For many patients who trusted their Medicare Advantage plans would be a helpful way to ensure care for the long haul, many are finding critical disadvantages ranging from gaps in local provider access to a lack of available promised services.
For others, it can be worse.
As Dave Lieber from the Dallas Morning News writes, one patient’s Medicare Advtange plan completely pulled up stakes.
From the article:
As his first cancer radiation treatment approached, his Medicare Advantage was canceled
Talk about horrible timing. How do you handle a crisis? Step 1: Panic. Step 2: Gain control.
When John Wieden of Keller opened the envelope last month, its contents startled him. His Medicare Advantage health insurance account, with whom he was a happy customer for 10 years, is suddenly shutting down.
The timing was awful.
Days before he learned he needed to undergo a series of radiation treatments for cancer.
He told The Watchdog, “The shocker is when, first of all, you’re told you have cancer. And the second shocker is your health insurance is being non-renewed. You go ‘oh boy.’ That’ll get the adrenaline flowing.”
The closure of Care N’ Care Insurance Co. of Farmers Branch was first reported in detail by D magazine’s CEO Healthcare. Their story stated that 125 employees would lose their jobs as the insurance plan winds down.
The letter from Care N’ Care to Wieden did not give specific reasons. But it appears that federal government adjustments to pricing in 2025 are expected to hurt the bottom line of some Medicare Advantage plans.
In a letter to its providers, Care N’ Care blames “lowering the benchmark for health care costs … coupled with increasing market pressures resulted in an untenable environment for smaller Medicare Advantage plans like Care N’ Care.”
Medicare Advantage Headlines >>
As his first cancer radiation treatment approached, his Medicare Advantage was canceled
For many patients who trusted their Medicare Advantage plans would be a helpful way to ensure care for the long
Three Health Insurers Exaggerated Medicare Advantage Enrollees’ Illnesses, Overcharging Taxpayers $140 Million
The disadvantages of Medicare Advantage programs can extend beyond frustration for patients and lower reimbursement rates for hospitals. A recent
Why Medicare Advantage Plans are Losing More Providers
Medicare Advantage plans’ excessive denials, restrictive provider networks, and contentious contract negotiations continue to increase the number of health systems
Medicare Advantage Has Become Notorious for Prior Authorization Burden
Medicare Advantage plans denied 7.4 percent of medical professionals’ prior authorization requests, or about 3.4 million requests, according to a
Ranking Medicare Advantage Insurers by Prior Authorization Denial Overturn Rates
While the majority of Medicare Advantage insurers overturn prior authorization denials when those decisions are appealed, the appeal process adds
See what else Groundswell Health is working on in healthcare >>
Support trending upward for rural healthcare
Strain and challenges for rural hospitals persist, but awareness is growing as lawmakers prioritize funding and programs for rural health
Groundswell Health Recognized With Industry Awards
Austin-based Groundswell Health this month received industry recognition for its work in strategic healthcare communications. The healthcare-focused communications firm
Celebrating Our Hospital Partners During National Hospital Week
May 12-18 is National Hospital Week, an opportunity to recognize and celebrate the hospitals, health systems, and dedicated health care
From Whim to WeWork to Winning Awards
Lance and I started working together in 2013. It didn’t take long to discover that what we had in common