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In reply to the discussion: New Medicare Program: Full List of Services That Will Need Prior Approval [View all]
thesquanderer
(12,892 posts)8. Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover.
That's one of its downsides. Of course, in that case, the purpose isn't to save the government money, but rather to maximize profit from the enrollees.
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New Medicare Program: Full List of Services That Will Need Prior Approval [View all]
BumRushDaShow
21 hrs ago
OP
They really went after nerves. Is salvation through pain part of the plan?
bucolic_frolic
21 hrs ago
#1
Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover.
thesquanderer
20 hrs ago
#8
Advantage plans are private insurance, and they should be banned from using " Medicare" in their name.
OMGWTF
19 hrs ago
#18
I agree. Unless maybe they more honestly called it something like "Medicare Alternative" or "Medicare Private Option."
thesquanderer
19 hrs ago
#25
They are literally Medicare plans, Authorized under the Medicare Part C statutes
Ms. Toad
19 hrs ago
#31
The person you're replying to said Advantage plans should not have been allowed as Medicare plans.
pnwmom
7 hrs ago
#63
But one of the main reasons to choose standard Medicare over a Medicare Advantage plan is to minimize a third party
Ms. Toad
18 hrs ago
#38
So? People pay MORE to join Traditional Medicare so that they can choose their own doctors
pnwmom
16 hrs ago
#48
Yes, they do, in order to get Parts A and B, which covers both hospitalization
pnwmom
15 hrs ago
#56
i've had the cellular. tissue application for foot wounds that would not heal
rampartd
20 hrs ago
#7
neck surgeries, knee surgeries, incontinence control, pain relief -- how very cruel, how very predictable
0rganism
20 hrs ago
#9
Our doc told us pre-approval is needed for what was our usual blood test
AverageOldGuy
20 hrs ago
#14
But this experiment is being done with Traditional Medicare patients, which doesn't require prior authorization.
pnwmom
16 hrs ago
#49
But private companies WILL provide the AI services performing prior authorizations for Traditional Medicare.
pnwmom
5 hrs ago
#66
The whole reason Iʻm paying extra for supplemental ins is to keep the imperfect gem, traditional medicare, where
mahina
19 hrs ago
#19
"Just reading our DUers here and the impacts this would make to their lives is powerful."
BumRushDaShow
19 hrs ago
#24
It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind)
Ms. Toad
18 hrs ago
#40
I expect this is being pilot-tested to eventually become a permanent change (with more procedures needing prepproval)
BumRushDaShow
17 hrs ago
#45
I know for those of us feds who planned to maintain their FEHB insurance plans when Medicare-eligible
BumRushDaShow
15 hrs ago
#51
When I had a cancer diagnosis, I was in surgery 2 days after getting the diagnosis,
pnwmom
7 hrs ago
#65
That's the general basis for my personal concern with the skin and tissue substitutes
Ms. Toad
1 hr ago
#68