When retired veterinarian Richard Timmins went on a Medicare Advantage plan in 2016, he admits that he knew very little about Traditional Medicare (also called Original Medicare) or the more than 3,800 Medicare Advantage plans that are marketed to seniors and the disabled.

“I went to a so-called Medicare Information Session and took the recommendation of the speaker and ran with it,” Timmins told Truthout. “I did not know that he was paid a commission for every person he signed up for a plan. The issue for me was cost.”

Like other Medicare beneficiaries, Timmins knew that the standard premium for Medicare coverage — $164 per month in 2023 — would be taken out of his monthly Social Security checks. He also understood that there would be a $226 annual deductible for Part B, which covers doctor’s visits, but after that deductible was met, Traditional Medicare would pick up 80 percent of the cost of his care. What’s more, he knew that dental, optical and audiology were not covered by the plan and that he would be responsible for paying the remainder of his health care costs — 20 percent of the total — out of pocket unless he purchased a separate, costly Medigap insurance plan.

Not surprisingly, when Medicare Advantage promised broader coverage for less money — the same deduction would be taken from his Social Security check, but he would not need a supplemental Medigap plan since Medicare Advantage (sometimes referred to as Plan C) would provide coverage for most of the services that Traditional Medicare did not offer — Timmins quickly signed up. That’s when his nightmare began.

After his primary care physician noticed a lump in his ear, Timmins was told that he needed to see a dermatologist. “I have a family history of skin cancer, so I tried to make an appointment right away but was told that I needed prior approval from my insurer to see the specialist,” he said. “It took seven months to get this approval and, in that time, the growth tripled in size and became painful. I finally had surgery to remove it in 2022. Had I been on Traditional Medicare, I would have quickly seen the dermatologist and the oncologist since prior approval is not required. I would have had the lump removed when it was smaller, before it extended into the tissue.”

The experience was eye-opening for Timmins and he is now an active member of Puget Sound Advocates for Retirement Action. Now knowledgeable about the nuances of different Medicare plans, he is eager to share his experience and discuss why Medicare Advantage can be so deceptive and dangerous.

Although thousands of different Advantage programs exist, most are run by seven private, for-profit insurance companies: Centene, Cigna, CVS-AETNA, Elevance, Humana, Molina and UnitedHealthcare. By 2023, UnitedHealthcare, which is owned by AARP, controlled 29 percent of the market; Humana controlled 18 percent and CVS-AETNA controlled 11 percent.

“The only way we can move people away from Medicare Advantage is to make Traditional Medicare stronger.”

They’ve cashed in. This year, 30.8 million people — 51 percent of those who are eligible for Medicare — are in Medicare Advantage programs, and the reason is obvious. Like Richard Timmins, most retired and disabled people need to keep costs down.

According to the National Institute on Retirement Security, Social Security is the sole source of income for 40.2 percent of retired people in the U.S. For 49.4 million retirees and their 2.6........

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