In Defense of Medicare Advantage Plans

Like most everyone else, I was shocked by the gruesome murder of Brian Thompson, CEO of United Health Care (UHC).  He was shot in the back as he walked across the street in Manhattan.  He had a wife and children.  Since I am an agent for UHC, as well as a policy holder, this wanton act of violence had a particular impact on me.  Thompson's alleged assailant is a young Ivy League graduate who was disgruntled by insurance in general.  As was initially thought, the assailant was not a policy holder of UHC. 
So why the murder?  It is thought that the act was a reflection of the population's general unhappiness with insurance.  Really?  I can only speak for myself and the thousands of people I've enrolled in Medicare Advantage Plans over the years.  I have seen how my clients have been cared for by the insurance company.  My clients are of Medicare age, i.e., the elderly, when the majority of health issues arise, including death.  They have been taken care of very well.
I myself have cancer, a catastrophic illness, in remission now, and have racked up humongous medical bills, all covered, with very little out-of-pocket expense.  There has been hospitalization, trips to the emergency room, CT and PET scans, infusions, and expensive tests up the wazoo, all covered by my insurance.  The premium for my Medicare Advantage Plan is $0, as in zero.  It includes prescription drug coverage, dental (which I use extensively), vision and eyeglass coverage, hearing aids (huh?), over-the-counter benefits for non-prescription needs (like toothpaste and vitamins), and health-food items like bananas and apples, gym membership, and home health physicals that are better than an annual physical by my doctor.  All this for a zero monthly premium.  I can't complain.  I say, “Thank you.” 
There has never been a problem of, “Will my insurance cover this-or-that procedure or test?”  There was an instance where a certain doctor's visit was not covered because of an “out-of-network” status.  I appealed this non-payment, and it was honored.  The appeal was simple.  All it involved was a telephone call to my insurance company, and it was taken care of by the person I spoke to.  I'll admit that I have the advantage of being an insurance agent and knowing how to speak insurance company language.  Therefore, I also help my clients if and when they have similar problems.   
My Medicare Advantage Plan has something called an “Out-of-Pocket Maximum.”  Not to be confused with a “Deductible” this OPM limits the amount I have to pay annually in co-payments.  Last year I reached this OPM and it looks like I will again this year.  This OPM is less than what I would pay annually at my age in monthly premium for a traditional Medicare Supplement, plus Part D prescription coverage.

There has been a lot of negative publicity about medicare advantage plans.  I don't understand it.  My experience with Medicare Advantage Plans, as a policy holder and as an agent, has all been favorable.  With a catastrophic illness, the last thing I need to worry about is, “Will my insurance cover this?”  There has been nary a problem.  This goes for my wife too, who has had a hip replacement, cataract surgery on both eyes, and hysterectomy.  One of my clients had a double lung transplant. 
For people without Medicare or Employee Group Insurance, there is the ACA.
I know I will get some negative response to this article, which is fine.  I can only site my experience and the experience of thousands of other policy holders.  We are fortunate here in SE Iowa to be so close to the University of Iowa Hospital in Iowa City, which has some of the finest medical care in the world.
But to shoot a CEO of an insurance company in the back with a “Ghost Gun” is more a reflection of our society, not our health care coverage. 
Have a good story?  Call or text Curt Swarm in Mt. Pleasant at 319-217-0526 or email him at curtswarm@yahoo.com.  Curt is available for public speaking.