[sam537]

Do you have any insight into how a Medicare eligible person choosing Medicare advantage lose most of their funding for extended care facilities or SAR/AR days (in exchange for subpar vision/dental)? That 39% does not evaporate into savings.

[bhupy]

Yes, Medicare traditionally never covered long term care. This was true for both Original Medicare, as well as for Medicare Advantage. Only Medicaid covered long term care, but as you may know that’s only for those with low income.

However, this is beginning to change. The Centers for Medicare and Medicaid Services has begun to allow private Medicare Part C insurers expand into long term care. Notably, to this day the public Medicare still doesn’t cover long term care, whereas M.Adv plans are beginning to.

If you’re talking about SNFs, Medicare Advantage is basically at parity with OM. I’ve seen Advantage plans by big payers like Humana with SNF benefit periods of 100 days. The 39% savings figure is on average, but if you require long term SNF stay, you’ll probably cost roughly the same to a private insurer as you do to Original Medicare. None of that stops private insurers from offering the benefit, since the actuarial math works out to the kind of savings that we’re mentioned above, across a whole benefit population.

> in exchange for subpar vision/dental

I’m not sure what data you’re looking at, but from where I sit, Medicare Advantage almost always includes vision/dental, whereas Original Medicare does not (which is why some seniors go for Medigap).