Medicare Advantage - Don't do it

[Soandso]

How Does the U.S. Healthcare System Compare to Other Countries?

Despite higher healthcare spending, America’s health outcomes are not any better than those in other developed countries.

www.pgpf.org

QUOTE: - cited article discusses USA spending and yet omits several other factors. For example: medical Doctors/Nurses/Therapists wages are high (USA cost of professional education and living is expensive), hospital emergency room staffing is unrealistically high from it's pattern of usage, litigation which necessitates pre-emptive medical testing, both Doctors and Hospitals carrying high premium medical mal-practice insurance etc.

 

[Somafunk]

Some folk are rather defensive of their country’s health care, every country needs to improve and the “pay to receive care” is fucking criminal and in a just society should not be something to be defended

 

[Petrushka]

Some folk are rather defensive of their country’s health care, every country needs to improve and the “pay to receive care” is fucking criminal and in a just society should not be something to be defended

Maybe so, but “care” is not a commodity. It is a bottomless pit. It gets rationed by price or by bureaucrats.

 

[Soandso]

… … “pay to receive care” is …criminal ….

Edited: pardon my initial posting mistake of using 1968 which I below have corrected to 1978.

Let's try a monetary angle and not run afoul of ASR's political banter protocols.

The USA does not require citizens to pay taxes that included funding medical insurance (except briefly). Way above we have Amirm's cipher on a 65 year old's monthly USA 2026 medical insurance premium (Medicare Supplement) which did not include monthly drug coverage premium or the necessary monthly Medicare Part B premium. I'm on a tablet so for my convenience will estimate that amounts to (approximately) a combined total of U$700 per month in medical insurance premiums.

Looking back to our sample of Amirm with a theoretical adult working life from age 18 to 65 puts into consideration potentially 46 years as a tax payer puts 2025's $698 (virtually my approximated U$700 cipher) to the equivalent of 1978's U$141 (in purchasing power) which here will be my theoretical starting date for an extrapolation.

Thus in the USA for 1978 by not being taxed U$141per month (to in effect otherwise cover national insurance contribution) the working person had that money available for their own disposition. In the recent 46 years mentioned the sum of U$141 invested in the stock market S&P500 and dividends re-invested would be worth in purchasing power about U$33,900 (according to on-line calculator in2013dollars dot com) in 2025 (that calculator is estimating the 2025 end point used).

Now that's just one month of 1978's health insurance equivalent to 2025's US dollars. Since premiums are monthly we can calculate that in 1978 the total 12 months x U$33,900 (see math above) would amount in 2025 to a bit under U$406,800 (since each successive month's worth of $141 is closer to . Yet this is just one year's calculation (1978) and does not parse the beneficial opportunity a USA taxpayer had the potential to accrue from not paying taxes toward national health care in the other intervening years of 1979 - 2024.

Yes, I accept this is a simplification of monetary values since it is just using one example. Also it relies on artificially positing parity of value for the healthcare/medical services/drugs etc. one might access. The case here reflects the investment vehicle yielded a 12.2% average annual rate of return. My point is that the USA taxpayer has had potential to direct some of their own financial resources for better or for worse should they incur medical expenses either uninsured or obtain insurance at market conditions.

 

[Soandso]

…“care” …gets rationed by price ….

Probably it is little understood that in the USA federal government funding from outside Medicare's own money is available to hospitals that care for the un-insured, and also those taking Medicare/MedAdvantage patients. However, these are explicitly disbursed in the amount matching any US State's own budgetary money paid to their hospitals for the un-insured and Medicare/MedAdvantage patients. (I have read the State must formalize requests for this federal money in a specific timeframe having duly legislated all aspects of it's State budget appropriations.)

Thus when we read about any State's rural populations' (regional) County Hospital closing due to financial losses there's often some degree of State legislative spending involved. If that State doesn't direct it's own tax revenues to a high enough level to in turn get a high enough financial contribution from the federal program to fund every public health benefit some people's access to care gets restricted.

Hospitals can operate legally organized as "public benefit corporations" (not just as private corporations) and it is those that State's are most integrally involved in keeping funded. These are reliably found in the State capitol city and as "teaching hospitals" affiliated with a University campus (often a State University).

 

[Canuck57]

255K views · 2.1K reactions | Scott Ramsey on Reels

www.facebook.com

Some humour for this thread!

 

[Power Pop 23]

One person's approach to aging well

A 102-Year-Old Yoga Teacher’s Simple Approach to Aging Well

For decades, Charlotte Chopin has been bending and stretching in Léré, a village in France. Here’s how she keeps moving.

www.nytimes.com

 

[amper42]

A cautionary tale on the drawbacks of not choosing regular Medicare from the beginning:

What I Learned Trying to Leave an Employer-Sponsored Medicare Advantage Plan - HumbleDollar

A Cautionary Tale: What I Learned Trying to Leave an Employer-Sponsored Medicare Advantage Plan This is the story of a friend I helped when she tried to move from her employer’s Group Medicare Advantage plan to Original Medicare and a Supplement. Her experience is a cautionary tale. I want to...

humbledollar.com

 

[Philbo King]

A cautionary tale on the drawbacks of not choosing regular Medicare from the beginning:

What I Learned Trying to Leave an Employer-Sponsored Medicare Advantage Plan - HumbleDollar

A Cautionary Tale: What I Learned Trying to Leave an Employer-Sponsored Medicare Advantage Plan This is the story of a friend I helped when she tried to move from her employer’s Group Medicare Advantage plan to Original Medicare and a Supplement. Her experience is a cautionary tale. I want to...

humbledollar.com

Excellent advice here. The takeaway: Never ever count on a for-profit corporation for anything...

 

[Sigberg Audio]

Edited: pardon my initial posting mistake of using 1968 which I below have corrected to 1978.

Let's try a monetary angle and not run afoul of ASR's political banter protocols.

The USA does not require citizens to pay taxes that included funding medical insurance (except briefly). Way above we have Amirm's cipher on a 65 year old's monthly USA 2026 medical insurance premium (Medicare Supplement) which did not include monthly drug coverage premium or the necessary monthly Medicare Part B premium. I'm on a tablet so for my convenience will estimate that amounts to (approximately) a combined total of U$700 per month in medical insurance premiums.

Looking back to our sample of Amirm with a theoretical adult working life from age 18 to 65 puts into consideration potentially 46 years as a tax payer puts 2025's $698 (virtually my approximated U$700 cipher) to the equivalent of 1978's U$141 (in purchasing power) which here will be my theoretical starting date for an extrapolation.

Thus in the USA for 1978 by not being taxed U$141per month (to in effect otherwise cover national insurance contribution) the working person had that money available for their own disposition. In the recent 46 years mentioned the sum of U$141 invested in the stock market S&P500 and dividends re-invested would be worth in purchasing power about U$33,900 (according to on-line calculator in2013dollars dot com) in 2025 (that calculator is estimating the 2025 end point used).

Now that's just one month of 1978's health insurance equivalent to 2025's US dollars. Since premiums are monthly we can calculate that in 1978 the total 12 months x U$33,900 (see math above) would amount in 2025 to a bit under U$406,800 (since each successive month's worth of $141 is closer to . Yet this is just one year's calculation (1978) and does not parse the beneficial opportunity a USA taxpayer had the potential to accrue from not paying taxes toward national health care in the other intervening years of 1979 - 2024.

Yes, I accept this is a simplification of monetary values since it is just using one example. Also it relies on artificially positing parity of value for the healthcare/medical services/drugs etc. one might access. The case here reflects the investment vehicle yielded a 12.2% average annual rate of return. My point is that the USA taxpayer has had potential to direct some of their own financial resources for better or for worse should they incur medical expenses either uninsured or obtain insurance at market conditions.

But some can't afford neither the insurance nor to put aside money, isn't that part of the problem? While in countries where healthcare is free, everyone get what they need if they require medical services irrespective of their social or financial status.

And even those who could theoretically afford it, don't have to worry about financial hardship if something unexpected should occur. Also if my understanding is correct the insurance is often connected to their employment, which means you get an unhealthy balance between employed and employer. Here in Norway my medical services are completely disconnected to both where I'm am employed, and even whether I'm employed at all.

 

[JustAnandaDourEyedDude]

I picked original Medicare, and not any Advantage plan. However, I am posting now to try to understand the dangers of some probable scams that may be targeting me. In November, I received a number of phone calls. I see about seven of them on my home phone's call history. This is a landline phone, and I was not at home for some of the calls. All of the calls appear to originate in my US area code, so I am guessing a sim farm is being used. I voted in the November 4th election, so this spate of calls to my usually silent phone may be related to that.

I did pick up three of the calls. All three callers were women. Each started off saying she is calling from "Medicare Providers" or (in the first caller's case) "Medicare Assistance), and then asking me to confirm my street address. They all cited my old address from six years ago, and I told the first two "yes". Today, in a distracted state, I idiotically corrected today's caller about the address. Each caller wanted to "update the database" and "verify information so that I would receive my next Medicare card and be able to claim reimbursement without issues for future medical visits.

All three wanted to know the start date of my Medicare coverage. I lied in the first two cases, and said that it would take me a long time to find my Medicare card to find this date. Each of the callers said that they would wait on the call while I looked for the card. When it became apparent to them that I was not going to come up with the date in any finite time, they hung up on me. I told today's caller that I did not have any card, and had yet to receive a new card. She said she would call back.

I called the Medicare.gov 1-800 line immediately, and had the service rep verify that my online account was not compromised. I googled for the significance of the start date and was unable to find anything related to fraud.

I posted this to ask if any ASR member in the US, or elsewhere, has any info regarding the significance of the start date (it is month/year, and the actual day is probably always the first of the month), and what sort of fraudulent activities it could be used in facilitating. Is it related to the birth month? Can anyone recognize any pattern? I will be cautious to not pick up any such call in the future, or hang up immediately if I do. I have just been incautious thus far because the numbers appear to be from within my area code, and I am expecting a Medicare card to arrive in the mail (just a coincidence). The caller ID shows no other info that the number and the name of my town or a neighboring locality. Certainly no name like "Medicare" which a gov't originating phone call should display.

 

[Bruce Morgen]

I am posting now to try to understand the dangers of some probable scams that may be targeting me.

These sort of phone scams -- most of them originating overseas with faux-U.S. numbers -- have been around for decades and tend to proliferate every October, because that's when Medicare-eligible folks are allowed to change plans. They're a nuisance, but don't comprise a threat if you simply hang up or otherwise ignore them. One lady with a distinct subcontinental -- India/Pakistan/Bangladesh/Sri Lanka? -- accent represented herself as calling from "The State Medicare Office" and, when I mentioned that there was no such entity and asked her from where she was actually calling, she unleashed a torrent of very unladylike profanity at me, thus allowing my to hang up with a big smile.

 

[JustAnandaDourEyedDude]

These sort of phone scams -- most of them originating overseas with faux-U.S. numbers -- have been around for decades and tend to proliferate every October, because that's when Medicare-eligible folks are allowed to change plans. They're a nuisance, but don't comprise a threat if you simply hang up or otherwise ignore them. One lady with a distinct subcontinental -- India/Pakistan/Bangladesh/Sri Lanka? -- accent represented herself as calling from "The State Medicare Office" and, when I mentioned that there was no such entity and asked her from where she was actually calling, she unleashed a torrent of very unladylike profanity at me, thus allowing my to hang up with a big smile.

Thanks for the input. Good to hear the callers are not a particularly dire threat if you give them no info. I can usually place accents, particularly from the Indian subcontinent. The previous "Medicare Providers" callers seemed to have an accent from the African subcontinent. Today's caller had mostly an American accent but was somewhat more soft-spoken than normal. I made a mistake conflating an info-digger with a delayed/missing Medicare card that I am expecting in the mail.

 

[amper42]

I picked original Medicare, and not any Advantage plan. However, I am posting now to try to understand the dangers of some probable scams that may be targeting me. In November, I received a number of phone calls. I see about seven of them on my home phone's call history. This is a landline phone, and I was not at home for some of the calls. All of the calls appear to originate in my US area code, so I am guessing a sim farm is being used. I voted in the November 4th election, so this spate of calls to my usually silent phone may be related to that.

I did pick up three of the calls. All three callers were women. Each started off saying she is calling from "Medicare Providers" or (in the first caller's case) "Medicare Assistance), and then asking me to confirm my street address. They all cited my old address from six years ago, and I told the first two "yes". Today, in a distracted state, I idiotically corrected today's caller about the address. Each caller wanted to "update the database" and "verify information so that I would receive my next Medicare card and be able to claim reimbursement without issues for future medical visits.

All three wanted to know the start date of my Medicare coverage. I lied in the first two cases, and said that it would take me a long time to find my Medicare card to find this date. Each of the callers said that they would wait on the call while I looked for the card. When it became apparent to them that I was not going to come up with the date in any finite time, they hung up on me. I told today's caller that I did not have any card, and had yet to receive a new card. She said she would call back.

I called the Medicare.gov 1-800 line immediately, and had the service rep verify that my online account was not compromised. I googled for the significance of the start date and was unable to find anything related to fraud.

I posted this to ask if any ASR member in the US, or elsewhere, has any info regarding the significance of the start date (it is month/year, and the actual day is probably always the first of the month), and what sort of fraudulent activities it could be used in facilitating. Is it related to the birth month? Can anyone recognize any pattern? I will be cautious to not pick up any such call in the future, or hang up immediately if I do. I have just been incautious thus far because the numbers appear to be from within my area code, and I am expecting a Medicare card to arrive in the mail (just a coincidence). The caller ID shows no other info that the number and the name of my town or a neighboring locality. Certainly no name like "Medicare" which a gov't originating phone call should display.

It's sad to say but I have learned NOT to answer the phone. I have a Panasonic KX-TGD862G cordless phone as a land line and I connect Ooma Telco (Phone over internet) to it. It gives me a phone line for $6.41 monthly. What I like about this setup is the phone will speak the name of each caller as it rings. If I don't recognize the caller - I don't answer. Any important calls not recognized leave a message and I call back. It's that easy to avoid spammers trying to steal information.

I get several calls from spammers each day and their phone numbers are recorded in a log in Ooma. If they leave a message selling me something, like Medicare or any other service it's recorded. If they call more than once I report them to the https://www.donotcall.gov/ (do not call list).

The phone is not your friend. It's become a tool for solicitors and fraudsters to attempt to take advantage of those who answer. Best to screen all calls. It's easy to do and gives you a printed record.

You will never get a call from Medicare. Anyone saying they are Medicare calling you, is a lie. If you don't screen your calls these fraudsters will ask you to divulge any and all private information about your Medicare card or other personal information. If you break rule number 1 and answer: Ask them for their full name and address and please spell it. Ask for the name of the company they represent. Tell them they are on a recorded line, you are on the Do not call list and this call is being reported to the proper authorities. Watch how quickly they hang up.

Best advice, have a caller ID that announces callers. If you don't know them don't answer. They can always fake where they are calling from. Being from your area code is just as likely spam as not.

 

[JustAnandaDourEyedDude]

It's sad to say but I have learned NOT to answer the phone. I have a Panasonic KX-TGD862G cordless phone as a land line and I connect Ooma Telco (Phone over internet) to it. It gives me a phone line for $6.41 monthly. What I like about this setup is the phone will speak the name of each caller as it rings. If I don't recognize the caller - I don't answer. Any important calls not recognized leave a message and I call back. It's that easy to avoid spammers trying to steal information.

I get several calls from spammers each day and their phone numbers are recorded in a log in Ooma. If they leave a message selling me something, like Medicare or any other service it's recorded. If they call more than once I report them to the https://www.donotcall.gov/ (do not call list).

The phone is not your friend. It's become a tool for solicitors and fraudsters to attempt to take advantage of those who answer. Best to screen all calls. It's easy to do and gives you a printed record.

You will never get a call from Medicare. Anyone saying they are Medicare calling you, is a lie. If you don't screen your calls these fraudsters will ask you to divulge any and all private information about your Medicare card or other personal information. If you break rule number 1 and answer: Ask them for their full name and address and please spell it. Ask for the name of the company they represent. Tell them they are on a recorded line, you are on the Do not call list and this call is being reported to the proper authorities. Watch how quickly they hang up.

Best advice, have a caller ID that announces callers. If you don't know them don't answer. They can always fake where they are calling from. Being from your area code is just as likely spam as not.

Thank you for sharing your lessons learned. All that you have written is great advice, and I hope people (including me) will steer their course by it. I worked in the civil service for many a year, and I should therefore have known better than to imagine that Medicare (or any other govt agency) would call me to confirm anything at all. This business of sim card farms is new to me. Their "from" phone numbers are different each time. I should construct a whitelist as you have.

I messed up today, because I did not know why my Medicare card had not yet reached me, and I jumped to the incorrect inference that the reason is that perhaps "authorized Medicare contractors" did not have my correct street address. I know that the start date of Medicare coverage is needed to be input when one creates one's Medicare.gov online account, but I wonder if accidentally disclosing it to scammers poses any danger beyond that. These folk seem very intent on finding out what that start date is.

 

[amper42]

Thank you for sharing your lessons learned. All that you have written is great advice, and I hope people (including me) will steer their course by it. I worked in the civil service for many a year, and I should therefore have known better than to imagine that Medicare (or any other govt agency) would call me to confirm anything at all. This business of sim card farms is new to me. Their "from" phone numbers are different each time. I should construct a whitelist as you have.

I messed up today, because I did not know why my Medicare card had not yet reached me, and I jumped to the incorrect inference that the reason is that perhaps "authorized Medicare contractors" did not have my correct street address. I know that the start date of Medicare coverage is needed to be input when one creates one's Medicare.gov online account, but I wonder if accidentally disclosing it to scammers poses any danger beyond that. These folk seem very intent on finding out what that start date is.

I'm not sure this is important. When you apply for Medicare you tell them the month you would like it to start but that may not actually be the real start date. The process for applying for Medicare has gotten complicated with multiple citizenship checks, birth certificate mailed in and perhaps even more data if you were born on a military base overseas while parents were in the US Military. That verification process takes time and the latest government shutdown didn't help. I would suggest it can take longer now than you might expect to get setup with Medicare initially. If you give it a month longer than you originally expected to get your Medicare acceptance letter you will be close to target.

As far as the scammers, they simply want any info you feed them. The date your Medicare starts doesn't offer them a golden ticket. The Medicare account number does. I would strongly suggest stop answering the phone, keep private info private and screen your calls instead. In the long run, all of the Medicare data will be stolen from doctor's, insurance companies and even the Federal Government via hackers. The only way to fight the fraud is keep data you hold confidential and report fake billings to Medicare and secondary insurance providers. Fraud is growing exponentially. Lock your credit with the three reporting agencies and protect yourself by having tight lips.

 

[Neddy]

A follow on to spam call IDs, regarding voice announcement of incoming caller IDs - esp on land lines:
I've found that a lot of real businesses don't bother to enter their caller ID anymore (name, number), and so end up in the 'leave a message' que....

Most of them are major medical specialties, but some have been plumbers, roofers, etc.
And most of Them don't leave a message - is the youngest generation afraid to leave messages??

(Not sure if this is by intent or b/c IT/phone techs are too pressed for productivity....I worked closely with the person who managed phone services/contracts for the state, and he was very diligent to make sure a) phone setup - cell and landlines - had setup checklist, b) they all had to answer if they had a reason to not show caller ID, and c) set up the desired caller IDs.
Some, like law enforcement, rarely had caller IDs.
It was a Process, admittedly, and slowed down - a tiny bit - the delivery of a new number, but ensured every new line had that addressed.
But he managed something like 50k lines, and their contracts, so was pretty busy, and needed the checklist to make sure all lines followed the same process.
That was (now) nearly 20 years ago, so no idea if the same diligence still applies. I suspect not.)

I've had medical 'schedulers' call nearly endlessly w/o leaving a message - very frustrating.

Anyway, when I do connect with these legit but No Caller ID callers, I always tell them to have their IT department add caller ID info to increase the 'hit rate' of their calls.
A large percentage of them react positively to the suggestion, as they are basically just a call center (local, or corporate) and have no idea who to contact with the complaint about no caller ID.

And I've actually had a few successes - a plumber and two of the medical offices later added caller IDs.

 

[amper42]

To

A follow on to spam call IDs, regarding voice announcement of incoming caller IDs - esp on land lines:
I've found that a lot of real businesses don't bother to enter their caller ID anymore (name, number), and so end up in the 'leave a message' que....

Most of them are major medical specialties, but some have been plumbers, roofers, etc.
And most of Them don't leave a message - is the youngest generation afraid to leave messages??

To be honest, if the person can't leave a message I can't be bothered with them.
Every medical provider will leave a message if they are worth using. But most don't use the phone past initial contact. After that, they typically send email for appointment reminders and such. The good ones also have a portal where you can easily leave a message for the doctor and view notes from your last few visits.

Most workman prefer to use text. They appreciate a picture of what needs to be fixed so they can have parts available. They also find texting fits their workload. The phone might be for initial contact with you calling them but most worker interaction is text these days.

 

[JustAnandaDourEyedDude]

I'm not sure this is important. When you apply for Medicare you tell them the month you would like it to start but that may not actually be the real start date. The process for applying for Medicare has gotten complicated with multiple citizenship checks, birth certificate mailed in and perhaps even more data if you were born on a military base overseas while parents were in the US Military. That verification process takes time and the latest government shutdown didn't help. I would suggest it can take longer now than you might expect to get setup with Medicare initially. If you give it a month longer than you originally expected to get your Medicare acceptance letter you will be close to target.

Yes, there is quite a bit of variability in the actual coverage start date. However, the online account creation process at Medicare.gov requires input of your coverage start date in the format MM/YYYY, in addition to a couple of other bits of info about you. Thankfully, I was unable to give yesterday's caller the start date. When ending the call, she said she would call me at a later date to "verify that you have received your card", which would no doubt involve "verifying" the coverage start date and Medicare number on the card. I hope that the website software is well enough designed and evolved that no-one can override an existing account by having the right info and going through the account creation process again. I had a brain burp yesterday leading to correcting my home address with the scammer, while I had not done so with the previous scammers. The Medicare rep at the 1-800 number confirmed exactly what you said, that Medicare would never call me on the phone, adding that Medicare never employs third party contractors to facilitate any Medicare customer-related process. She said that I could print a replacement card from my online Medicare account. I am sure this makes online account takeover all the more a scammer goal.

As far as the scammers, they simply want any info you feed them. The date your Medicare starts doesn't offer them a golden ticket. The Medicare account number does. I would strongly suggest stop answering the phone, keep private info private and screen your calls instead. In the long run, all of the Medicare data will be stolen from doctor's, insurance companies and even the Federal Government via hackers. The only way to fight the fraud is keep data you hold confidential and report fake billings to Medicare and secondary insurance providers. Fraud is growing exponentially. Lock your credit with the three reporting agencies and protect yourself by having tight lips.

All excellent advice. I will be on my guard in the future, and never disclose personal info to anyone whose identity and authorization I cannot verify beyond a doubt. Because of the succession of different callers in November, at least three of whom (and likely all of whom) were fishing for the same bit of info (the coverage start date), I suspect a call center is behind this (possibly abroad). They had my phone number and the old address. They each asked me to confirm the address to give me the psychological impression that they were legit. They must be using robocall software through a sim card farm which triggers a connection to a live scammer when you answer your phone and say "hello". My phone company adds the text "Probably fraud" to the Caller ID of various incoming calls when the phone company tracks their pattern, and I never pick up such calls. However, the phone company's fraud-prediction software seems defeated by this latest scammer strategy of using constantly changing randomly selected lines from large sim card pools. The scammers may be replacing the sim cards as and when they get tagged by the phone company. As you say, exponentially growing fraud.

 

[amper42]

Medicare does not call you. Period.
If someone is calling you and wants any info about your Medicare card start date or account numbers hang up.