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Medicare Advantage
Trends
- 1AI is increasingly deciding who gets medical care●AI is deciding whether or not people receive medical care
Health insurers in the United States are using artificial intelligence systems to help determine whether patients' treatments and claims are approved, raising concerns about wrongful denials of care. Commenters are debating the risks of automating coverage decisions at companies like UnitedHealth, Medicare Advantage plans, Cigna and Humana, and whether regulators can keep pace.
- 2Trump administration uses AI to deny seniors' medical claims▼Trump admin using AI to deny medical care for seniors in disastrous experiment
The Trump administration is expanding the use of artificial intelligence to decide whether Medicare Advantage claims for seniors are approved, and critics call it a disastrous experiment. Ars Technica reports that vendors rolling out AI denial systems have an incentive to deny as many claims as possible, since they profit when care is refused. Critics warn the tools are being used to override doctors' judgments and systematically reject legitimate care for older Americans.
- 3Medicare Advantage Plan Cancellations Could Limit Your Options This Fall●You May Get Two Envelopes From Your Insurer This Fall. One Says Your Plan Changed. One Says It's Gone. Only the Second One Comes With a Medigap Right
Millions of Medicare Advantage and Part D plan holders could receive two letters from insurers this fall: one announcing plan changes for the coming year, and another confirming their plan is being discontinued. Policy experts note that only enrollees whose plans are cancelled get a guaranteed issue right to buy a Medigap supplemental policy without medical underwriting, making the second letter far more consequential than it looks.