Medicare Advantage was designed to save the government money. But a Wall Street Journal investigation found that private insurers used the program to generate extra payments through questionable diagnoses. The investigation uncovered instances of potentially deadly illnesses like AIDS, where patients received no follow-up care, as well as diagnoses that were medically impossible. This happened in part when insurers sent nurse practitioners into Medicare Advantage recipients’ homes. Jessica Mendoza discusses the investigation with WSJ’s Christopher Weaver as well as a nurse who participated in the program. Further Listening: -A Life-or-Death Insurance Denial -Even Doctors Are Frustrated With Health Insurance Sign up for WSJ’s free What’s News newsletter. Learn more about your ad choices. Visit megaphone.fm/adchoices
Full Episode
Medicare is America's government-run health care plan. It provides care for anyone 65 and over and some people with disabilities. But what a lot of people may not realize is that a majority of those on Medicare get it through a program called Medicare Advantage.
Yeah, there's more than 60 million people in Medicare, and more than half of those are in Medicare Advantage at this point.
And the thing about Medicare Advantage is that the plans are paid for by the government but managed by private insurance companies.
Medicare Advantage is sort of dominated by these huge insurance companies like United Health Group, Humana, Aetna, and Elevens.
And that's really why we called the series at some level Medicare Inc. Because people think, oh, this is a government program. But it's also a huge, huge, huge business for some of the biggest companies in America.
I'm Chris Weaver.
I'm Ana Wildey-Matthews.
I'm an investigative reporter at The Wall Street Journal.
And I cover health insurance for The Wall Street Journal.
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