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Medicare Advantage Could Put Sicker Patients at a Disadvantage

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    I found this article to be an interesting read. Some studies are showing that Medicare Advantage may not be benefiting sicker patients as well as it does healthier ones. The studies are saying that Advantage plans may disadvantage sicker people by making care harder to get, by way of per-approvals and red tape. One interesting point is that Medicare Advantage enrollees have to travel father for medical services, because it was found that enrollees used fewer hospital services. It may also be, in part, due to the programs trying to achieve new efficiencies, after all, some private Medicare plans can exclude some doctors and hospitals from their networks. I could see where restrictions on access to medical treatment could hit sicker patients harder in the long run. If this is true, is it in patients best interest to opt for traditional medicare?
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    Interesting. I guess by this logic, it's not necessarily that the program just at a disadvantage for sicker patients. Maybe another way to say it is that it's like most insurance policy companies out there - it discourages one to actually use the services it provides. Of course they want the buy in. And then would just prefer everyone not to use any of it's services; to just feel good about being covered, just in case.
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    Sadly, yes. It's one of, if not THE most difficult situations people face these days. Do I or don't I use my insurance, but hey, that's what they are "there" for.
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    Yes, this is sad and an issue for me. I had to drop my medigap and go straight medicare and medicaid just to see the doctor of choice and necessity. I couldn't even get a referal they wanted me to see their doctors first. After a complex history with spine and neck surgerys due to a bad doctor, and also wanting laser surgery over fentanyl and morphine as I had in the past to coexist. Its easer to get a pain script filled and covered by insurance then seeing a doctor who actually does something not just "masks" the pain. Not to mention the costs where so much more for the pills then the surgery. Its disheartening and i believe a 1 reason for narcotic and "pill popping" prescription addicts....I'll keep it brief! Now each state has income limits for medicaid assistance in florida i qualified for both and honestly was the best treatment, easiest axcess to care for myself. However, I moved back to michigan and Im $70 over the amount for medicaid. I qualify and have it once i meet$660/month deductible. Hummm, my income is poverty level or below but because and this is since obamacare , even moreso I found out my spenddown pays from the date forward. Hence, for instance i had laser surgery paid 660$ on the 28th of the month, so coverage was from 28th to end of the month, not even for the entire month. Im all for paying for what is mine, but they make it for people who dont work and have basically for me in michigan, less then $930/month. So having disability/social security imo has become sometimes difficult. You have monthly premiums say $120 and also a $400 deductible on all prescriptions that has to be met prior to recieving and medigap assistance. So I bring in $1000 and it looks like january i wont afford rent, as $520 alone goes to part d. Heaven forbid i have a $5 or $10 copay because i wont have the funds. IMO social security became a target due to baby booomers poulation to basically suck funds from to give to some that dont want to work: are single parent possibly and honestly its not in their favo to work. It sickens me as it wasnt this way 3 years ago......Rewards for playing the system, smh as i stand behind the lady at walgreens w 3 kids running wildly, shes on her phone setting up the ale of what i presume and heard her say, where narcotics. I'm crying as i ask the pharmacist if i can purchase 2 days worth of my rx....Lady says honey you need medicaid!