Medicare Advantage Plans Taking Advantage Of Some Seniors

Elderly lady holding caregivers hand - In home dementia care Pebble Beach

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.

New Treatment For Macular Degeneration On The Way

A doctor showing the report to the senior female patient

AARP The Magazine had some amazing stories in its October/November 22 issue regarding innovations in health care.  One new device on the market are eye implants for age-related Macular Degeneration which would avoid the need for regular injections right into the eye.  The Susvimo eye implants, on the other hand, release a steady dose of the anti-VDGF drug ranibizumab (Lucentis).  They are about the size of a grain of rice and they are implanted under the eyelid where it can’t be seen and won’t impair vision.  The FDA approved the device in October of 2021 and research has shown that it works as well as monthly injections, although it has a higher rate of side effects including redness, pain and light sensitivity.

 

Medicare Could Soon Cover Dental And Eye Care

A caregiver holding the woman's hand and speaking

As part of a large budget bill making its way through Congress, there is a provision to provide dental and eye care for Medicare recipients for the first time in our nation’s history.  Ironically, the bill is facing opposition from dentists, who fear that government reimbursement rates would be too low.  Back in 1965, the American Dental Association fought to keep dental from being a paid service for Medicare recipients.  Sadly, nearly half of all Americans over the age of 65 did not visit a dentist last year, and almost 20% have lost all of their teeth.  I know about the problem firsthand.  In addition to owning Family inHome Caregiving, I am president of the non-profit Hands to Help Seniors which provides emergency assistance to seniors in a financial pickle.  The vast majority of our donations go to providing dental care to low-income senior citizens, which is very expensive.

https://www.nytimes.com/2021/08/29/upshot/medicare-dental-care.html