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The good news about Medicare Advantage

D. Lynn Johnson, Guest Commentary • Mar 26, 2018 at 8:24 AM

Editor’s Note: D. Lynn Johnson of Kingsport is a former Eastman Chemical Co. lobbyist and pharmaceutical industry consultant. He submitted this commentary in response to Judy Garland’s Community Voices column regarding Medicaid Advantage published March 18. Johnson wrote the column after he was invited by a coalition supporting Medicaid Advantage to discuss his satisfaction with the program with U.S. Rep. Phil Roe.

I’d like to put a check in the “win” column for senior citizens and disabled people across Tennessee. They have choices for their health care thanks to Medicare Advantage, and it makes a difference in their wellness and vitality.

I’ve had a Medicare Advantage plan for 10 years, and it’s served me exceptionally well. Even though there’s no crisis to report, I believe it’s important to speak up about Medicare Advantage’s many upsides so our elected leaders, including U.S. Rep. Phil Roe, know we want the program protected. Washington, D.C., being what it is, it’s best to be proactive.

So why am I an advocate for Medicare Advantage? There’s simply more packed into a Medicare Advantage plan. Seniors get the expected forms of coverage for major medical needs, physicians’ services and prescription drugs. But we also receive a wealth of other benefits targeted at keeping us healthy. From checkups and health screenings to chronic disease management assistance and fitness programs, seniors like me get a lot for very little money.

Because there is private sector competition involved, it drives innovation among the Medicare Advantage health plans. Many plans are using telemedicine to make it easier for patients, especially those who are frail or live far from a medical center, to be overseen by their doctors. Others are optimizing their care coordination and patient-centered approach to ensure the various elements of a care plan come together as they should. This can improve outcomes and reduce complications and hospital admissions.

The best part, these services come as an “all in one” package. I’m not stuck juggling various insurance policies, trying to figure out which plan covers which services. When I go to the doctor, the pharmacy, a lab, or the hospital, I hand them my Advantage plan card and that’s the end of it. If I have questions about how to make use of a program or service, the providers participating in the network, etc., I can just call or go online for information.

The “Golden Years” can bring financial pressures. Many of us switch from paid work to family time and community activities. We hope we’ve saved enough, but there are always concerns that an unforeseen medical condition could get expensive.

This isn’t a problem, however, with Medicare Advantage. In every single Advantage plan, there are caps on the out-of-pocket expenses any member can be expected to pay in a given year. There’s no chance of medical bills piling up. Combined with the reasonable co-pays and the widespread availability of no-premium plans, Medicare Advantage offers seniors on a fixed income great financial security.

This makes the program especially valuable to the more vulnerable members of our community. There are many seniors across Tennessee who get by on less than $20,000 per year, usually just a small social security check. It would be very difficult for these seniors to afford quality healthcare without Medicare Advantage. In fact, over one-third of Medicare Advantage enrollees are very low-income, and I’m glad they have this coverage.

At a time when our representatives in the nation’s capital don’t seem to agree on much, they’ve nonetheless continued to come together around Medicare Advantage. I appreciate the hard work of the Tennessee Congressional Delegation including Roe to ensure that the program gets better every year.

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