Managed Care Medicare? Why You Should Avoid

As you probably know by now, when you are about to turn 65, you receive a large amount of unwanted mail trying to persuade you to enroll in a specific Medicare plan.

At first, it can be very confusing. Prior to becoming eligible for Medicare, Medicare seemed like a simple program. You turn 65 and go on Medicare.

Unfortunately, Medicare has become more complicated as the government has allowed private, for-profit companies such as Humana to steer you into Managed Care Medicare Plans that can provide far less access to the health care you need and require you to pay far higher costs than you should.

These plans are very profitable for these companies at the expense of your health and financial well-being. The high profits these companies make from these plans are the reason they spend so many millions of dollars advertising them on television and in your mailbox when you are about to turn 65.

2019-08-16 Charles Bradshaw
Charles Bradshaw

It is important that you understand how Managed Care plans work with Medicare.

Medicare consists of two primary parts – Medicare Parts A and B.

Medicare Part A pays most of the costs if you are an in-patient in the hospital or a rehabilitation patient in a Skilled Nursing Facility.

Medicare Part B pays around 80 percent of the cost for most other health care services such as doctor’s visits, outpatient services, x-rays, lab work, physical therapy and sophisticated diagnostic testing such as MRIs.

When you have Medicare Parts A and B as your primary, the government pays your health care costs. With this coverage, you can go to any doctor or hospital that accepts Medicare as almost all do.

With Medicare Parts A and B as your primary insurance you can also get a Medicare Supplement that covers all or almost all of your share of Medicare which is around 20 percent.

This is wonderful coverage that gives you the best chance for the best health outcome possible if you have a serious health situation.

Unfortunately, for-profit companies such as Humana want you to waive this wonderful coverage and sign your Medicare benefits over to them.

If you enroll in the for-profit managed care plans Humana advertises so much – also called Medicare Replacement or Medicare Advantage plans – the government no longer pays your medical bills and instead sends around $800 per month to Humana to pay your medical bills.

Humana in turn requires you to only use their network of doctors and hospitals as well as requiring you to contribute in most situations up to $6,700 per year for the cost of your care if you become sick.

But this is not the worst part of this scheme.

If you sign your Medicare benefits over to Humana, Humana will decide what medical care they will cover. And they often will say “no” to expensive care in order to spend as little as possible on your care and maximize their profits.

You see, Humana gets the $800 per month from the government whether they spend it on your care or not. And most of whatever they do not spend they keep as net income which goes toward exorbitant executive salaries and bonuses.

In 2017 Humana made $2.4 billion dollars as a company and most of that money came from profits from the Medicare Advantage program.

All of these profits from Humana’s Medicare Advantage scheme came from spending less and providing less health services for its members than those members would have received on average had they stayed on regular Medicare.

You see, what “Managed Care” really means is managing your care to spend less so an insurance company can make a lot more money.

You have worked hard all of your life to pay into a Medicare system that promises to give you the best chance for the best health outcome without forcing you to spend thousands or tens of thousands of dollars in unexpected costs if you become sick.

You should never give up this hard-earned benefit to enroll in a Medicare Advantage plan that will increase profits at a big insurance company at the expenses of your financial well-being and your health.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

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You can also call me at (865) 851-1120 or email me at

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of

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