A retiree in Wisconsin opens a letter from her cardiologist’s office: starting next January, the hospital system will no longer be in-network for her Humana (NYSE: HUM) Medicare Advantage plan. She has been with that cardiologist for nine years. Her first instinct is to switch back to Original Medicare and buy a Medigap policy. That intention is understandable. Whether it works depends on her health, her state, and one unforgiving deadline.
Likely now she will be considered uninsurable.
Hospitals commonly cite slow reimbursement, payment disputes, prior-authorization requirements, and the administrative cost of dealing with Medicare Advantage plans. In other cases, the insurer terminates the contract. Either way, the negotiations happen across a conference table, and the patient loses a nine-year relationship with her doctor.
It seems like Wisconsin might be one of the few states where this will work to her advantage:
Google AI:
Medical underwriting: Because you have had Medicare Advantage for 10 years, applying for Medigap usually means the insurance company can review your health history and can charge you more or deny you coverage based on your medical background (unless you live in a state like Wisconsin, New York, or Connecticut that has continuous open enrollment or different consumer protections).
I tried to verify this at the source but a quick word search for “Wisconsin” produced no results so no assurance that the AI response is valid.
Congress has made some progress in reducing health care costs. Some drug prices are now negotiated. The prez has offered lower tariffs when drug companies agree to sell in the US for same prices negotiated in Europe.
Steps in the right direction but health care costs continue to rise faster than inflation.
Healthcare is a priority in most families. Along w food and housing, energy, utilities. For most rising health care costs means reduced savings.