Latest Breaking News

SergeStorms

(19,915 posts)

42. Exactly.

Fri Dec 26, 2025, 05:30 PM

11 hrs ago

Why this is being flagged (other than cost cutting) is another question. Is the treatment of dubious efficacy? We need one of our DU physicians to offer an opinion here.

Edit history

Please sign in to view edit histories.

Recommendations

0 members have recommended this reply (displayed in chronological order):

65 replies

= new reply since forum marked as read

Highlight:

New Medicare Program: Full List of Services That Will Need Prior Approval [View all] BumRushDaShow 14 hrs ago OP

They really went after nerves. Is salvation through pain part of the plan? bucolic_frolic 14 hrs ago #1

Steroid injections have kept me ok on my feet redstatebluegirl 14 hrs ago #3

Me too. mgardener 14 hrs ago #4

This message was self-deleted by its author Trueblue Texan 13 hrs ago #11

I just got a shot in my shoulder LittleGirl 13 hrs ago #12

That should still be okay. Igel 13 hrs ago #17

Right? LittleGirl 11 hrs ago #41

Exactly. SergeStorms 11 hrs ago #42

Had that one too Bayard 5 hrs ago #59

Same here Bayard 5 hrs ago #58

That's what made Mother Theresa druidity33 13 hrs ago #21

How about a pilot program Henry203 14 hrs ago #2

Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover. thesquanderer 14 hrs ago #8

Advantage plans are private insurance, and they should be banned from using " Medicare" in their name. OMGWTF 13 hrs ago #18

I agree. Unless maybe they more honestly called it something like "Medicare Alternative" or "Medicare Private Option." thesquanderer 12 hrs ago #25

Alternative Medical Services. cstanleytech 6 hrs ago #57

They are literally Medicare plans, Authorized under the Medicare Part C statutes Ms. Toad 12 hrs ago #31

The person you're replying to said Advantage plans should not have been allowed as Medicare plans. pnwmom 1 hr ago #63

Ban "Medicare" from their name ENTIRELY Seinan Sensei 12 hrs ago #34

huh? Skittles 8 hrs ago #54

I should have said upcoding Henry203 8 hrs ago #55

AI prior authorization approval is already a relatively common practice anciano 14 hrs ago #5

And it needs legislatively banned. benfranklin1776 12 hrs ago #27

Not just the Ai part of it, but the outside authorization mahina 12 hrs ago #32

Agreed! benfranklin1776 5 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 11 hrs ago #38

"Healthcare" is an umbrella term that encompasses anciano 11 hrs ago #39

Healthcare is distinct from how that care is paid for. Ms. Toad 11 hrs ago #44

So? People pay MORE to join Traditional Medicare so that they can choose their own doctors pnwmom 10 hrs ago #48

No LtTx 9 hrs ago #53

Yes, they do, in order to get Parts A and B, which covers both hospitalization pnwmom 8 hrs ago #56

And yet the govt is clamping down on prior authorization in Advantage plans pnwmom 1 hr ago #64

Brought to you by the same people who believe in ivermectin for covid Raven123 14 hrs ago #6

i've had the cellular. tissue application for foot wounds that would not heal rampartd 14 hrs ago #7

neck surgeries, knee surgeries, incontinence control, pain relief -- how very cruel, how very predictable 0rganism 14 hrs ago #9

So delay and deny are what's in store for our Buddyzbuddy 13 hrs ago #10

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

Our doc told us pre-approval is needed for what was our usual blood test AverageOldGuy 13 hrs ago #14

If you are no standard medicare, your doctor is wrong. Ms. Toad 12 hrs ago #36

Under an Advantage plan with an HMO dickthegrouch 13 hrs ago #15

But this experiment is being done with Traditional Medicare patients, which doesn't require prior authorization. pnwmom 10 hrs ago #49

Companies running this make money with every denied claim groundloop 13 hrs ago #16

Death by spreadsheet OMGWTF 13 hrs ago #20

Private insurance companies don't run traditional Medicare. ShazzieB 13 hrs ago #22

AI "death panels"..... SergeStorms 11 hrs ago #43

The whole reason Iʻm paying extra for supplemental ins is to keep the imperfect gem, traditional medicare, where mahina 13 hrs ago #19

"Just reading our DUers here and the impacts this would make to their lives is powerful." BumRushDaShow 13 hrs ago #24

This part caught my eye. ShazzieB 13 hrs ago #23

Amen 💪🏼 benfranklin1776 12 hrs ago #28

Don't You Mean OhioTim 10 hrs ago #46

I know what you mean, but I prefer not to think in those terms. ShazzieB 4 hrs ago #61

Doesn't sound reasonable or even rational Joinfortmill 12 hrs ago #26

Does one need advanced approval to die? milestogo 12 hrs ago #29

That's next... 2naSalit 10 hrs ago #50

So they're creating those death panels that Sarah Palin warned us about WestMichRad 12 hrs ago #30

Trump Qualifies For One OhioTim 12 hrs ago #33

two actually - do his diapers require prior approval? RainCaster 3 hrs ago #62

Deep brain stimulation for the treatment of essential tremor progressoid 12 hrs ago #35

At best, it will delay treatment. Treatment delayed is treatment denied. SunSeeker 12 hrs ago #37

It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind) Ms. Toad 11 hrs ago #40

I expect this is being pilot-tested to eventually become a permanent change (with more procedures needing prepproval) BumRushDaShow 11 hrs ago #45

I agree. Ms. Toad 10 hrs ago #47

I know for those of us feds who planned to maintain their FEHB insurance plans when Medicare-eligible BumRushDaShow 9 hrs ago #51

When I had a cancer diagnosis, I was in surgery 2 days after getting the diagnosis, pnwmom 1 hr ago #65

The U.S. is the only modern nation without a universal tax supported health care system for all their citizens. It makes ShazamIam 9 hrs ago #52