Mixing Facts With Opinion

AHIP is a trade association, the members are insurance companies. Or course, they are promoting Medicare Advantage. To bluntly call something “better,” however, needs to be examined, rather than to be accepted as fact.


  • Providing Better Financial Security. Every Medicare Advantage has an out-of-pocket limit, and if you reach it, your costs are $0 for healthcare services. So yes, this is definitely true when compared to original Medicare, which has no out-of-pocket maximum limit.

  • Popular & Growing. No doubt, something that I have stated about 1 trillion times. 50% market share is almost a certainty.


  • Reducing Costs for Taxpayers. Unclear, despite the quotation cited.

  • Promoting Health & Peace of Mind. That is pretty aggressive. The additional benefits, screenings, surveys likely contribute to promoting your health, sure, let’s give them that. But, another motivation is to reduce claims paid by the carrier. And make no mistake: the #1 task of an insurance company is to make sure that its projections of costs are largely correct, and that the variance of errors is low. To the degree that this works hand-in-hand with “promoting health & peace of mind?”

  • Deliver Better Services. It’s not a question of whether or not certain Medicare Advantage plans have included these additional services, that is indisputable. But to call it “better” is too strong. Readers here know that this is the wrong place to find out definitively what is “best.” That will entirely depend on the individual situation. There are many instances where the nature of Medicare Advantage is inherently inferior and no matter what carriers do, they cannot remove those inherent differences.

  • Payments Equivalent to Original Medicare. “Medicare Advantage delivers more benefits and better value than original Medicare.” So if I received 10 extra benefits with a financial value of $0.1, but where it is weak or where there will be ongoing controversies (prior authorizations, for example), and it costs me an extra $100, is that better? This will again be on a case-by-case basis, not for overall, definitive-looking conclusions. To state it is “better?” Maybe, or not.

Bottom line: be careful when seeing pictorials with bullet points, even if the author is qualified (this party is qualified). Admittedly you can ‘say’ the same thing about me, which is why I have to repeat myself and why the list of topics is long, it’s that way so you can ask yourself what the likelihood is that the message is the same across this variety of topics? That is left to you.