I just read starting next year pre auth will be required for some procedures in regular Medicare in 6 states (not mine yet).
Wonder if that’s a precursor for things to come ? will it eventually push it into the same league with advantage plans ?
The ensh|ttifcation of everything. And you can bet if AI is involved you are going to held up (or maybe killed) by some monumental screwup denials.
Death Panels something - something - Tan Suit - something - not born in America - something
Let me try to make one up… let’s say your last name is “Healthy”, and your doctor wants to perform cancer or heart surgery, I can see a large language model coming back with “DENIED BECAUSE YOU ARE HEALTHY”.
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I was wondering if traditional Medicare is going down this path if it might be better to get an advantage plan, screwed either way but might as well pay less.
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Honestly… I’d stick with traditional Medicare. My gut instinct, I hope it’s correct, is that the AI will be used to try to flag fraud, and there is a lot of Medicare fraud, whereas for for-profit insurance company the AI isn’t just trying to find exceptions… the AI is a vital part of their business model and profit plan. You can always go from traditional (original) to Advantage at any time, but going back is not possible generally if you want to get back to Medigap and Prescription Drug Plan, and everyone needs Medigap and Prescription Drug Plan.
Raise the question again in a few years.
I also wonder when I hear on the news that _”2 were shot and killed and 2 are in critical condition” in less than desirable neighborhoods who is paying for those in “critical condition” ? the chance that they have health insurance is probably south of one percent.
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If someone has no health insurance (4+ million people in my State) and they show up with a GSW at an ER, the ER has a legal obligation to treat them. Those costs get amortized around to all other users.
The short answer is… you and I are paying.
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