Manage episode 522112525 series 3673442
Medicare Advantage vs Original Medicare: What seniors need to know before choosing coverage. In this comprehensive episode, we break down the critical differences between Medicare Advantage (Part C) and Original Medicare, exposing the hidden costs, network restrictions, and prior authorization requirements that affect over 31 million Americans.
Discover why major hospitals like Mayo Clinic are dropping Medicare Advantage contracts, how insurance companies profit from denying care, and what "risk adjustment upcoding" costs taxpayers $25 billion annually. We explain complex healthcare policy using simple analogies anyone can understand—no medical degree required.
Topics covered:
- How Medicare Advantage actually works (and who pays whom)
- Real-world cost comparisons for healthy vs. sick seniors
- The truth about "$0 premium" plans and hidden out-of-pocket costs
- Prior authorization nightmares and denial rates 10x higher than traditional Medicare
- Why Medicare Advantage might save you money when you're healthy but cost thousands more when you're sick
- Network adequacy problems and access to specialized care
- Hospital and physician perspectives on MA reimbursement rates
- Political reasons Medicare Advantage persists despite costing more
- Practical advice for choosing the right Medicare coverage
Whether you're approaching Medicare eligibility, helping aging parents navigate their options, or simply want to understand one of America's most expensive healthcare programs, this episode provides the clear, unbiased information you need to make informed decisions.
This podcast was created with the assistance of artificial intelligence with publicly available resources.
4 episodes