The editor/author is an insurance agent in Tucson, Arizona More →
Medicare Advantage plans will not face big payment cuts until 2012. Under the health care reform bill, Advantage plans will get the same payments in 2011 as they receive in 2010. So November 2010 should not see big changes to Medicare Advantage plans such as large increases in premiums and co-pays, or wide-spread plan cancellations. That is more likely to happen in November 2011 when 2012 plan details are released.
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In the long list of provisions in the health care reform law that will affect Medicare, it looks like the most important element is the Independent Payment Advisory Board. This appointed board will have the ability to set policy for Medicare.
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All the delays in passing the health care reform bill will also delay positive changes to Part D coverage. Seniors were supposed to get relief this year, but it appears that people who fall into the doughnut hole in 2010 will only get a $250 rebate. Changes that were supposed to take effect in 2010 have been moved to 2011.
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The Health Care Reform Law will affect Medicare in many ways. Cuts to Medicare Advantage plans and increases for primary care doctors are just some of the changes. The list is from The Medicare Rights Center.
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A recent report from Congress highlighted why Democrats hate Medicare Advantage. The study of Medicare Advantage plans’ revenues and expenses from 2005 to 2008 found that the average Medicare Advantage insurer spent over 15% of its revenues on marketing, administrative costs, and profits.
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Dade County, Florida has 81 Medicare Advantage plans and most of the HMO plans offer seniors practically-free healthcare. $0 premium; $0 co-pay for hospitalization; $0 to see doctors. At the same time, seniors in Arizona are facing substantial changes in their plans in 2010, including a $36 monthly premium for a plan that has always been $0. Hospital co-pays that would be $900 in 2009 will be $2,000 next year.
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The Medicare Payment Advisory Commission (Medpac), released a report in June 2009 which looked at how secondary insurance influences how much healthcare people seek out. Through number crunching and regression analysis, researchers determined that “secondary insurance has a substantial impact on Medicare spending, especially Part B spending, particularly among people who had first-dollar or nearly-first-dollar coverage.”
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Opponents of Medicare Advantage have a mantra that says private Medicare plans receive fourteen percent more money per enrollee than is spent on the average Medicare beneficiary. President Obama and legislators writing healthcare reform bills all agree that billions of dollars must be cut from Medicare Advantage plans over the next five years.
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In 1962 Ronald Reagan was a spokesman for groups opposed to the introduction of Medicare. Socialism and the loss of personal freedom were the battlecry of the opposition to Medicare. A Medicare bill was defeated in 1962. Click on the video link.
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October 2009: America’s Health Insurance Plans released the following statement at the end of September, 2009 regarding the impact of proposed cuts to Medicare Advantage: FACT: The impact of proposed cuts to Medicare Advantage (MA) would vary greatly depending on how the cuts are structured and where a senior happens to live. The House legislation [...]
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CMS has launched an investigation of Humana after questions were raised over letters it sent to its beneficiaries on the subject of health reform. Officials are looking into the issue of whether Humana used scare tactics when it reached out to Medicare Advantage members and took a stand on health reform legislation.
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If Medicare Advantage plans impose higher premiums and higher co-payments for servcies, over 10 million people enrolled in these plans will be affected. In some states the numbers are quite high.
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I got a call the other day from a client who is 88 years old. He had received a mailing from friends in Georgia that was 11 pages of misinformation about health care/health insurance reform plans being debated in Congress. Needless to say, this information scared him and his wife.
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In a 1996 New York Times article, Tucson, AZ Medicare HMO plans were touted as a model for saving Medicare dollars, and 42 percent of seniors in Pima County were enrolled in such plans.
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A May 2009 AHIP survey showed out‐of‐network physicians in Arizona billed between 670 and 1,670 percent of the Medicare fee for that service in 2008.
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House bill 3200 targets changes in Medicare Advantage that will effect enrollment periods and costs in the private plans.
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