There is a lot of discussion in the Dialysis space regarding Medicare advantage. Medicare advantage impacts independent Dialysis providers the most. Medicare advantage is heavily marketed to patients and patients are able to enroll on a quarterly basis. Some of the potential benefits marketed to patients is often misleading. For example, Medicare advantage plans will promise covered services, such as transportation, but transportation to dialysis is not included.
Patients are told that joining a Medicare advantage plan will not require a change of dialysis provider, but the plan rarely shows the inpatient Dialysis and Nephrology providers when marketing and selling Medicare advantage plans. Medicare advantage is also not transparent regarding patients on dialysis maximum out-of-pocket cost that they are responsible for covering.
When a traditional Medicare patient changes to a Medicare advantage plan they’re permitted to keep their Medigap secondary insurance coverage. However the Dialysis space has seen that most Medicare advantage plans advise against keeping the patients Medigap insurance. Some of the information presented to the patient advises against keeping the Medigap insurance telling patients they’re better off, directing those dollars through their out-of-pocket expenses
If the patient chooses to return to traditional Medicare, the patient must undergo underwriting, which is different in each state, to reinstate or acquire their Medigap policy. There are other multiple aspects of Medicare advantage that do not benefit the dialysis patient and provider, but too much to put here.
That's very interesting, Kim—thank you for sharing. It definitely feels like a gap that needs more attention, both from a policy and patient education perspective. Probably a dumb question, but would that vary depending on the payor?
![Signals From [Space]](https://substackcdn.com/image/fetch/w_80,h_80,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F55686857-6b99-45a6-ac0f-09c9f023f2a0_500x500.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/w_36,h_36,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F55686857-6b99-45a6-ac0f-09c9f023f2a0_500x500.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/e_trim:10:white/e_trim:10:transparent/h_72,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4d588ac1-7fac-4bd4-829d-fc7b4e8f1326_1512x288.png)
There is a lot of discussion in the Dialysis space regarding Medicare advantage. Medicare advantage impacts independent Dialysis providers the most. Medicare advantage is heavily marketed to patients and patients are able to enroll on a quarterly basis. Some of the potential benefits marketed to patients is often misleading. For example, Medicare advantage plans will promise covered services, such as transportation, but transportation to dialysis is not included.
Patients are told that joining a Medicare advantage plan will not require a change of dialysis provider, but the plan rarely shows the inpatient Dialysis and Nephrology providers when marketing and selling Medicare advantage plans. Medicare advantage is also not transparent regarding patients on dialysis maximum out-of-pocket cost that they are responsible for covering.
When a traditional Medicare patient changes to a Medicare advantage plan they’re permitted to keep their Medigap secondary insurance coverage. However the Dialysis space has seen that most Medicare advantage plans advise against keeping the patients Medigap insurance. Some of the information presented to the patient advises against keeping the Medigap insurance telling patients they’re better off, directing those dollars through their out-of-pocket expenses
If the patient chooses to return to traditional Medicare, the patient must undergo underwriting, which is different in each state, to reinstate or acquire their Medigap policy. There are other multiple aspects of Medicare advantage that do not benefit the dialysis patient and provider, but too much to put here.
That's very interesting, Kim—thank you for sharing. It definitely feels like a gap that needs more attention, both from a policy and patient education perspective. Probably a dumb question, but would that vary depending on the payor?