“In western Montana, an 81-year-old woman with diabetes is fighting with Humana, the seller of her Medicare Advantage plan and an aggressive marketer of Medicare insurance options,” Trudy Lieberman writes over at Healthcare Uncovered. “Humana, which holds the No. 2 spot for MA plan sales, is requiring the woman to pay the initial cost of $400 and then 90%, or $360, of the costs after that for a continuous blood glucose monitor her doctor says actually costs about $60 to $70 every two weeks. ‘Humana won’t pay for it,’ her physician, Dr. Gabe Charbonneau, said. ‘Without a lot of help, she will stop taking her meds.’ She can’t afford the device her doctor recommends on her own. Her diabetes is not well controlled, and continuous monitoring would help her stay on her medications, preventing severe complications. Instead, Charbonneau said, her Humana MA plan wants her to use finger sticks to signal when she needs more insulin. The Montana patient, who has tried four different MA plans over the years, is one of 30 million Medicare beneficiaries who have given up their traditional Medicare benefits to join those plans, which are approved by Medicare but operated by private insurers. They’re enticed by offers of gym memberships, help to pay for vision and hearing care, and a newer entry in the grab bag of sales enticements — a card that allows beneficiaries to buy certain items with a grocery card issued by insurers. But Medicare beneficiaries are taking a gamble when they sign up. When they … ditch their traditional benefits for Advantage plans, they are betting they won’t get sick and need expensive care, and they hope that if they do, their claims will make it through the insurance company’s checkpoints designed to limit payment.” Trudy Lieberman, “Private Medicare blitz: for-profit health insurers are pressing hard for new enrollees in their taxpayer-supported Medicare businesses in 2024,” Healthcare Uncovered.
