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Older Americans Say They Feel Trapped in Medicare Advantage Plans
As enrollment in private Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.
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Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
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Watch: Older Americans Say They Feel Stuck in Medicare Advantage Plans
You’ve probably seen advertising about Medicare Advantage plans. KFF Health News' Sarah Jane Tribble explains the pros and cons of this insurance option as enrollment in these plans increases.
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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
By Susan Jaffe -
Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton
KFF Health News gives readers a chance to comment on a recent batch of stories.
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Tiny, Rural Hospitals Feel the Pinch as Medicare Advantage Plans Grow
More than half of seniors are enrolled in private Medicare Advantage plans instead of traditional Medicare. Rural enrollment has increased fourfold and many small-town hospitals say that threatens their viability.
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Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
By Susan Jaffe -
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
By Susan Jaffe -
New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
The Policy, and Politics, of Medicare Advantage
Episode 290Medicare Advantage, the private plan alternative to traditional Medicare, is embroiled in a growing controversy over whether insurers are being overpaid and what it would mean to reduce those payments. Meanwhile, even as maternal mortality in the U.S. continues to rise, providers of care to pregnant women say they’re leaving states with abortion bans that prevent them from treating pregnancy complications. Margot Sanger-Katz of The New York Times, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more.
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Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."
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How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
By Fred Schulte and Holly K. Hacker -
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges
Taxpayers had to foot the bills for care that should have cost far less, according to records released after KHN filed a lawsuit under the Freedom of Information Act. The government may seek to recover up to $650 million as a result.
By Fred Schulte and Holly K. Hacker -
Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
By Fred Schulte -
Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging
The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.
By Fred Schulte -
Medicare Advantage Plans Send Pals to Seniors’ Homes for Companionship — And Profits
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.
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Readers and Tweeters Find Disadvantages in Medicare Advantage
KHN gives readers a chance to comment on a recent batch of stories.
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Researcher: Medicare Advantage Plans Costing Billions More Than They Should
Some insurers pocketed ‘eye-popping’ overpayments, billing records show.
By Fred Schulte -
She Struggled To Get a Lifesaving Drug Even After Insurers Vowed To Help
Margaret Hvatum ended up in the hospital after her insurer denied coverage of a medicine she relies on to boost her immune system. Hvatum got entangled in the preapproval process, which the insurance industry has vowed to improve.