Medicare Advantage Plan members have more than doubled since 2007 according to a study done by the Kaiser Family Foundation. However, they are not always the great deal as they seem on the surface. The Wall Street Journal recently profiled Bob Miller who had surgery on one eye but just a few weeks later when he was scheduled to have surgery on the other eye, he was informed the night before that the surgery was canceled because his Medicare Advantage plan refused to cover it. Unfortunately, you will not be able to figure out if some plans are covering your planned medical care until you fill out the medical preauthorization form and send it in. Miller eventually got the cataract surgery but had to wait several weeks. “Prior authorization policy when levelled in such a heavy handed and irrational way is an undeniable power grab by insurers to really put profits over patients,” said Alice Epitropoulos, the ophthalmologist who performed the surgery on Miller.
