Guest Commentary: There are many disadvantages to Medicare Advantage

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Regina Scanlon is a retired educator with almost 40 years’ experience. She has lived in Delaware almost continuously since 1968, in Dover and Rehoboth Beach.

In his State of the Union address on Feb. 7, 2023, President Joe Biden said:

“So tonight, let’s all agree to stand up for seniors. Stand up and show them we will not cut Social Security. We will not cut Medicare.

“Those benefits belong to the American people. They earned them.

“If anyone tries to cut Social Security, I will stop them. And if anyone tries to cut Medicare, I will stop them.

“I will not allow them to be taken away.

“Not today. Not tomorrow. Not ever.”

Unfortunately, in Delaware, the governor and legislature are attempting to take away Medicare from Delaware pensioners. We were told last year that we had to give up Medicare or give up the supplemental benefits we had earned from years of state employment. A lawsuit by Retirees Investing in Social Equity Delaware temporarily stopped this disaster for pensioners.

The replacement proposed for Medicare was a Medicare Advantage health insurance program. It is not Medicare. It is not accepted by all doctors and hospitals that currently take Medicare. They can choose to participate or not, and often it is not in their best interest to participate because it imposes additional paperwork and preapprovals and a whole new set of requirements to get treatment approved for their patients. Since there are numerous Advantage programs with different requirements, this places a burden on doctors and their staff to comply with each individual Advantage program’s demands. Already, I have heard from a pensioner who will have to find a new family doctor if the state switches to an Advantage program because her doctor (who takes traditional Medicare) said she will not participate in the state’s Advantage program if it is established.

Advantage programs are profitable programs for insurance companies, which is why there are constant ads and promotions to get Medicare recipients to give up their Medicare and sign up for an Advantage program. They make it difficult for patients to get care and have numerous requirements for preauthorization.

Gov. John Carney and some legislators seem determined to take away pensioners’ Medicare. I believe they have been swayed by lobbyists and have ignored pensioners’ concerns over lack of accessibility to health care. Those concerns include being unable to get care in places across the country that take traditional Medicare; needing to delay treatment to get preauthorization; putting a burden on older citizens to read numerous pages of requirements; having to check if doctors take this specific Advantage program; filing appeals (all at a time when they are older and sick); losing the doctors who have been treating them for years; and a litany of other challenges.

In the literature to pensioners, the insurance company did not list any of these disadvantages. What they did list were two advantages: access to SilverSneakers, which is not available in some areas, and a few free meals after being in the hospital, the value of which is irrelevant when considering what retirees will be giving up.

For most state employees, earnings have almost always been less than they could have earned in the public sector. What compensated for that reduced take-home pay were the benefits: health care coverage before and after retirement, including supplemental health benefits added to Medicare, and a pension.

At the federal level, the president and both Republicans and Democrats in the House of Representatives and Senate have indicated that they will not take Medicare away from U.S. citizens, but here in Delaware, our governor and the legislature are doing the opposite to state retirees.

Last year, we were given the ultimatum to either give up Medicare or lose our state supplemental benefits. The court gave us a reprieve. What will happen this year? Will the governor and state legislators guarantee us access to Medicare and our benefits or will they renege on their commitment to us?

Editor’s note: Delaware’s Retiree Healthcare Benefits Advisory Subcommittee will meet in a hybrid format from 10 a.m. to noon today at the Statewide Benefits Office and via Microsoft Teams. Those interested in attending can request access by emailing sebc@delaware.gov or by visiting publicmeetings.delaware.gov.

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