Advantage plans hurt Medicare

Please respond to the concerns mentioned in this article:


I've always trusted AARP to be an honest advocate for seniors but this information is very disturbing!

Is AARP just an insurance salesman or a true advocate for seniors and medicare???

Periodic Contributor

The article mentioned is compelling. It states: 

"Seniors buying Medicare Advantage plans often think — even though they know they’re getting the plan through an insurance company — that they’re somehow still in Medicare or backstopped by Medicare. The reality is they’re neither.

With Medicare Advantage, they’re at the total mercy of the insurance company providing the Advantage plan. They can deny care (and frequently do), refuse to pay for tests, and even refuse to authorize or pay for surgeries and other life-saving procedures."


Many seniors are happy with their Medicare Advantage plan. There are currently no plans to do away with them that I know of. However the REACH program takes seniors out of the traditional Medicare plan they chose and puts them into an Advantage plan without their knowledge or consent. Why is their choice negated? Why is AARP not opposing this? It appears that money is the reason.

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Regular Contributor

The ACO REACH program is NOT the same as Medicare Advantage.  MA is functionally a one-way ticket after the 1st year as going back to Medicare Traditional leaves one subject to underwriting for a Medicare Supplement (denial or MUCH higher premiums).  MA can restrict folks to ONLY using providers within their MA network, but beneficiaries in ACO REACH retain the option to go to any provider that accepts Medicare.

See this CMS FAQ, particularly Q 11 & 12:



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Periodic Contributor

I wrote a written inquiry to AARP sometime last year inquiring as to how and why they made the decision to promote UHC.  I got a canned response saying AARP has not received any complaints from it's members regarding the services UHC provides.  My question was ignored.  One would like to think that AARP engaged in due diligence when they selected UHC, but likely it has to do with contributions that UHC makes to AARP.  Interestingly, my pension plan promotes UHC.  If enough AARP members banded together and requested transparency from AARP, perhaps our questions would be answered.  I don't think any of us believe there won't be some corruption/fraud in these programs, but we do have a right to know how it is AARP is such a supporter of UHC.

I agree.......

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See the NYT article on the billions in suspected medicare fraud from United Heathcare (UHC) and other insurers. The government pays more for sicker patients so doctors are incented to fake illnesses. Why does AARP support UHC when they are embroiled in lawsuits. C 'mon AARP take the high road.


Exactly. Is this a pay to play ploy on  AARPs behalf?  
How can you help bankroll this sort of fraud and at the same time consider yourself an advocate for seniors?

Honored Social Butterfly

One thing left out so far is cost of program. At the start of the Advantage programs Medicare paid the carriers the amount it cost medicare to provide the service plus 15%. The ACA was to reduce that to zero, but I think it only cut it to 10% so far. That means everyone paying a medicare tax is paying more due to the advantage programs. Those that want to save Medicare money should be against the advantage programs until that difference reaches zero.

Honored Social Butterfly


All Medicare beneficiaries have to decide for themselves what is the best way for them to get their Medicare benefits.


Medicare Advantage plans are part of the Medicare system and both the Traditional program and Medicare Advantage as well as all Part D programs are regulated and monitored by under the Dept of Health and Human Services.


Many beneficiaries like their Medicare Advantage plan and they also have the option of changing every year to another if their needs change.  The % of beneficiaries choosing a MA plan as the manner in which they get their benefit is about 35_40% of all beneficiaries in the program.

Many beneficiaries aren't poor but yet live on a budget and feel that they cannot afford a Medicare Supplemental (Medigap) plan with a monthly premium that escalates over time.  Thus they opt for a MA plan so that they know their cost and can plan for these cost.


Having Traditional Medicare WITHOUT a Medicare Supplemental (medigap) plan leaves ones open to a lot of out of pocket cost since Traditional Medicare has NO limit on out of pocket cost - but Medicare Advantage DO!


Medicare Advantage plans cover the EXACT same things as Traditional Medicare except in a different way.


  • We could talk about MA discounts or savings for people under a specific income (Medicare Savings Program)  
  • We could talk about Medicare Advantage plans offering some added benefits which some people need - which aren't offered by the Traditional program.
  • We could talk about dual eligibles (people who have Medicare and Medicaid) and how special managed care MA plans helps them.
  • We could talk about programs such as Accountable Care Organizations, Medicare Direct Contracting Entities and how all these also help certain beneficiaries.  

All of these special programs are designed & regulated by  to help specific sets of beneficiaries depending upon their needs and their income.


One thing that the Medicare program has to watch and many of the rules surrounding the  program takes into consideration - they do not want beneficiaries signing up for a MA plan and then perhaps years later begin to need lots and lots of care, switching  from a MA plan to Traditional Medicare - that's the reason for the rules on when one can get a Medigap plan are limited and sometimes costly if one wants to do it and if they can (underwriting applies).



It's Always Something . . . . Roseanna Roseannadanna
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Gold Conversationalist


Are you on Medicare?


I am and I have a Senior Care Advantage Plan. I don't want anyone messing with my plan. I pay extra money to have it, but I don't make any co-pays when I visit a doctor. I do have very reasonable co-pays on my prescriptions. I also have dental coverage and visit my dentist two times a year. For a cleaning and checkup, I don't pay anything. I also get an eye exam once a year and again I have no money out of my pocket.


I don't care for the ads on TV but then I already have my plan.


A person gets what they pay for. Be sure to check out the plans they offer and ask for information about what coverage is provided with each plan. 


I should be getting information about my plan for next year soon and what the cost will be.


I also get $30 every quarter to spend on over the counter drugs. This is placed on a card. It does not roll over, so I try to spend all of it.

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Social Butterfly

Good post "Rick",


Please note the disparaging "concerns" are only in the comments; those comments refer to UHC association, not AARP.


UHC has been a strong sponsor of AARP activities for decades; while I don't approve, I do understand the necessity. 


So, my thought is consider the information as biased until you form your truth...


Additionally, it seems AARP has been receiving some very pointed jabs recently (e.g... WSJ Oped today on the AARP | Constant spam texts after joining AARP ); not sure why but seems targeted, so I worry...



Phil Harris, actor and showman, to John Fogerty of CCR: “If I’d known I’d live this long, I’d have taken better care of myself.”
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