Poll respondents on MA plans: ‘It’s just too much’

YARMOUTH, Maine – When it comes to Medicare Advantage, respondents to a recent HME Newspoll have two predictions: The numbers of beneficiaries enrolled in these plans will increase under the new administration of President-elect Donald Trump, and it won’t be good for HME providers. 

Most respondents already serve patients with MA plans (84%) and expect their percentage of patients who have these plans to increase this year (59%). The problem: They experience more challenges serving this population (78%). 

“We will close our business if the Medicare Advantage population rises as there is no profit to be made from Advantage plans, with their poor allowables for equipment and repairs,” wrote one respondent. 

During his first term, Trump and many congressional Republicans implemented policies that expanded Medicare Advantage plans, which now cover more than half of all Medicare beneficiaries. In his second term, more of the same is expected. 

Respondents say poor reimbursement is the No. 1 challenge they face with MA plans (43%), followed by denials (27%) and prior authorizations (10%). Another 20% say the plans are challenging for other reasons, like exclusive or closed networks.  

“We have encountered a magnitude of issues with Medicare Advantage plans,” wrote one respondent. “It’s a heavy increase in administrative costs. We have to deal with denials, prior authorization issues, in-network status issues and reimbursement issues, not to mention the issues of patients being transferred from one MAP to a second MAP and sometimes a third. It’s just too much.” 

But some respondents say it doesn’t matter who is in the Oval Office – MA plans are here to stay. 

“Biden, Harris, Gore, Clinton, Trump… it doesn’t matter,” wrote one respondent. “The Medicare population has been increasingly moving to Advantage programs to save money. With most of this population on a fixed income and the cost of living skyrocketing, they are smart if they review their needs and find a good Advantage plan.” 

The steady stream of TV advertisements for MA plans and their promises of increased coverage at lower costs plays right into that, one respondent wrote. 

“Free eye care! Free groceries! Free home medical equipment!” wrote one respondent, perhaps tongue-in-cheek. “This is going to be the greatest Medicare the world has ever seen!”