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ShazzieB

(22,164 posts)

23. This part caught my eye.

Fri Dec 26, 2025, 03:56 PM

Yesterday

"The pilot will last six years. It begins on January 1, 2026, for those on traditional Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington."

I wonder how they decided which states were to be the guinea pigs. My condolences to all traditional Meducare recipients who live in one of those states.

It says this pilot plan is supposed to last 6 years. I hope it can be rescinded sooner than that once Democrats are back in power.

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BumRushDaShow Joinfortmill benfranklin1776 Dixc SunSeeker oberle area51

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Highlight:

New Medicare Program: Full List of Services That Will Need Prior Approval [View all] BumRushDaShow Yesterday OP

They really went after nerves. Is salvation through pain part of the plan? bucolic_frolic Yesterday #1

Steroid injections have kept me ok on my feet redstatebluegirl Yesterday #3

Me too. mgardener Yesterday #4

This message was self-deleted by its author Trueblue Texan Yesterday #11

I just got a shot in my shoulder LittleGirl Yesterday #12

That should still be okay. Igel Yesterday #17

Right? LittleGirl Yesterday #41

Exactly. SergeStorms Yesterday #42

Had that one too Bayard 18 hrs ago #59

I get steroid shots in my scaphoid joint for arthritis. The list specifies that steroid shots in joints are not included Martin68 5 hrs ago #70

Same here Bayard 18 hrs ago #58

That's what made Mother Theresa druidity33 Yesterday #21

How about a pilot program Henry203 Yesterday #2

Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover. thesquanderer Yesterday #8

Advantage plans are private insurance, and they should be banned from using " Medicare" in their name. OMGWTF Yesterday #18

I agree. Unless maybe they more honestly called it something like "Medicare Alternative" or "Medicare Private Option." thesquanderer Yesterday #25

Alternative Medical Services. cstanleytech 19 hrs ago #57

They are literally Medicare plans, Authorized under the Medicare Part C statutes Ms. Toad Yesterday #31

The person you're replying to said Advantage plans should not have been allowed as Medicare plans. pnwmom 14 hrs ago #63

No. They said they should be banned from using "Medicare" in their names. Ms. Toad 7 hrs ago #69

Ban "Medicare" from their name ENTIRELY Seinan Sensei Yesterday #34

Medicare Advantage plans are PPO/HMOs, just like regular private company insurance carriers. Medigap is fee-for-service. valleyrogue 1 hr ago #75

huh? Skittles 21 hrs ago #54

I should have said upcoding Henry203 21 hrs ago #55

AI prior authorization approval is already a relatively common practice anciano Yesterday #5

And it needs legislatively banned. benfranklin1776 Yesterday #27

Not just the Ai part of it, but the outside authorization mahina Yesterday #32

Agreed! benfranklin1776 18 hrs ago #60

But one of the main reasons to choose standard Medicare over a Medicare Advantage plan is to minimize a third party Ms. Toad Yesterday #38

"Healthcare" is an umbrella term that encompasses anciano Yesterday #39

Healthcare is distinct from how that care is paid for. Ms. Toad Yesterday #44

So? People pay MORE to join Traditional Medicare so that they can choose their own doctors pnwmom 22 hrs ago #48

No LtTx 21 hrs ago #53

Yes, they do, in order to get Parts A and B, which covers both hospitalization pnwmom 21 hrs ago #56

And yet the govt is clamping down on prior authorization in Advantage plans pnwmom 14 hrs ago #64

Brought to you by the same people who believe in ivermectin for covid Raven123 Yesterday #6

i've had the cellular. tissue application for foot wounds that would not heal rampartd Yesterday #7

neck surgeries, knee surgeries, incontinence control, pain relief -- how very cruel, how very predictable 0rganism Yesterday #9

So delay and deny are what's in store for our Buddyzbuddy Yesterday #10

We have to move to Medicare for all and cover everything. ChicagoTeamster Yesterday #13

Our doc told us pre-approval is needed for what was our usual blood test AverageOldGuy Yesterday #14

If you are no standard medicare, your doctor is wrong. Ms. Toad Yesterday #36

Under an Advantage plan with an HMO dickthegrouch Yesterday #15

But this experiment is being done with Traditional Medicare patients, which doesn't require prior authorization. pnwmom 22 hrs ago #49

Companies running this make money with every denied claim groundloop Yesterday #16

Death by spreadsheet OMGWTF Yesterday #20

Private insurance companies don't run traditional Medicare. ShazzieB Yesterday #22

AI "death panels"..... SergeStorms Yesterday #43

But private companies WILL provide the AI services performing prior authorizations for Traditional Medicare. pnwmom 12 hrs ago #66

Yes, I see that now. ShazzieB 1 hr ago #74

Yes! You found the key point. That, and the fact that some of the decision makers pnwmom 15 min ago #76

The whole reason Iʻm paying extra for supplemental ins is to keep the imperfect gem, traditional medicare, where mahina Yesterday #19

"Just reading our DUers here and the impacts this would make to their lives is powerful." BumRushDaShow Yesterday #24

This part caught my eye. ShazzieB Yesterday #23

Amen 💪🏼 benfranklin1776 Yesterday #28

Don't You Mean OhioTim 23 hrs ago #46

I know what you mean, but I prefer not to think in those terms. ShazzieB 17 hrs ago #61

Doesn't sound reasonable or even rational Joinfortmill Yesterday #26

Does one need advanced approval to die? milestogo Yesterday #29

That's next... 2naSalit 22 hrs ago #50

So they're creating those death panels that Sarah Palin warned us about WestMichRad Yesterday #30

Trump Qualifies For One OhioTim Yesterday #33

two actually - do his diapers require prior approval? RainCaster 15 hrs ago #62

Deep brain stimulation for the treatment of essential tremor progressoid Yesterday #35

It's fairly new TexasBushwhacker 5 hrs ago #71

I'm lucky (???) in that I'm already bald. :) progressoid 5 hrs ago #72

At best, it will delay treatment. Treatment delayed is treatment denied. SunSeeker Yesterday #37

It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind) Ms. Toad Yesterday #40

I expect this is being pilot-tested to eventually become a permanent change (with more procedures needing prepproval) BumRushDaShow 23 hrs ago #45

I agree. Ms. Toad 23 hrs ago #47

I know for those of us feds who planned to maintain their FEHB insurance plans when Medicare-eligible BumRushDaShow 21 hrs ago #51

When I had a cancer diagnosis, I was in surgery 2 days after getting the diagnosis, pnwmom 14 hrs ago #65

That's the general basis for my personal concern with the skin and tissue substitutes Ms. Toad 7 hrs ago #68

The U.S. is the only modern nation without a universal tax supported health care system for all their citizens. It makes ShazamIam 21 hrs ago #52

WHY?? travelingthrulife 8 hrs ago #67

RFK, Jr. and Dr. Oz lonely bird 4 hrs ago #73