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Instead of paying for medical procedures as they occur (which original Medicare does), Advantage plans are paid a set amount for each enrollee every year, paid from the Medicare trust fund. The amount is something like 12 or 13 thousand dollars per person.

If the enrollee doesn’t use the entire amount during the year, then the insurance company administering the Advantage plan gets to keep the excess amount as profit - that’s part of this 84 billion in overpayments. They toss a few bones to the enrollees, like cash for food, dental coverage, or vision coverage. Enrollees like those benefits, so they get into arguments on social media and defend the plans. That was by design, so people will defend the plans.