10 February 2019 Blog Post: Medicare

I thought that some of our patients nearing Medicare enrollment age would be interested in the following exchange that I had with a Neurosurgical colleague who was bemoaning an extended authorization process for a CT scan on a patient with a Medicare Advantage plan.
Dr. Gantwerker posted: “To any of you reaching Medicare age: Do not, under any circumstances, sign up for a “Medicare Advantage” plan. It is an hmo by any other name. If you are able to, stay on Medicare with a supplement. Medicare is and remains the best insurance out there. The advantage plan only throws roadblocks In the way of your doctors ordering completely appropriate tests. I just spent an hour on the phone arguing with somebody about why a patient with an upper cervical spine fracture need another CT scan. This is not a time Or money saver. What it is is strictly a money saver for the paper pushing people whose job it is to get you less quality physicians and care.”
To which I replied: “Brian R. Gantwerker, this is an excellent point. To add on, I find that the selection of a supplemental plan becomes an issue that Medicare replacement plans exploit when marketing (and, yes, it is marketing) to patients. Medicare covers 80% of incurred costs and the remaining 20% (sometimes called “Medigap”) is then covered by a supplemental plan which needs to be purchased and paid for by the patient. Selecting an affordable supplemental plan does not need to be a frightening proposition. I typically direct my patients to the AARP website who has an excellent tool to help choose one (www.aarp.org). Also, AARP itself offers a plan administered through UnitedHealthcare but on their site they strike a good balance between promoting such and encouraging patients to be savvy consumers. AARP is a great place to start looking (they can even save you on an Amazon Prime Membership!). Many of my patients have supplemental plans through USAA, Mutual of Omaha, and Blue Cross/Blue Shield among others. Patients have worked their entire life to be able to utilize their Medicare plan and it seems hasty to simply sign it away without careful analysis or research. Medicare.gov also provides an excellent tool so patients can understand their true cost, enabling an informed (rather than advertising or fear driven) decision.”
Dr. Gantwerker replied: “I agree, Phil. My parents were/are members and have had the best coverage throught the UHC suppplement AND hospital indemnity insurance and that has been priceless! Thank you for the tool you shared.”

𝗦𝗶𝗴𝗻 𝗨𝗽 𝗳𝗼𝗿 𝗢𝘂𝗿 𝗡𝗲𝘄𝘀𝗹𝗲𝘁𝘁𝗲𝗿

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