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Will Obamacare Save Medicare Advantage Plans?

Medicare Advantage PlansMedicare Advantage plans will not be hurt by the Affordable Care Act based on projections made by the Centers for Medicare and Medicaid Services (CMS). Medicare Advantage plan premiums were seen to decrease by an average of seven percent in 2012, and are projected to decrease by 10 percent next year. Not surprisingly, the number of people enrolling in one of these plans is expected to increase by 28 percent.

And, it may come as a surprise that the benefits offered still remain the same despite the decrease in premiums. Jon Blum, the CMS Director, says projections that the Congressional Budget Office (CBO) made have turned out not to be accurate. Advantage plans are still going strong.

While the federal subsidies to certain Medicare Advantage plans that were thought not to meet certain standards were decreased, bonuses were available to other plans deemed to be high-performing plans. These incentives seem to be working. Blum says that their program will continue to remain strong because of unrelenting interest shown by insurance companies.

Medicare Advantage plans were created as a private insurance alternative to traditional Medicare. This alternative combines benefits from Medicare Part A and B. Advantage plans also usually offer some Part D prescription drug coverage and extras, like help to pay for eyeglasses and hearing aids. Thus, Advantage plans are often referred to Medicare Part C.

The highlight of Advantage plans is their low premiums. These plans also guarantee applications will be accepted in spite of pre-existing health problems, with the exception of end-stage renal disease or ESRD. Those who have had a successful kidney transplant are likely to be able to get an Advantage plan, though.

Most Advantage plans restrict coverage to providers that are affiliated with their network unless you need emergency medical care. If you have a doctor you trust, always see whether a plan covers her or his services before applying.

Blum also said that Medicare beneficiaries will start to receive notifications if the plan that they enrolled in performs poorly (a plan that receives less than three stars). These star ratings reflect the level of federal subsidy, and it’s thought that higher subsidies allow plans to reduce, and in some cases eliminate, Advantage plan premiums. Beneficiaries do pay Medicare Part B premiums when enrolled in an Advantage plan.

Author: Jim McFadden
Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.

 

 
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