AI Cannot Be Used To Deny Health Care Coverage, Feds Clarify To Insurers 81
An anonymous reader quotes a report from Ars Technica: Health insurance companies cannot use algorithms or artificial intelligence to determine care or deny coverage to members on Medicare Advantage plans, the Centers for Medicare & Medicaid Services (CMS) clarified in a memo (PDF) sent to all Medicare Advantage insurers. The memo -- formatted like an FAQ on Medicare Advantage (MA) plan rules -- comes just months after patients filed lawsuits claiming that UnitedHealth and Humana have been using a deeply flawed, AI-powered tool to deny care to elderly patients on MA plans. The lawsuits, which seek class-action status, center on the same AI tool, called nH Predict, used by both insurers and developed by NaviHealth, a UnitedHealth subsidiary.
According to the lawsuits, nH Predict produces draconian estimates for how long a patient will need post-acute care in facilities like skilled nursing homes and rehabilitation centers after an acute injury, illness, or event, like a fall or a stroke. And NaviHealth employees face discipline for deviating from the estimates, even though they often don't match prescribing physicians' recommendations or Medicare coverage rules. For instance, while MA plans typically provide up to 100 days of covered care in a nursing home after a three-day hospital stay, using nH Predict, patients on UnitedHealth's MA plan rarely stay in nursing homes for more than 14 days before receiving payment denials, the lawsuits allege.
It's unclear how nH Predict works exactly, but it reportedly uses a database of 6 million patients to develop its predictions. Still, according to people familiar with the software, it only accounts for a small set of patient factors, not a full look at a patient's individual circumstances. This is a clear no-no, according to the CMS's memo. For coverage decisions, insurers must "base the decision on the individual patient's circumstances, so an algorithm that determines coverage based on a larger data set instead of the individual patient's medical history, the physician's recommendations, or clinical notes would not be compliant," the CMS wrote. "In all, the CMS finds that AI tools can be used by insurers when evaluating coverage -- but really only as a check to make sure the insurer is following the rules," reports Ars. "An 'algorithm or software tool should only be used to ensure fidelity,' with coverage criteria, the CMS wrote. And, because 'publicly posted coverage criteria are static and unchanging, artificial intelligence cannot be used to shift the coverage criteria over time' or apply hidden coverage criteria."
The CMS also warned insurers to ensure that any AI tool or algorithm used "is not perpetuating or exacerbating existing bias, or introducing new biases." It ended its notice by telling insurers that it is increasing its audit activities and "will be monitoring closely whether MA plans are utilizing and applying internal coverage criteria that are not found in Medicare laws."
According to the lawsuits, nH Predict produces draconian estimates for how long a patient will need post-acute care in facilities like skilled nursing homes and rehabilitation centers after an acute injury, illness, or event, like a fall or a stroke. And NaviHealth employees face discipline for deviating from the estimates, even though they often don't match prescribing physicians' recommendations or Medicare coverage rules. For instance, while MA plans typically provide up to 100 days of covered care in a nursing home after a three-day hospital stay, using nH Predict, patients on UnitedHealth's MA plan rarely stay in nursing homes for more than 14 days before receiving payment denials, the lawsuits allege.
It's unclear how nH Predict works exactly, but it reportedly uses a database of 6 million patients to develop its predictions. Still, according to people familiar with the software, it only accounts for a small set of patient factors, not a full look at a patient's individual circumstances. This is a clear no-no, according to the CMS's memo. For coverage decisions, insurers must "base the decision on the individual patient's circumstances, so an algorithm that determines coverage based on a larger data set instead of the individual patient's medical history, the physician's recommendations, or clinical notes would not be compliant," the CMS wrote. "In all, the CMS finds that AI tools can be used by insurers when evaluating coverage -- but really only as a check to make sure the insurer is following the rules," reports Ars. "An 'algorithm or software tool should only be used to ensure fidelity,' with coverage criteria, the CMS wrote. And, because 'publicly posted coverage criteria are static and unchanging, artificial intelligence cannot be used to shift the coverage criteria over time' or apply hidden coverage criteria."
The CMS also warned insurers to ensure that any AI tool or algorithm used "is not perpetuating or exacerbating existing bias, or introducing new biases." It ended its notice by telling insurers that it is increasing its audit activities and "will be monitoring closely whether MA plans are utilizing and applying internal coverage criteria that are not found in Medicare laws."
Genetic Nondescrimination (Score:5, Interesting)
I mention it because you can just imagine what the super-consolidated insurance+provider networks (looking at you, United Healthcare bastards) could do with large data models ("AI" in common usage these days) to deny coverage and care. It's an example - flawed, imperfect, rare, and controversial though it is - where government has shown a little foresight and enacted some real protections for its citizens.
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And the "no pre-existing conditions" provisions of the Affordable Care Act ("Obamacare") from 2010.
There's no guarantee that one will continue on...if Trump wins (which in the realm of possibility), he's been talking of repealing the ACA. Of course, he said that last time and did nothing, so like so many things Trump says it's unclear what he'll really do until he does or doesn't do it. But for my liking, there's too much of a possibility of that becoming reality. If not Trump, given conservative hostility to healthcare we're potentially always one election away from that super-consolidated scenario anyw
Re:Genetic Nondescrimination (Score:5, Interesting)
Anonymous Coward, allow me to introduce you to this organization called the US Congress. They are very good at getting in their own way, and are largely unable to accomplish anything - evil or helpful. Repeal would have to come from Congress. Sure, Trump may win in November, but even under the more generous projections I've seen, he won't have a sizable House majority, nor will Republicans have >60 votes in the Senate. This makes repeal of Obamacare a practical impossibility. And even Republican control of government doesn't make repeal a certainty: there may actually be a few lawmakers that think wide access to health insurance is good (or, at least, settled) policy. Don't forget: it was John McCain, a Republican, that tanked the effort last go 'round.
Trump can, through executive action, appointments, regulatory moves, and general malevolence, do a lot to undercut Obamacare, but an actual repeal ain't gonna happen.
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Damn, I have mod points and was going to mod you up but I misclicked and moded you down so I'm replying to undo my mod.
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That's a very pollyana outlook, I think. Back in early 2016, even the most pessimistic projections said trump had pretty much no chance and that the nomination would go to a somewhat more sane republican like Kasich , Rubio, or even Jeb. And given just how razor-thin the margins are in congress, I don't think it's wise to dismiss the possibility that he will not just win, but gain control of both houses and get a rubber stamp on all his whims, rants, rages, and other braindroppings.
You point out McCain, s
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That's a very pollyana outlook, I think. Back in early 2016, even the most pessimistic projections said trump had pretty much no chance and that the nomination would go to a somewhat more sane republican like Kasich , Rubio, or even Jeb. And given just how razor-thin the margins are in congress, I don't think it's wise to dismiss the possibility that he will not just win, but gain control of both houses and get a rubber stamp on all his whims, rants, rages, and other braindroppings.
A person who has stated that he will be a dictator if elected - what is the use of a congress when you have to obey his order. You don't need anyone but soldiers to do that, And he plans on purifying the blood of america, and getting rid of vermin as well.
I'll be if he's elected, at least those of us who obey will get pretty spiffy uniforms, if prior art is any indication.
On which side will you stand citizen?
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Trump can, through executive action, appointments, regulatory moves, and general malevolence, do a lot to undercut Obamacare, but an actual repeal ain't gonna happen.
He has already stated that he will be a dictator, so there will be only one power, and he has the ability to kill anyone or anything in his way using Seal Team six..
So congress doesn't need to pass anything, and the supreme court is defunct, and the only people needed are those that enforce his will.
Thats the weird thing - ha says exactly what he plans on doing, and for some weird reason, Republican politicians that are desperate for power don't understand that if Trump is elected, there will be Tru
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Of course there will be voting, just limited counting.
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Repeal would have to come from Congress.
What makes you think Trump will not go full dictator if he gets re-elected? What makes you think Congress will still exist? You saw how he wants to hold on to power. The only reason to elect him now is to serve a huge "Fuck YOU!" to those who own everything. It will result in the end of America.
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The Former Alleged President (FAP) had a good run at repealing the ACA, he needed the Senate to sign on to that repeal. However, John McCain would not fall for the bs and earned FAP's never ending hatred. It isn't that FAP had any particular qualm about the features of the ACA, it was that it was Obama's program.
FAP did the same thing for the JCPOA, the agreement with Iran to put a damper on their nuclear program for awhile.
FAP has no policy positions in the sense of an ideology, he cannot think that far ah
Re:Genetic Nondescrimination (Score:5, Insightful)
FAP has no policy positions in the sense of an ideology, he cannot think that far ahead.
I think that understates the risk of the "FAP". He may still have no clue, but Project 2025 [wikipedia.org] is a well thought out ideological attempt to turn the USA into a proper dictatorship with real fascist / top down command and control well integrated. This is very much like in 1932 when senior business leaders thought they'd place another "great" leader into place and control him. We know exactly what he's planning but many people are in denial.
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He can't even cite his favorite Bible verse [youtube.com]. Not even one of the 10 commandments. He certainly wasn't going to mention the one about bearing false witness. That's how little he thinks.
The Wrong Ban. (Score:5, Insightful)
It would seem these days that when Greed N. Corruption is told “No”, Greed simply finds a way to re-define a technology to get around a ban.
Prepare for “AI” to be re-defined into something that becomes quite the loophole, and does fuck all to prevent abuse.
Start banning re-definition abuse. It’s excessively stupid and confusing anyway.
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It would seem these days that when Greed N. Corruption is told “No”, Greed simply finds a way to re-define a technology to get around a ban.
Prepare for “AI” to be re-defined into something that becomes quite the loophole, and does fuck all to prevent abuse.
Start banning re-definition abuse. It’s excessively stupid and confusing anyway.
I suspect all this means is that they'll need a human to approve the rejection.
It's like putting a bandaid over a sucking chest wound. The entire US health care system is made to be abused.
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I've read alot of reddit, and there are stories of people secretly approving even though they weren't allowed and jeopardizing their jobs. Ai would never do that.
#Tangential #anecdotal
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The AI regulators believe that people sitting in insurance offices are twiddling their mustaches, waiting for a minority of the Wrong Kind to ask for something, so they can feel
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Nah, the mustache twiddlers with the dopamine high are carefully tucked away behind a couple layers of bureaucratic flowchart followers for their protection. The dopamine hit doesn't come directly from the denial, it comes from the resulting tiny bumps in the quarterly profits.
That's NOT AI (Score:2)
Which is defined as a process above and beyond simple flow chart following. What's needed is a system that prints out its justification for the decision, based on the data given to it. This should be mandatorily supplied to the customer.
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Re:The Wrong Ban. (Score:5, Insightful)
But that's not what they did. They designed a system to ignore criteria they were legally required to consider and to use criteria they were forbidden to use to make an illegal decision while shrouding it all in a fog so nobody could blow the whistle. Meanwhile, the former flowchart followers weren't suddenly given interesting and rewarding jobs, they just became Stepford people whose primary job was to say "COMPUTER....says no" (glassy stare optional).
Since AI decision making is by nature opaque and the health insurance deniers have already demonstrated their tendency to break the law and obfuscate the evidence, they are not trusted to use it.
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1. Jim: Wow, these regulations are thousands of pages, this is too complicated. Hey Bob, what do I do for this case? 2. Bob: Oh, I think Janice had a case like this, ask her.
And thus Janice’ preferences were enshrined into the system. The obvious solution of course, is more regulation!
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You believe the AI did that, do you? How did you know it's name is Jim?
If the regulation contains a thousand rules, it's because the insurance provider twisted logic into a pretzel with lawyers and found a gray area to do the wrong thing in 999 times.
Is it really that hard to stop practicing medicine without a license and follow the doctor's advice?
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These used to be called expert systems. The difference between an expert system and AI is anyone's guess.
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It's not so much that they will change the definition, but that they will use or develop a product that doesn't fit that definition. Re-enter "machine learning" or "algorithmic scoring models."
What *is* AI anyway! We nerds know that it's not *actually* intelligent, but a fancy prediction model. So what did the Feds ban, exactly?
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So what did the Feds ban, exactly?
Use of computer software to automatically generate healthcare denial without an explanation. The "algorithm" covers what's really banned and the "AI" covers excuses people could have to claim their software wasn't working on a traditional algorithm.
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I've spent years working in healthcare. That kind of "ban" would be extremely easy to circumvent. Just provide an explanation. The explanation might be a generic catch-all, but it would be an explanation.
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That's true. However it's a fault of the system. This would be overcome very easily if anyone cared, or more specifically, if the people in charge of the law cared. You simply give 20+ year jail sentences to anyone who instructs people to do this and offer bounties equivalent to at least a years salary of an insurance analyst for proof of deliberate misbehavior. "It would cost more" they say. I laugh at this knowing that in France healthcare is effectively universal, much cheaper than in the US and actually
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Right, because it's really easy to tell--and prove--when someone does something to work around the rules! In most civilized countries, you are innocent until proven guilty, and that's an intentionally high legal bar. I have no desire to live in a country where laws are so draconian. It might solve the problem in your imaginary world, but that same draconian rule will also smash completely innocent people, because the law (and bureaucrats) are too dumb to distinguish between those who are intending to do rig
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Right, because it's really easy to tell--and prove--when someone does something to work around the rules! In most civilized countries, you are innocent until proven guilty, and that's an intentionally high legal bar. I have no desire to live in a country where laws are so draconian.
There's a difference between actually enforcing laws and changing the principles of "innocent until proven guilty". In fact, if you look at the current two tier system of justice, which both the UK and the US have, in the bottom tier (normal/poor people) you end up with very little of that protection whilst in the top tier (rich people/companies) you end up with a complete failure to deliver justice. In this particular case I'll say that the US is worse than the UK simply because we don't have nearly as muc
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Let's grant that your two-tier system of justice is real, for the sake of argument. How does your draconian ban, the one you suggested at the start of this thread--how does such a ban make any kind of positive difference? The insurance companies are clearly in that top tier, and will use their lawyers to get around that ban. The little guys, the solo doctor who can't afford expensive lawyers, will be the ones crushed by such a ban. To the extent that your two-tier system of justice is real, tough bans don't
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Let's grant that your two-tier system of justice is real, for the sake of argument.
Thanks ;-)
How does your draconian ban, the one you suggested at the start of this thread--how does such a ban make any kind of positive difference? The insurance companies are clearly in that top tier, and will use their lawyers to get around that ban. The little guys, the solo doctor who can't afford expensive lawyers, will be the ones crushed by such a ban. To the extent that your two-tier system of justice is real, tough bans don't undo that.
This is no special ban. There's nothing magical here. This is a simple attempt at enforcing fraud laws. The small normal doctor will not be committing fraud and so is very unlikely to be touched. In the case of the large insurance company I would imagine a process like the following:
multiple clients report fraudulent refusal of treatment to the police
using statistically competent people and legally required access to health care data they establish that fraud is likely
instead of treating this as a
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This is a simple attempt at enforcing fraud laws.
This is the issue, there is nothing simple about enforcing fraud laws. Let's take a couple of your example bullet points:
multiple clients report fraudulent refusal of treatment to the police
So how do police know that the "multiple clients" aren't actually trying to scam or blackmail or otherwise pressure the doctor? To make that determination, police must conduct an investigation. This is neither cheap nor easy.
using statistically competent people and legally required access to health care data they establish that fraud is likely
As for plea agreements, the fact that the vast majority of cases end up with plea agreements, doesn't indicate that the vast majority of cases end in injustice. Yes,
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It would seem these days that when Greed N. Corruption is told “No”, Greed simply finds a way to re-define a technology to get around a ban.
These days? What halcyon days were otherwise? And did people live in those days?
They don't even need to do that (Score:5, Insightful)
The Koch Brothers and the Heritage Foundation spend millions if not billions packing the courts for 40 years while the American voter worried about gays and political correctness and woke and the Satanic Panic and whatever else moral panics they could cook up. We're really starting to see and feel those consequences on an individual level. The rights our grandfathers are being slowly stripped away by the courts and by gridlock in legislatures.
The Remedy is to vote and to vote in primary elections, paying attention to who the corpos are.
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rule the regulatory body can't do the thing they were created to do w/o Congress and rely on pro-corporate members
The revolving door stopped doing what they wanted, so they pretend that the body was never supposed to be independent. But for as long as corporate influence worked directly on the regulatory body, nobody said anything.
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No. What we really need to ban is anyone besides the patient's doctor having any say or veto on the care plan that the doctor prescribes and the patient consents to. Yes, no AI; but also no pinheaded buerocrat, no moralizing pill counter in the pharmacy, no lawyer, and definitely no politician, should ever be allowed to come between the patient and the care their doctor deems appropiate.
Yes, I know the obvious retort. And yes, doctors can go rogue and do need oversight. But that oversight needs to be by
Time for the human accountability for AI act (Score:3)
Re:Time for the human accountability for AI act (Score:5, Insightful)
You're overlooking the 'magic' of training an AI model on a large set of data. Nobody designed the model or programmed it to say no. It was generated by an algorithm which used a set of data from insurers who have been rejecting claims out of hand for decades.
The bias is in the data used to train the model and there's no easy way to filter it out (nor would the insurance companies like it to be filtered out as that bias is very profitable for them).
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Nobody designed the model or programmed it to say no.
Not saying you're wrong, but incomplete. They have to prompt the model for the output. While not traditional programming, prompt engineering is a loose form of programming. That isn't to say I think they outright said to say no, but I'm sure it wasn't prompted to be lenient.
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The real issue (Score:3)
"And NaviHealth employees face discipline for deviating from the estimates, even though they often don't match prescribing physicians' recommendations or Medicare coverage rules."
This is the real issue. AI can be a useful tool, but it can't be the decider. I have no problem with companies using AI for a first pass to give a recommendation, but then a real person needs to check the results and have the ability to override it because AI is nowhere near reliable and accurate at this point. Unfortunately, companies, in the rush for profits, don't care about that. They just see it can produce results (and in this case results that will save them even more money) so they start cutting staff and relying solely on the AI. The problem with AI isn't really AI, it is companies seeing it as a profit center and just rushing into it and not caring about accuracy.
Re:The real issue (Score:5, Insightful)
so they start cutting staff and relying solely on the AI. The problem with AI isn't really AI, it is companies seeing it as a profit center and just rushing into it and not caring about accuracy.
It is soooo much worse than you are thinking. They don't cut staff to save money. They do it so the staff can't make good decisions and accidentally deny people coverage. They make it difficult for the employees with time limitations. They use computerized forms that will auto-deny coverage if everything is not entered in the expected way. And insurance companies aren't accountable to anybody. If they wrongly deny coverage, the worst that happens is the customer asks again and they eventually provide it. Despite the fact that statistically, some of those people will die.
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I totally agree. I was just trying to generalize more because this is a problem across industries, not just in the insurance industry. They get the extra benefit of more denials, but the same thing is happening across other industries as well.
for profit healthcare is the real issue! (Score:2)
for profit healthcare is the real issue!
as well pushing doctors to rush to get more income vs takeing the time. Paying $300+ for 15 min wtf?
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Paying $300+ for 15 min wtf?
The worst part is, a huge amount of that is overhead.
You can't even do your own billing anymore without an army of staff because of constantly changing regulation and the sheer number of insurance companies and the difficulty of medical coding for billing.
Malpractice insurance is crazy high because any time a doctor makes a mistake - even one that was unavoidable - someone is likely to get a huge payout.
And then there's the education process itself where you graduate 6 digits in debt. And if that wasn't en
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The reason "self-driving" cars are more dangerous than standard cars is that you're not paying attention except when it asks you to. It would be one thing if the AI was merely aggregating data in a more useful way. If it makes the recommendation it is already going to influence the human review whether it was right or wrong. It will end up being a filter causing you to not look at the right things. This type of model can't ever tell you why. It can only spit out an answer, and it might be hallucinating
Universal Healthcare (Score:5, Insightful)
Is so complicated, that only 32 of the 33 developed nations have it figured out.
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... works so well in Canada that more than 2,000 people died while waiting for an appointment in 2020, according to the National Post [nationalpost.com].
Re:Universal Healthcare (Score:4, Insightful)
The results were obtained by the conservative-leaning think tank Second Street,
... good sign, it'll be a fair report...
It counted patients who died while waiting for surgery, diagnostic scans and appointments with specialists.
procedures that would improve quality of life in their final years, such as cataract, knee and hip surgery, were also included in the figure.
So the report is close to uninformative. If someone is in poor health, they probably have a bunch of appointments lined up. Them dying on a waiting list isn't surprising information.
Non public care doesn't even solve that. Shoot in America land of the great, my routine eye appointment scheduled 8 months out. Oops, kid was sick that day and have to reschedule, 10 months now.
Sure wait times suck, so pay for more doctors and pay the doctors more to attract people to the role.
Or switch to a private system so that AI can screw others over so maybe you can get your appointment, hopefully...
Capitalism and healthcare don't mix (Score:4, Insightful)
I live in Canada, and I can tell you that our healthcare system has some serious problems. That said, you couldn't pay me enough money to move to the US, given its wasteful, rapacious, nickel-and-diming private healthcare system. When average US citizens avoid going to the doctor in record numbers [cbsnews.com] because of costs, and some of them die as a result [theguardian.com], then the healthcare system is far, far sicker than the people it's (not) treating.
We kinda expect Walmart to be the dicks they obviously were in that second link, but we need to expect much, much better from the healthcare sector. The ONLY way that will happen is to make healthcare universal, and to remove corporations' greedy AI-assisted talons from the controls.
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My mother in law is Canadian and has voted conservative all her life. Two years ago she required a stay in the town hospital for a kidney infection. Needless to say that was a wakeup call for her after seeing what the healthcare cuts are doing. It's so bad that the emergency room in that hospital is now part time from 8am to 6pm. So you better schedule all your medical emergencies around it.
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Two years ago she required a stay in the town hospital for a kidney infection. Needless to say that was a wakeup call for her after seeing what the healthcare cuts are doing.
Unfortunately conservatives tend to have a general lack of basic compassion and an ability to "put yourself in their shoes". You can talk about an issue until your vocal chords are shredded and they just won't see it as a problem, or why it's their issue, until it impacts them. Only when it does impact them is when they suddenly gain the ability to understand what other people have been trying to tell them the entire time.
Even then, all too often, any compassion gained is often laser focussed and hyper li
Re:Capitalism and healthcare don't mix (Score:4, Insightful)
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You can imagine the impact it will have in the for-profit US. When boomers start dying off in larger numbers, it will be cord cutting with cable all over again. They are going to try to maintain revenue even over a huge drop in customers. Nevermind the fact that we do actually have partly socialized medical insurance for retirees but due to inflation, it's mostly paid for by contributions of the much smaller working younger generation.
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It's the cuts from the conservatives killing the industry.
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Also good points. I've thought about the 'pending' demographic crisis, but until I read your comment I had missed the obvious conclusion that we're seeing its effects right now. I was blaming our current situation solely on Covid, underfunding, and bad policies, not realizing that we're already suffering from an ageing population as well.
Common Problem Different Symptoms (Score:2)
While I'm a Canadian too and greatly prefer the national system, it's a fallacy to think that if the US switched to nation
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All good points. What also worries me is that in addition to those factors, and the demographic ones mentioned in another comment here, we'll also have to deal with 'environmental refugees' as global warming grows worse. All of our infrastructure is poised to be put under huge stress over the next two decades or so, and we aren't anywhere near ready for it.
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Medicare Advantage is a Bad Deal for Customers (Score:5, Interesting)
Don't get Medicare Advantage or let your aging relatives buy it. There are cost advantages but they come with major disadvantages.
The biggest issue (by far) is that once you sign up with a Medicare Advantage plan you no longer access standard Medicare. You are completely dependent on the company you selected which gets a flat fee from Medicare to take care of your coverage, medications and how long you get to spend in the hospital. This means that they have a large incentive to minimize your care, and they do.
The companies have no problem refusing to cover beyond their estimate, regardless of what your doctor says you need. Just ask my dad who signed up with a large nationally known company. He had surgery for cancer and the insurance company determined he should be in the hospital for four days. There were complications and the surgeon recommended two more days. The insurance company would not pay more than their estimate. Even worse, they had a limit on a how much they would pay for pain medication so my dad ended up paying the difference on both the hospital stay and the additional pain medication. No amount of talking to agents or filing grievances with the company would budge them from their very firm estimates. From what I've read, this seems this is the norm for MA plans.
Medicare Advantage is less expensive than traditional Medicare coverage, but the cost savings will easily be lost if you actually need care. The insurance companies spend very heavily on advertising these plans because they make a crap ton from them.
Re:Medicare Advantage is a Bad Deal for Customers (Score:5, Interesting)
I know this is not popular on
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what really is the point of spending 100's of thousands to keep you alive a few more days?
The point is that 99% of that amount is just overhead and/or greed. Fake prices kill people.
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I think you can switch back, during the end of year enrollment. The problem is that medicare unlike ACA has the old underwriting of the supplement. You pretty much need the supplement policy on traditional medicare. And if you are not healthy, the supplement plan can deny to underwrite you. So I think what happens is medicare [dis]advantage is great when you first sign up as it is less expensive. But when you need it, it sucks, so people try to move back to traditional. But then you really can't because now you aren't healthy and the supplement plans won't underwrite you.
Why would we treat old people like this? They have already given everything they could give to society and then get treated like this. If they were provably bad people, they would be in jail, but they are not, so why are we treating them like this?
Fucking disgusting. Can't even die in peace. Your schools will continue to be shot up by the disenfranchised youth who get to witness this shit. Enjoy the world you have created.
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You're thinking of Medicare For All, a single payer system that has been proposed to replace the current for-profit system.
It doesn't exist yet. Hopefully it will exist in our lifetime.
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I concur. I spent nearly 6 months before retirement carefully comparing all the plans and offerings. What people need to know is that only classic Medicare is in the business of reducing costs. They are the only insurer who posts what they will cover up front. There is never any arguing with providers over what is covered and for how much. Medicare pays for what they say they will pay, and although there are deductions, etc. you're not on the hook for a penny more than the published prices.
Medicare Advantag
Yea now prove it was used. Enforce it. (Score:2)
Not likely.
lol, right (Score:2)
If you think AI is NOT going to be used in this fashion, regardless of whatever law, request, or sense of decency, then you are naive and a fool.
Of course AI is going to be used to undermine health care for people, along with any other application where AI can give corporations an edge over the paying customer.
AI, just another tool to fuck people over.
Pay for a service, just don't expect to receive that service fully when you need it.
How dare you get sick??? (Score:1)
How DARE you get sick and cost us our profits??? You ought to be ashamed of yourselves.
It's unclear how nH Predict works exactly? (Score:2)
It's mid-February 2024, and I'm now taking daily, 16 T3's, 600mg slow release codeine, and 40mg Toradol. The medication dosage is completely off t
Wow! What a relief! (Score:2)
Fundamental problem in the US (Score:2)
The US appears to have a fundamental misunderstanding regarding health insurance. Aside from policy limits, insurance does not get to make health care decisions. The doctors do that. Insurance just pays the bills.
Almost all treatments are pretty standardized by now. Appendicitis? An appendectomy takes X hours with Y personnel, and (in the absence of complications), the patient spends Z days in the hospital. There really shouldn't be much room for disagreement.
Here, at least, those standards of care have
Whatâ(TM)s the point of insurance (Score:1)