it is. Think about it for a second: how can you have reasonable deductibles or copays if you have a zero monthly premium which many of these plans tout. What if you decide to go visit relatives in another state and get sick and find out that there are no doctors or hospitals in your network there?
The real problem I believe is the Federal Government itself. If it was up to CMS, everyone over 65 would be on MA plans. Why? Because our esteemed politicians who claim to be looking out for us want to push 100% of the risk of taking care of people over 65 to private insurance companies. One man’s opinion: the typical US retiree is better off with a Medigap plan.
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