The PUP Medicare Advantage fiasco never ends

[RVRoadie]

For those of you caught up in the PUP debacle, the fun never stops. We just got our letters from Medicare, they want some of their money back for the Medicare Part B premium reductions going back to 2012, when we got our first Medicare Advantage Plans. I just got PUP this year, and had Preferred Care Partners before that. There is no explanation for why they are doing this, and the letter contradicts all previous letters stating what my Medicare Part B premium reductions would be. To get it back, my SS check will be reduced next month for whatever they want back. Both PCP and PUP are now out of business, thanks in part to the medicare cuts in the Affordable Care Act. So, who you gonna call?

Anyone know what is going on. It amounts so several hundred dollars. Not to mention the loss of all Medicare Advantage rebates going forward. Only Ultima and Freedom still offer rebates as far as I know. If anybody is on those plans, the writing is on the wall. You should expect them to suffer the same fate as PCP and PUP.

[NYGUY]

For those of you caught up in the PUP debacle, the fun never stops. We just got our letters from Medicare, they want some of their money back for the Medicare Part B premium reductions going back to 2012, when we got our first Medicare Advantage Plans. I just got PUP this year, and had Preferred Care Partners before that. There is no explanation for why they are doing this, and the letter contradicts all previous letters stating what my Medicare Part B premium reductions would be. To get it back, my SS check will be reduced next month for whatever they want back. Both PCP and PUP are now out of business, thanks in part to the medicare cuts in the Affordable Care Act. So, who you gonna call?

Anyone know what is going on. It amounts so several hundred dollars. Not to mention the loss of all Medicare Advantage rebates going forward. Only Ultima and Freedom still offer rebates as far as I know. If anybody is on those plans, the writing is on the wall. You should expect them to suffer the same fate as PCP and PUP.

These issues have nothing to do with the ACA, although they are a good target once we are led down the road of negativity. The problem was, they were not sustainable. You can not give rebates, while giving gym memberships and the other benefits. Always remember the saying...."if it's too good to be true..." Unfortunately, us seniors, living on limited incomes, often times are drawn into these come ons. And, you are right, those plans still offering those same inducements, will suffer the same fate....they will go broke due having an unsustainable business model!!

[Carla B]

These "Advantage" plans have been around at least since the early 1980's. Someone I knew at that time was very happy to be enrolled in one until it became insolvent, also in the early 1980's.

[NYGUY]

These "Advantage" plans have been around at least since the early 1980's. Someone I knew at that time was very happy to be enrolled in one until it became insolvent, also in the early 1980's.

Yep, like I said!!

[RVRoadie]

These issues have nothing to do with the ACA,

Are you kidding? Why did Senator Nelson fight for and get a waiver for Florida when it came to Medicare Advantage cuts. A lot of good that did. Three years ago there were more than a dozen plans to choose from. Now you can count them on one hand. Soon they will all be gone and all seniors will be trapped in Original Medicare, forced to buy supplemental policies to protect themselves.

Medicare Advantage was a great alternative for those that wanted to share a little risk with an insurance company in return for lower premiums and better benefits.

[NYGUY]

Medicare Advantage was a great alternative for those that wanted to share a little risk with an insurance company in return for lower premiums and better benefits.

You did finally get to the point....I didn't say anything about Medicare Advantage cuts....my point was, the insurance plans the OP was discussing, were unsustainable business models. And just as you noted with "risk". In the case of these plans, too much risk!! I have had Advantage plans for years, but never the ones giving away the kitchen sink....because I knew they could not stay in business!!

[Bizdoc]

I recall during the last Medicare open season, there was considerable discussion about Advantage plans which had cut or reduced rebates. A number of folks were upset that the reductions had happened.

The rebates had to come from somewhere. There are not fairy dollars paying for them. The shareholders of the companies involved are not such wonderful people that they gave up dividends to pay for them. The money came straight from the extra funds these plans receive from Medicare.That money was supposed to fund extra services which would help keep subscribers more healthy.

Why is Medicare demanding repayment of the rebates? Because that money was Medicare funds spent not for health care but to "buy" your cooperation in their plan. Unfortunately, they spent the money that should have gone to doctors and which Medicare is now on the hook for.

The alternative is that the taxpayers would be on the hook. Medicare is doing the right thing here, just as they do the right thing when they go after doctors and hospitals for over-payments.

[NotGolfer]

We had Preferred Care Partners (which isn't PUP) up until they got purchased by UHC. Got a bill this week from our former dentist requesting payment on a procedure done over a year ago. The insurance that PCP turned their patients over to claims it's the dental office's fault in how they made their appointments. The dental office says that the insurance company is trying to screw folks over by denying coverage. We're taking this to the Florida Insurance Commissioner...

I will name the dental clinic if asked...my question is though, has anyone else run into this??

[Shirleevee]

These issues have nothing to do with the ACA, although they are a good target once we are led down the road of negativity. The problem was, they were not sustainable. You can not give rebates, while giving gym memberships and the other benefits. Always remember the saying...."if it's too good to be true..." Unfortunately, us seniors, living on limited incomes, often times are drawn into these come ons. And, you are right, those plans still offering those same inducements, will suffer the same fate....they will go broke due having an unsustainable business model!!

Blame ACA/Obamacare tsk tsk........this has been going on for years. Preferred Care got rid of the Sumter & Marion County monst:sing:er they created selling to UHC......Now PUP.....what sounds like a freeby more than likely will give you a headache.

[graciegirl]

I recall during the last Medicare open season, there was considerable discussion about Advantage plans which had cut or reduced rebates. A number of folks were upset that the reductions had happened.

The rebates had to come from somewhere. There are not fairy dollars paying for them. The shareholders of the companies involved are not such wonderful people that they gave up dividends to pay for them. The money came straight from the extra funds these plans receive from Medicare.That money was supposed to fund extra services which would help keep subscribers more healthy.

Why is Medicare demanding repayment of the rebates? Because that money was Medicare funds spent not for health care but to "buy" your cooperation in their plan. Unfortunately, they spent the money that should have gone to doctors and which Medicare is now on the hook for.

The alternative is that the taxpayers would be on the hook. Medicare is doing the right thing here, just as they do the right thing when they go after doctors and hospitals for over-payments.


Your explanation was clear and concise without any nasty side comments.
I have learned to expect that from you. Thank you, Bizdoc.

[gomoho]

We also received that letter but they are only asking for the money they didn't receive once PUP went insolvent. Reread the letter. And to those who were adverse to the risk of these plans I understand your concern; however, I have thousands of extra dollars in my pocket by taking a risk. And seamlessly switched to another advantage plan.