Warning! Medicare is not what you think it is

Suzanne FiscelIa, PA-C, BCPA / November 21, 2022

Medicare

I’d rather have a Medicare team of experts, wouldn’t you?

 

You know you have to sign up.

You spend a few minutes looking at the price.

Oh, and you want to make sure your doctor is in your plan.

But do you look any further? NO?????????????????????

It would be foolish not to.  What we in the medical profession know should make you rethink your Medicare insurance. Read on…

 

There are certain things you need to know before you make this decision.

 

Do you know there are 223 Medicare Advantage plans? Do they tell you how wonderful their specialists, surgeons, treatment plans, and medications are?  Do they tell you they will send you to the top medical centers in the country to give you care?

NO??????????????

Oh, you mean they only tell you the price? They don’t mention specialists when they push these plans?

Do you understand that if you or your loved one is diagnosed with cancer, heart disease, or back disorders, not all top medical centers take Advantage plans? Your plan says you can be seen, but only by a few.

For example, we know that the Mayo Clinic does not take Advantage plans as of February 2022.

Johns Hopkins, one of the top foremost medical centers in our country takes only a few Advantage plans.

And the third cream-off-the-crop medical center is the Cleveland Clinic.
They also do not take all the Advantage plans.

Please note that this article may contain affiliate links.  You can read my full disclosure at the bottom of the page.

 

These facts leave you without the best medical care.

 

You’re a smart patient.

You like to advocate for yourself or your loved one, so you want that second opinion. You ask around.

Any of the top three above is where you want to go.

You call one of these top three.

Most of them have satellite offices within your area. If not, you’ll go to the main campus.

They tell you that your plan is considered out of network. This means that you and your loved one will have to carry the cost of consultation, possible surgeries, hospitalizations, and treatment. Even the better medications aren’t covered and you can’t afford them.

This can be up to 50% and you will be required to pay it before you can be seen.

 

When you realize your Medicare insurance is garbage. 

 

It hurts to see so many people frustrated when they realize that their insurance doesn’t give them the choice to get the best second opinion, the best surgeon, or the best treatment.

How is this good medicine?

Shouldn’t you have the right to go where you want to go when you’re diagnosed with cancer, a heart problem, or a spinal disorder?

Are you surprised when I tell you, “It’s what doctors do?”

They run to top medical centers.”

They seek out the best. And they know who the best is.

While there are over 223 Medicare Advantage plans, there’s only one Medicare original plan and a few supplemental plans to cover the 20% not covered by Medicare Original.  And some of these supplemental plans also limit you as to where you can go.

And yes, Medicare Original is the most expensive but it’s the BEST! You can get the BEST treatments, surgeons, doctors, and second opinions without worry. You have the freedom to choose your own medical care. Isn’t this what we all want?

But no, insurance companies do not want you to understand that you get what you pay for.

So, make sure your decision is based on your knowledge, your chances, and your health, and not just on cost.

 

How poor medical treatment is worse than no medical treatment.

 

One study showed that more people die in a poor quality health care system than those who had no healthcare system. This was a pretty shocking claim.

We know physicians spend over 11,000 hours getting trained, while Nurse Practitioners and Physician Assistants (myself included) have 400 – 2000 hours of clinical training. Misdiagnosis is now rampant in our country. A misdiagnosis prolongs correct treatment and a possible life saved.

But it’s not the fault of the physicians, NPs, or PAs. We all know that our many Healthcare Systems dictate how and where their employed physicians and secondary providers will see you.

Also, most doctors and secondary providers are told they only have 6 minutes to spend with you.

And yet we know that you have so much more to tell us!

Do you think the Mayo Clinic, The Cleveland Clinic, or Johns Hopkins spend 6 minutes with you?
No way.

Here are 2 true examples…

1 – I have a friend whose husband had cancer.
He was going to a local cancer specialist.
I suggested that she convince her husband to go two hours north to the incredible Moffett Cancer Center in Tampa.

The next time I saw her she told me they went and could not believe the difference in the quality of care. They spent 2 days with him. His treatment plan was all wrong.
They changed it and they saw hope when no one else did.
And yes he did beat his cancer.

2 – Another time, I had a mother of three come into my urgent care. She was on Medicaid. I asked her who the kids’ pediatrician was. And she started to cry. She said he was two hours away in Tampa Florida.

Because there just weren’t enough pediatricians in the area who took Medicaid, her access to care was bumped to Tampa. This is why she was coming into the urgent care.

I am not surprised.
I see the frustration.

 

Do you want the best Medicare or is the second best good enough?

 

You may have health insurance, but do you have access to choose the care you want?  Hmmm.

I wrote a book, “Overcoming the Chronic Pain of Healthcare”.  It’s on Amazon. It’s all about the many mistakes I’ve seen and how to get through a poor healthcare system without making them.

Whichever Medicare plan you or your loved one decides to buy, just understand that the quality of medicine you will have access to is determined by the plan you buy. 

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Suzanne FiscelIa, PA-C, BCPA

I know exactly what it's like to feel like you just can't keep up. Working a full-time job, raising 3 children as a single mom, and taking care of her aging mother. But after feeling lost, overwhelmed, and guilty for spreading herself too thin, I saw all her patients and their caregivers going through the same thing. I learned how to put simple systems in place to keep my life free from distractions, find free time to do the things I wanted, and enjoy my family along the way. These simple step-by-step solutions have been shared with my patients, friends, and family. They too have found organization, confidence, peace, and freedom. Now we all live the life we love while caregiving! Come join us!
sue

Hi I'm Suzanne

And my mission is to find you practical easy-to-follow solutions for everyday caregiving. Find out more HERE.

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