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ShazzieB

(22,173 posts)

23. This part caught my eye.

Fri Dec 26, 2025, 03:56 PM

Friday

"The pilot will last six years. It begins on January 1, 2026, for those on traditional Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington."

I wonder how they decided which states were to be the guinea pigs. My condolences to all traditional Meducare recipients who live in one of those states.

It says this pilot plan is supposed to last 6 years. I hope it can be rescinded sooner than that once Democrats are back in power.

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BumRushDaShow Joinfortmill benfranklin1776 Dixc SunSeeker oberle area51

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Highlight:

New Medicare Program: Full List of Services That Will Need Prior Approval [View all] BumRushDaShow Friday OP

They really went after nerves. Is salvation through pain part of the plan? bucolic_frolic Friday #1

Steroid injections have kept me ok on my feet redstatebluegirl Friday #3

Me too. mgardener Friday #4

This message was self-deleted by its author Trueblue Texan Friday #11

I just got a shot in my shoulder LittleGirl Friday #12

That should still be okay. Igel Friday #17

Right? LittleGirl Friday #41

Exactly. SergeStorms Friday #42

Had that one too Bayard Friday #59

I get steroid shots in my scaphoid joint for arthritis. The list specifies that steroid shots in joints are not included Martin68 Yesterday #70

Same here Bayard Friday #58

That's what made Mother Theresa druidity33 Friday #21

How about a pilot program Henry203 Friday #2

Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover. thesquanderer Friday #8

Advantage plans are private insurance, and they should be banned from using " Medicare" in their name. OMGWTF Friday #18

I agree. Unless maybe they more honestly called it something like "Medicare Alternative" or "Medicare Private Option." thesquanderer Friday #25

Alternative Medical Services. cstanleytech Friday #57

They are literally Medicare plans, Authorized under the Medicare Part C statutes Ms. Toad Friday #31

The person you're replying to said Advantage plans should not have been allowed as Medicare plans. pnwmom Yesterday #63

No. They said they should be banned from using "Medicare" in their names. Ms. Toad Yesterday #69

Ban "Medicare" from their name ENTIRELY Seinan Sensei Friday #34

Medicare Advantage plans are PPO/HMOs, just like regular private company insurance carriers. Medigap is fee-for-service. valleyrogue Yesterday #75

Medicare Advantage can require pre-authorizations not required for Medicare/Medigap, thesquanderer 22 hrs ago #77

huh? Skittles Friday #54

I should have said upcoding Henry203 Friday #55

AI prior authorization approval is already a relatively common practice anciano Friday #5

And it needs legislatively banned. benfranklin1776 Friday #27

Not just the Ai part of it, but the outside authorization mahina Friday #32

Agreed! benfranklin1776 Friday #60

But one of the main reasons to choose standard Medicare over a Medicare Advantage plan is to minimize a third party Ms. Toad Friday #38

"Healthcare" is an umbrella term that encompasses anciano Friday #39

Healthcare is distinct from how that care is paid for. Ms. Toad Friday #44

So? People pay MORE to join Traditional Medicare so that they can choose their own doctors pnwmom Friday #48

No LtTx Friday #53

Yes, they do, in order to get Parts A and B, which covers both hospitalization pnwmom Friday #56

And yet the govt is clamping down on prior authorization in Advantage plans pnwmom Yesterday #64

Brought to you by the same people who believe in ivermectin for covid Raven123 Friday #6

i've had the cellular. tissue application for foot wounds that would not heal rampartd Friday #7

neck surgeries, knee surgeries, incontinence control, pain relief -- how very cruel, how very predictable 0rganism Friday #9

So delay and deny are what's in store for our Buddyzbuddy Friday #10

We have to move to Medicare for all and cover everything. ChicagoTeamster Friday #13

Our doc told us pre-approval is needed for what was our usual blood test AverageOldGuy Friday #14

If you are no standard medicare, your doctor is wrong. Ms. Toad Friday #36

Under an Advantage plan with an HMO dickthegrouch Friday #15

But this experiment is being done with Traditional Medicare patients, which doesn't require prior authorization. pnwmom Friday #49

Companies running this make money with every denied claim groundloop Friday #16

Death by spreadsheet OMGWTF Friday #20

Private insurance companies don't run traditional Medicare. ShazzieB Friday #22

AI "death panels"..... SergeStorms Friday #43

But private companies WILL provide the AI services performing prior authorizations for Traditional Medicare. pnwmom Yesterday #66

Yes, I see that now. ShazzieB Yesterday #74

Yes! You found the key point. That, and the fact that some of the decision makers pnwmom Yesterday #76

The whole reason Iʻm paying extra for supplemental ins is to keep the imperfect gem, traditional medicare, where mahina Friday #19

"Just reading our DUers here and the impacts this would make to their lives is powerful." BumRushDaShow Friday #24

This part caught my eye. ShazzieB Friday #23

Amen 💪🏼 benfranklin1776 Friday #28

Don't You Mean OhioTim Friday #46

I know what you mean, but I prefer not to think in those terms. ShazzieB Yesterday #61

Doesn't sound reasonable or even rational Joinfortmill Friday #26

Does one need advanced approval to die? milestogo Friday #29

That's next... 2naSalit Friday #50

So they're creating those death panels that Sarah Palin warned us about WestMichRad Friday #30

Trump Qualifies For One OhioTim Friday #33

two actually - do his diapers require prior approval? RainCaster Yesterday #62

Deep brain stimulation for the treatment of essential tremor progressoid Friday #35

It's fairly new TexasBushwhacker Yesterday #71

I'm lucky (???) in that I'm already bald. :) progressoid Yesterday #72

I actually looked into the focused ultrasound TexasBushwhacker 3 hrs ago #78

At best, it will delay treatment. Treatment delayed is treatment denied. SunSeeker Friday #37

It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind) Ms. Toad Friday #40

I expect this is being pilot-tested to eventually become a permanent change (with more procedures needing prepproval) BumRushDaShow Friday #45

I agree. Ms. Toad Friday #47

I know for those of us feds who planned to maintain their FEHB insurance plans when Medicare-eligible BumRushDaShow Friday #51

When I had a cancer diagnosis, I was in surgery 2 days after getting the diagnosis, pnwmom Yesterday #65

That's the general basis for my personal concern with the skin and tissue substitutes Ms. Toad Yesterday #68

The U.S. is the only modern nation without a universal tax supported health care system for all their citizens. It makes ShazamIam Friday #52

WHY?? travelingthrulife Yesterday #67

RFK, Jr. and Dr. Oz lonely bird Yesterday #73