Are Your Senior Patients Aware of the Disadvantages of Medicare Advantage Plans? (Copy)
Are You Aware That by December 30, Millions of Patients May be Denied Access to Needed Medical Services Including Your Hospital?
By Barbara Carey and Mike McCall
In the US 55.8 million people, 16.8% of the population is over 65 years of age. The Boomer population, the largest group of citizens, are in that category and they are major users of healthcare services. They are making critical Medicare plan decisions which will determine access to your services and providers or be denied access for two key reasons: (1) Your hospital is not “in-network” or (2) Your treatments or tests are denied authorization.
The major thing that patients need to know about their Medicare coverage is that Medicare Advantage plan administrators will decide which providers and services that they can access and how much care they can receive. In Original Medicare, their physician makes that decision in collaboration with patients.
Hospitals who are proactive and educate their senior patients will help them make the right decision. Systems with thousands of patients can influence this critical decision by providing accurate and timely information through their physician groups and service points. This will give especially those complex patients continued access to provider and hospital services because they will have the information to make an informed choice. It will save the hospital the administrative hassle and cost of going through the authorization process and in many cases the denial process with Medicare Advantage Plans.
In the rural hospital arena, approximately 70% of a hospital’s revenue is from Medicare patients so this decision is really important to a rural hospital’s financial well-being. These institutions need to protect access to their services and their already thin margins.
Is it a hospital’s right to provide consumer information?
Yes, a proactive medical provider can help patients sort through the celebrity ads and the complicated Medicare rules to see what is really important to their future access to healthcare services.
One thing that is important for current Medicare Advantage Plan patients to know is that they can switch back to Original Medicare at this time. However, supplemental Medicare or Medigap coverage is not guaranteed. They must go through a vetting or underwriting process, and they can be denied coverage.
This fact is often overlooked when patients have experienced denials and want to switch back to Original Medicare.
If a hospital has Medicare communications prepared to give to their patients comparing Original Medicare to Medicare Advantage plans, they need to disseminate these immediately. If leaders need information, TCI has a vetted Fact Sheet and Presentation that have accurate, easy to understand information ready to help now. A video for website use will be available in early December.
55.8 million people are making their plan decisions based on what celebrities say they need. There is a better way.
Help your patients understand the differences in Original Medicare and Medicare Advantage Plans so they can make the right decision for their healthcare needs.
Contact TCI for information on our Medicare Tool Kit!
We Help Our Clients Understand Their Environment and to Find Solutions.
Call Us 1-888-922-2824 or Email barbara@tciconsults.com
