Grassroots fights health care law
POSTED: Thursday, May 27, 2010 - 11:01am
UPDATED: Thursday, May 27, 2010 - 3:16pm
What was once a deal to give seniors better medicare benefits is now becoming a high-cost trade off for seniors and taxpayers alike.
Experts and studies are now warning older adults about switching to Medicare Advantage. It was a plan developed in the 1980s when private health insurance companies promised they could provide more benefits than traditional medicare. But in the last few years, it hasn't been the case for many seniors.
Today Rosie Henderson walks around her yard and caring for her plants.
"Sometimes I can walk. Some days I can't," she says.
But some days, arthritis, high blood pressure, and high cholesterol keeps her indoors. One of those bad days, she got a phone call about switching from traditional Medicare to Medicare Advantage.
"They said that it would pay for everything. He called on the phone and said 'did you know you can get this and you can get that,'" Henderson said.
Private insurance companies often call and invite seniors to switch to their plans; touting extra benefits like dental and vision coverage.
"I though it would be more ease about what I was going to be doing," she said.
Government documents show about 1/5th of seniors are on these Medicare Advantage plans.
But more than a year after switching, Henderson found out it wasn't right for her.
"That's when I started getting a letter that they will not pay for my bills," she says.
Turns out, the HMO providing her Medicare Advantage coverage didn't include coverage for the doctor she sees every three months.
"I know, last year, I had to pay $287," Henderson says.
It's a big chunk of the budget for someone retired and on a fixed income.
"I have actually known them not to buy their medicine, not to have enough to eat, not to be able to pay their electric and other utility bills," says Dovie Lawrence with the East Texas Area Agency on Aging.
It's a non-profit group helping seniors. Lawrence says she's helped many East Texans left with hundreds of dollars in bills after unknowingly getting into a Medicare Advantage plan.
"The coverage is not uniform. they don't all pay for this just on a routine scale," Lawrence says.
Private HMOs providing those plans aren't required to cover any amount of benefits or any type of doctor.
"They're going to get paid whether they have to provide a service at all," Lawrence says.
Several studies and government reports show federal taxes are paying anywhere between 9 to 20 percent more to the HMOs for the same services traditional medicare provides.
Seniors are essentially handing over their share of the medicare cash to the private companies ; who many health care providers are now refusing to deal with.