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Medicare Advantage Under Scrutiny - Chief Healthcare Executive
No doubt that Medicare Advantage plans have greatly increased in popularity over the years, to the point that about half of all seniors over age 65 an over have eschewed “traditional Medicare” federal government coverage to, instead, take advantage of the often more robust coverage provided with Medicare Advantage (for clarity, Medicare Advantage plans are healthcare coverage delivered by private insurance companies, rather than the federal government).
Generally, Medicare Advantage plans usually offer additional healthcare-related coverage (think dental, vision, and/or prescription drug) at either no additional cost, or only a relatively small additional amount (on top of the mandatory Medicare Part B premium). That additional coverage at a small additional expense is enticing, for sure, which likely contributes to the increased popularity of Medicare Advantage plans. But is there a cloud gathering over this popular private healthcare option called Medicare Advantage?
Turns out that many medical service providers, including hospitals and physician groups, are complaining that Medicare Advantage plans are too frequently requiring pre-approval of common medical procedures, and all too often denying claims, considerably affecting their bottom line and affecting patient wellness. As a result, a bipartisan group of U.S. Senators has asked the Centers for Medicare & Medicaid Services (CMS) to dig deeper into these allegations to assess whether reform is needed. Read all about it in this article by Ron Southwick appearing at Chief Healthcare Executive.