Local Hospitals Drop Popular Medicare Advantage Plans: Hinsdale Letter To The Editor

This letter to the editor is from Hinsdale resident Linda Burke:

This letter may be important to area seniors now on Medicare Advantage plans or who are considering Medicare Advantage.
Four local hospitals affiliated with UChicagoMedicine AdventHealth – Bolingbrook, Glen Oaks, Hinsdale, and LaGrange – will cut ties with several popular Medicare Advantage plans on January 1, 2027. The plans to be dropped are AARP Medicare Advantage plans through UnitedHealthcare, Healthspring, and UnitedHealthcare (individual and group retirees).

Medicare Open Enrollment runs from Oct. 15-Dec. 7. During this time especially, seniors are targeted with a ceaseless barrage of TV advertising for Medicare Advantage plans, with far fewer ads for traditional Medicare. I define traditional Medicare as Medicare Parts A and B with medigap (also known as a supplement) and a Part D plan for medications.

Medicare Advantage is not really Medicare, but a private medical insurance plan, usually an HMO.

Not mentioned in the ads, one of the many serious drawbacks of Medicare Advantage is its limited networks, caused in part by the frequency of doctors and hospitals dropping out of specific MA plans or MA in general, due to low reimbursements and a burdensome process of prior authorizations.

This fact explains why UChicago hospitals plan to drop the Medicare Advantage plans AARP UnitedHealthcare, Healthspring, and some other UnitedHealthcare plans. As of January 1, UChicago hospitals will be out of network for these plans, leaving their enrollees with a scramble to find another MA plan still accepted by UChicago hospitals, or search for doctors and hospitals that still accept their current plan. Patients who want to switch from Medicare Advantage to traditional Medicare may find themselves unable to do so, as insurance companies are allowed to deny them a Medigap plan outright, or charge them an unaffordable premium.
(Only four states ‒ CT, MA, NY, ME ‒ require insurance companies to issue a medigap policy with no underwriting when a patient switches from Medicare Advantage to traditional Medicare.)

Not mentioned in the TV commercials for Medicare Advantage are the many serious problems with these plans in addition to extremely limited networks. Brokers receive a commission twice as high for selling a Medicare Advantage plan compared to traditional Medicare, as Medicare Advantage is run for profit, actually costing the taxpayer 14 percent more than traditional Medicare – dollars retained by the insurance companies and never returned to the taxpayer. Profits are reaped by tactics including limited networks, denial of care, prior authorizations aimed at denial of care, and outright fraud, such as overcoding on a multi-billion dollar scale. With the money now wasted by Medicare Advantage plans, as argued by health policy experts, we could shore up traditional Medicare – with no “gap” – for all American seniors.
Are there any short-term solutions to these problems with Medicare Advantage, and its local iteration in particular?
Yes. For seniors, if at all possible, choose traditional Medicare at age 65, including medigap type G and a good part D plan. There will be medigap and part D premiums upfront, but few if any surprises or copays. The same cannot be said of Medicare Advantage plans.

Seniors, if your only choice is Medicare Advantage, and you are scheduled to be dropped from network by UChicago, I feel it is not too late to call or write to these hospitals to ask for reinstatement of the dropped Medicare Advantage plans.
In the short term, UChicago hospitals should go back to the negotiating table and come to an agreement with the dropped Medicare Advantage plans before the end of Medicare open enrollment on December 7. Too many seniors rely on popular Medicare Advantage plans, including AARP United Health, to leave these patients in the lurch, notified only by a postal letter that didn’t arrive until two weeks into the open enrollment period.

For the longer term, UChicago hospitals should cease to promote Chapter, actually a Medicare Advantage broker, as a source of advice on Medicare choices, as they do in a separate postal letter to seniors. These hospitals could easily call on the excellent University of Chicago Department of Health Policy for experts to advise on the full range of information about Medicare, including Medicare Advantage DISadvantages.
All of us can call or write to our U.S. Senators and Congressman with a request for truth in advertising of Medicare Advantage, including its downsides for patients and higher cost to the taxpayer. Ideally, we can add, this honest process will lead to the abolition of Medicare Advantage and the money saved, devoted to shoring up traditional Medicare with no “gap.”