AMERICANS DUMP MEDICARE ADVANTAGE PLANS OVER AI

Are Seniors about to be killed off by Artificial Intelligence Algorithms?

Smart seniors are not waiting to find out. Seniors have tried Medicare Advantage Plans and are saying no more. They are dumping Advantage Plans and PPOs because the care rendered by the MA plans is chock full of delays and denials. The insurance companies and hospitals don’t care at all. Seniors are not particularly high tech so they don’t actually understand how a computer system can call the shots over medical care. They always thought doctors made those decisions. But now more than often, they find they don’t have a regular doctor because they rarely see the same doctor twice. Part of the overall plan of Medicare Advantage plans is to force patients into thinking all doctors are a commodity and one is just as good as the other which they know from experience is not true. 

With denials of care as an everyday policy, these patients are getting sicker and many will die before they ever receive care. That may suit the computer but it doesn’t suit the patient. So the patients are dumping MA plans and going back on Medicare. Medicare allows the patient to see the doctor of their choice and go to the facility of their choice WITHOUT PRE-APPROVALS. Pre-Approvals subject patients to deal with non-medical front office clerks that act more as firewalls to deter care and cause delays. 

AI denials:
A major factor behind the shift away from Medicare Advantage is the growing use of AI algorithms by insurance companies to make coverage decisions, often resulting in denials for seemingly necessary medical procedures, particularly post-acute care, which patients feel are being prioritized for cost-cutting over their health needs.

Patient frustration:
As AI algorithms become more sophisticated, patients are reporting increased difficulty navigating denials, leading to lengthy appeals processes and frustration with the perceived lack of transparency in decision-making. Further inexperienced doctors do not know how to properly code for requested procedures. Insurance companies take full advantage of that and it angers the patients. 

Lawmaker scrutiny: [This is a joke.]
Concerns about the use of AI in Medicare Advantage have drawn attention from legislators, with calls for the Centers for Medicare & Medicaid Services (CMS) to implement stricter oversight and regulations on how insurers utilize AI to make coverage determinations the Impact on vulnerable populations. 

THIS BOILS DOWN TO POLITICAL HOGWASH:

Before you get all excited about Elizabeth Warren holding yet another hearing, remember that Democrats and Republicans voted for their own PPO insurance system six days before giving Obamacare to the public. Their PPO is funded 100% by the government, for life. No out of pocket, everything approved and can be used worldwide. Pelosi broke her hip in a fall in Europe and got instant care and instant surgery and it didn’t cost her a dime. Congress has what they want and the MA patient is just the fertilizer to which they pander.

Congress knew to get out of Obamacare and Medicare when they did. 

CMS rarely enforces Medicare Fraud with MA plans until they find a multimillion dollar theft by a pharmacy for example that falsely bills for medications they don’t actually give to the patient. Otherwise they don’t bother, and if they do they delay by years and patients are NEVER COMPENSATED! Patients report procedures for which they were billed but for which they were never giving the procedure. CMS does nothing. 

Shift to traditional Medicare:

Medicare Advantage only makes money by denying care so figure it out… Seniors should smarten up and dump their MA programs and return to traditional Medicare. MA is an abysmal failure.

But but but what about the strain on the Medicare system?

Oh but but but… there is no strain on the backs of the seniors and taxpayer to pay for Pelosi’s PPO and international hip replacement surgery. Every patient that has suffered delays in care and denials should dump their MA plan immediately. It is not going to get better. It is a failed system. The AI algorithms don’t care whether you live or die. The hospital network and insurance firewalls you talk to on the phone don’t care whether you live or die. You are just an inconvenience to them; you are worthless. GET OUT of MA plans ASAP!

Increased litigation: Unless you bring your own case no lawyer is going to take a case over your denial of care unless it results in wrongful death. You won’t be around for that. 

What can be done? Get out, Get out, Get out of Medicare Advantage plans they are just Disadvantaged Plans.