by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today January 15, 2025
Even though almost all Medicare Advantage (MA) plans boast coverage of supplemental benefits – dental, vision, and hearing – enrollees didn’t get more care, and they spent just as much out of pocket as those with traditional Medicare, a cross-sectional study showed…
In 2023, MA plans enrolled more than half (51%) of Medicare beneficiaries… A 2024 found that 31% of MA enrollees hadn’t used their supplemental benefits in the past year, with 58% not using dental, 59% not using vision, and 93% not using hearing benefits…They found that many MA beneficiaries weren’t aware that they had dental (54.2%) or vision (54.3%) coverage…
Cai and colleagues pointed out that during the study period, MA plans were paid $37.2 billion each year more than taxpayers would have spent on traditional Medicare for those enrollees (a figure that’s expected to now total $82 billion annually). Only about 10% of that cost (the $3.9 billion) went to MA enrollees as payments for supplemental services, they said. Instead, a recent study showed that insurer overhead and profit accounted for a far larger share of those overpayments… [end quote]
Insurance companies bombard the elderly with advertising around open enrollment time but fail to tell them how to use their benefits.
Totally unrelated as I am on conventional Medicare, but Blue Cross honked up their billing for my supplement. Received an e-mail on the 6th reminding me of the charge that will occur on the 25th. Received an e-mail on the 14th, reminding me of the charge that will occur on the 25th, but for double the amount. Checked my account on their web site, which showed the double amount due. Called “customer service” last night, and the automated thing said over an hour wait, so decided to try again this morning. This morning their automated attendant said they have found their system has billed everyone for February, and March, at the same time, and said to only pay the February premium. My account on the web site still shows the double amount due, and no way of paying only the February premium. So, I get to circle back again, tomorrow, to see if they have this straightened out yet…because I have nothing better to do, than circle back, repeatedly, to see if corporations are doing their job.
/sarcasm
Probably mentioned this before. I have a friend in work, a middle manger, who has his own insurance company. He is selling MA plans.
I have kidded with him that the entire lot of them are liars. He laughed the way I presented it. I have charm in person. Why bother on the internet? He did agree they all lie. He claims he can see every single lie very clearly, “it sucks”.
Tell them if they don’t get their billing straightened out ASAP, you will start billing them by the hour for your time spent fixing their problem. Fix or pay–their choice.
I wouldn’t be surprised that if you sent them an invoice for something like this, they might just pay it in 30 days or in 60 days. If their software to match invoices to PO numbers is as bad as their software for claims/etc is, then it’s probably a 50/50 chance that you would get a check in the mail someday.
That has crossed my mind, right after my annual checkup, with a clean bill of health. Seems that, even if you have a supplemental plan, no other company is required to take you on, unless they think you are a good risk.
I pay 3 Blue Cross supplementals. Mine, Neurospouse and her Dental supplemental (waste of money in my opinion).
I pay them as a (non-automated) bill-pay through my bank on the first of every month (allowing for weekends), and they all are debited properly by my bank.
Occasionally, one of us receives a snail-mail notice that we have a payment due which sends me checking whether I might have missed something or selected the wrong account etc., only to find when I check on-line that everything is up to date.
It’s my belief that their accounting dept. is just sometimes slower to process the payments, but the computer-generated notices get triggered while that process is on-going.
It seems to take as much as 2 weeks to process. Maybe there are manual processes involved and they’re short of staff?
It’s never all of the BCBN accounts, usually just one but it happens 3-4 times per year.
The supplemental insurance to traditional Medicare covers the out of pocket costs that Medicare doesn’t cover 100%, right? If Medicare doesn’t cover the procedures in the first place…
I have seen a couple of ads for “dental insurance” (on TV). They claim to be a “real” insurance company, but I have not looked at what they offer or cover.
Well even the dental insurance that folk are used to as part of an employer provided group health plan isn’t really “real” insurance. It might provide some insulation against costs of some dental needs, there’s quite a low annual limit etc. Granted it’s usually for no extra charge so no reason not to have it (what my office manager called a “throw 'em a bone plan”), it’s rarely worth trying to copy something similar when you’re paying the premiums yourself.
I know most dental “insurance” isn’t “real” insurance (i.e. Delta Dental). An employer paid for it, so it was worth having (g). I never bought it myself because I read the benefits (capped at $1K or something silly like that) and the annual premiums were $600-$800/yr, so a bad deal.
I guess I misspoke calling a supplemental. It’s just dental insurance that Neurospouse decided she wanted and got it from BCBS. Billing and payment dates are the same as our Supplemental plans so I just considered it as the same.
As you say, if Medicare doesn’t cover it, it’s not really related to Medicare - it’s just the same provider.
Thanks for correcting my thinking on that.
You’re right. Additionally, that $600-$800/yr, is the premium when part of a group health plan so looking for something on your own is likely to cost more for the same converage.
Folk can get very odd ideas about dental insurance… and dental care itself, I guess. So many examples but one in particular illustrates the faulty reasoning I’m talking about. A woman about my own age (say, late 40s back then) had been part of the practice for about 5 years. Started with quite a lot by way of dental needs…so made good use of her dental benefits…but moved quite quickly into “maintenance mode” with minimal to no treatment needs beyond a periodic oral exam and routine cleanings. Towards the end of one visit, she was excitedly telling us about her new job…travel allowance and a load of other perks and a salary increase of $15k a year! She went on to say that she sadly wouldn’t be able to come any longer…we thought, naturally, that she would be moving also for her new job, like you would, right? Nope, nothing like that…her new job didn’t come with dental insurance!! I just burst out laughing at the incongruity of such a comment. My office manager asked her just how much of that extra $15k she’d be spending on the sort of minimal care she’d be likely to need based on her track record. I don’t think she really knew but it was probably more than she wanted to part with. Cannot make this stuff up.
