'Think Twice' 

Editor:

Medicare's open enrollment period is nearly upon us and with it will come pitches from Medicare Advantage to sign up for their plan ("California Says No to Privatizing Medicare," Sept. 7). Many attempts at getting potential enrollees to sign up are downright deceitful, including letters such as the one just received at our house from "Medicare Planning of America," which has no connection to our government's Medicare program. It is crucial to get the back story on Medicare Advantage rather than relying on the information provided in their slick marketing campaigns.

Medicare Advantage is a privately run version of traditional Medicare in which large, for-profit insurance companies are paid by the government to "manage" the care of enrollees. The plans are enticing as they tout lower premiums and extra benefits, however, they do not deliver what they promise.

Investigations into Medicare Advantage have shown that enrollees most in need of care for chronic or complex conditions frequently have to contend with delays in getting care authorized, denials of care and limited provider networks. Medicare Advantage also shortchanges the taxpayers by overcharging Medicare in a practice referred to as upcoding. Because Medicare Advantage gets higher reimbursement rates from Medicare for more complex patients, Medicare Advantage has been found to exaggerate or falsify diagnoses in order to maximize their profits. In a recent case, the Department of Justice found Cigna insurance in violation of the False Claims Act after submitting false and exaggerated claims for Medicare Advantage enrollees and fined the company $172 million.

Aside from cheating taxpayers with bloated charges to Medicare, Medicare Advantage is directly threatening the long-term viability of traditional Medicare. I encourage you to think twice before signing up for Medicare Advantage. 

 Jennie Brown, Trinidad