Yep, and it is preventable. The one thing I can say is NEVER let your parents sign up for a "medicare" advantage plan. There is no advantage. The company my mom was with is one of the largest and profited something like 18 BILLION off medicare last year. How do you think that is possible? Because they overcharge medicare and deny coverage.
People sign up for (or are tempted to sign up for) Medicare C because traditional Medicare is too complex and bafflingly bad. Traditional Medicare requires paying for your Part B premium, a separate Part D plan and premium (from the private insurance companies), likely a third “Medigap” plan and premium (also from the private insurance companies IIRC) and then separate private vision and dental coverages.
And for all of that, you’re stuck paying at least 20% of everything, on top of separate deductibles for each part and no out of pocket caps at all (meaning Medicare isn’t even an ACA compliant health care plan). Part C simplifies this for so many people by rolling all of Part B, Part D and usually vision and dental into a single premium and puts out of pocket caps on the amount of money you might need to shell out. Is it any wonder people keep choosing Part C even if it means their providers have to fight the insurance more?
Source? UNH’s entire net income in 2023 was $22.3B, and their market cap is more than 5x the next biggest managed care organization (MCO).
The other MCOs all had net income less than $8B (CVS/Elevance/Cigna/Humana/etc).
There is no way a business earned a profit of $18B just from Medicare and it not being visible on their net income figures.
That is not to say Medicare Advantage is good for most customers (the common advice is to stay away from it), but fantastical numbers don’t help arguments.
Profit is not income. That $18B could be spend on salaries, bonuses, company assests, etc, and I'm not an accountant but if it's getting spent on the business it doesn't have to be included in their income reports.
Profit without a qualifier is assumed to mean net income, which is all revenue minus all expenses.
But even supposing that the business earns $18B from Medicare Advantage after all is said and done, it doesn’t pass the smell test because at that level of profit, these businesses should shut everything else down and just do Medicare Advantage.
Wish I could upvote this more. Switched mine to BCBS PPO with medigap supplemental plan for their Medicare provider. They got to go to the best cancer hospital and specialists you can just call up the office and schedule. It costs like $900 a month though and they pay 20% with 80% plan coverage up to catastrophic out of pocket limit. PPO if you want to give your loved ones a fighting chance.
