The Center for Medicare Advocacy, Justice in Aging, and the Medicare Rights Center have issued a joint statement condemning the 2018 edition of Medicare & You,
the annual guide published by the federal government; the groups say
that the Trump administration is lying to seniors in order to trick them
into switching to privatized, HMO-run Medicare Advantage programs, away
from the superior, publicly maintained Meidcare system.
First, in several places, the Handbook suggests that Medicare Advantage
is the less expensive alternative for beneficiaries. This is an
overstatement. There are many variables determining whether enrollment
in a M edicare Advantage plan may be more or less expensive for any
particular Medicare beneficiary. Factors including premiums, co –
payment structure, available providers, the individual’s medical needs,
etc. all can affect the relative affordability of Medicare Advantage
generally as well as the affordability of any particular Medicare
Advantage plan. The repeated suggestion that Medicare Advantage can save
beneficiaries money does not fairly and fully represent these
realities.
Moreover, in numerous descriptions, the Handbook fails to make clear a
key distinction between Original Medicare and Medicare Advantage:
Original Medicare provides access to all Medicare participating
providers nationwide, while Medicare Advantage limits access to a set
network of providers in a specific geographic area.
Even more problematic is the treatment of prior authorization
requirements in Medicare Advantage. On both page 6 and page 62, the
Handbook attempts to paint this restriction on access to services as a
benefit, rather than as what it is, a mandatory hurdle for Medicare
Advantage members that is not required for individuals in Original
Medicare. On page 62, the Handbook goes so far as to describe prior
authorization as a “right” that people in Original Medicare “can’t get.”
Describing a restriction as a “right” and then saying that people who
are not subject to this restriction are disadvantaged twists the facts
beyond recognition.
