@jp2306867 As you may not know, Traditional Medicare also uses "for profit" Medicare Administrative Contractors (MAC). Some of the MACs are insurance companies, subsidiaries, and/or spin offs. MACs are the organizations that pay the claims in addition to other support services. I do not know of any MACs that work for free. If you think of the government like an employer that provides health insurance benefits, such benefits may be self funded, insured, and/or a combination of self funded and insured. The latter is the approach that the government is using with Medicare. FYI, the Managed Care approach was extremely successful in the private sector circa 1990s. The government noticed the savings in the private sector and enacted the Balanced Budget Act (BBA) in 1997. The BBA created Medicare Choice which at that time was mostly HMOs. In 2003, Medicare Choice was renamed Medicare Advantage by the Medicare Modernization Act (MMA). So, Medicare Advantage (MA) has been around for 25 years. It is essentially a Managed Care approach that is outsourced to insurance companies that have a proven record. If you were waiting for the government to create a managed care plan for Medicare, we would be waiting a long time because it is difficult to accomplish. So, one of the advantages of MA is a cap on your out of pocket expenses (i.e., a stop loss) should you have a medical episode that creates catastrophic medical expenses. Folks can transfer that risk to a MA Plan or an insurance company. With Traditional Medicare you are self insuring that risk or buying a Medigap Insurance Policy from a "for profit" insurance company. Currently, using Traditional Medicare with a Medigaop insurance policy will be more expensive.
