Re “More than 12,000 affected by latest health plan changes: Must find new doctors, switch plans, or pay more” (Business, Oct. 4): The cases of Beth Israel Lahey Health and Mass General Brigham illustrate one of the disadvantages of enrolling in Medicare Advantage (the privatized, for-profit version) as opposed to traditional Medicare (the original, largely public version). All over the country, hospitals and medical practices are withdrawing from insurance networks over delayed or denied payments for medically necessary care.
Patients often discover that they must find a new doctor or that they no longer have access to the nearest hospital. Traditional Medicare does not have restrictive networks, and patients may choose any provider in the country that accepts Medicare, as nearly all do.
There is a further disadvantage to Medicare Advantage. Unlike traditional Medicare, the plans require prior authorization of certain tests, medicines, and procedures. The more denials they issue, the more profits may grow.
Patients might be happy with their plans and realize savings in the short term while they are still healthy, but when they become seriously ill, they often discover that their insurance isn’t there when they need it most. Statistics and countless anecdotes attest to this.
Seniors should think long term, ignore the enticing and misleading ads, and choose traditional Medicare, not Medicare Advantage.
Michael P. Bacon
Westbrook, Maine
Plan disruptions one of many Medicare Advantage disadvantages
