Kaiser Permanente Senior Advantage to end 12-31-16

[Lee M-S]

As I understand it, "Kaiser" is nonprofit. "Kaiser Permanente" is for-profit.
I'm not certain what the dividing line is between the two.

><(((*< ... ><(("< ... ><('< ... >o>

[kalakoa]

the part that seems to be causing the most anger is the sudden and dramatic tripling of the cost

This is happening all over the industry; every time I see a new report of huge cost increases, I ask myself "where is all that money going?"

[Chunkster]

@ kalakoa: A lot of that money is going into the pockets of insurance company executives, some (but not all) of whom have multi-million $ salaries. A lot more is going into the salaries of paper pushers at both the insurance companies and the providers' offices. Our patchwork system of insurance companies has produced the highest ratio of administrative expenses to care costs of any "advanced" nation. One study I read recently said that 32% of our health care expenses are directly related to insurance administration. The reason Obamacare is failing is probably that it did not go far enough toward a single payer system. Even the Democrats who passed Obama's "reform" felt compelled to pander to the insurance industry. Bringing it back to Hawaii, Kaiser seems have moved toward the bottom ranking of these administrative nightmares by having crappy cost accounting department. Costs did not go up 300% in one year!

[Guest]

If you have medicare, you have medical insurance.
Don't waste your money.

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You can't fix Samsara.

[Lee M-S]

Soooo, I've been doing my research and talking to people. A friend told me...

"Any supplemental plan is required by law to accept new Medicare enrollees without health questions.

However, if you are not new to Medicare and are coming from an Advantage plan, there is no guarantee of your insurability because the insurance company is allowed to ask you health questions and deny coverage under certain conditions.

Whenever an Advantage plan is canceled, you are entitled to sign up for original Medicare and apply for a secondary insurance plan without any health questions being asked; you are guaranteed to be insured - no denial of coverage, no rating on the premium."

So a HUGE question here is, Did Kaiser cancel the plan or change it? AAAAAARRRRGGGGHHHHH

This could be their way of getting rid of expensive patients by denying coverage due to existing conditions.

[kalakoa]

no guarantee of your insurability because the insurance company is allowed to ask you health questions and deny coverage

Obamacare was supposed to eliminate the "disqualification for pre-existing conditions" problem. Right?

[jlgerk]

quote:

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Originally posted by imagtek

If you have medicare, you have medical insurance.
Don't waste your money.

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You can't fix Samsara.

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do you have ANY idea what Medicare does and does NOT cover ?

[geochem]

Everyone who still believes in a free lunch, please raise your hands...

Who's the "bad guy" here?
The highly paid insurance executives? if you think competent management of huge, technically complex, rule-bound, businesses with a highly diverse work-force is expensive, try incompetent management and see what it costs.

The appointed Insurance Commissioner? His job is to ensure that at least a couple of medical coverage providers remains viable in the state because the alternative doesn't look at all pretty...

The thousands of paper-pushers? Whose dead end, mind-numbingly boring, job is to ensure that endless rules controlling the minutia of medical care and medical coverage are all strictly complied with?

Or is it the no small minority of our population who, to put it politely, haven't really taken the best care of their individual corpus, but still think it's a great idea to move out to the a$$ end of the medical care universe and are still entitled to the best possible medical care that (someone else's) money can provide?

I wonder???

[Chunkster]

quote:

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Originally posted by Lee M-S


So a HUGE question here is, Did Kaiser cancel the plan or change it? AAAAAARRRRGGGGHHHHH

This could be their way of getting rid of expensive patients by denying coverage due to existing conditions.

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More than one person I have spoken to (including a mainland insurance company employee) says this is exactly what Kaiser is doing. By eliminating the less expensive option and only providing a plan at three times the cost, Kaiser knows that a significant number of its Medicare patients will not be able to stay with them. No one denies that Kaiser's costs have gone up, but they have not tripled in a single year. It's hard not to think that this was designed to drive people away.

To put this into perspective again, the annual increase in the premium is $1572 or $3144 for a couple. That is just the increase, not the total premium. The financial aid that Kaiser touts in its press releases has such low asset levels that senior families now barely able to maintain a middle class lifestyle would have to be pushed into real poverty to qualify for help. Thanks, Kaiser.

[kalakoa]

Who's the "bad guy" here? highly paid insurance executives? appointed Insurance Commissioner? thousands of paper-pushers?

All of these are sitting between me and my doctor. None of them dispense medical advice, perform procedures, or write prescriptions. If my taxes and premiums weren't being redirected into supporting this "overhead", I could simply pay the doctor directly.

Catastrophic coverage is another issue, obviously, but one which could be greatly simplified if there weren't so much "overhead".