Hospital association issues Medicare plan warning

It is the time of the year when enrollment is open in the federal governments Medicare program and area residents report their mailboxes are being filled with advertising offers soliciting business related to the medicare program.

However, not all of the offers may be as good as they sound.

The Nebraska Hospital Association has been telling seniors to make sure they full understand what they’re signing up for when they chose a plan.

The Omaha World-Herald reported in October that nationwide about 51 percent of seniors are now covered by Medicare Advantage plans administered by private health insurers. That’s up from just more than a third of seniors five years ago.

On first glance the advantage plans are appealing because they offer what appears to be lower out-of-pocket expenses. But don’t be so sure that will always be true in the long run.

Jeremy Nordquist, the president of the state hospital association, said the plans are restricting access to health services by denying covered services that are medically necessary and by requiring extensive documentation to demonstrate the necessity.

Not all advantage plans are accepted by rural hospitals.

The World-Herald story said 90 percent of Nebraska hospitals reported the Medicare Advantage plans negatively impact the care the hospital can provide and more than 92 percent said prior authorization required under the plans delays necessary care. In many instances the patient may have to travel to a distant hospital to receive the desired care.

Subscribers to this newspaper who have strong opinions about the Medicare Advantage program have paid for the publication of an advertisement urging seniors to become informed before signing up for an Advantage plan. That advertisement will be published in seven issues of The Express.