Medicare Advantage Plans Improve under Obamacare

Obamacare ACA provisions improve Medicare Advantage quality.

Not too long ago the talk in conservative circles was how the cuts to Medicare Advantage plans under the Affordable Care Act would hurt seniors. The Centers for Medicare and Medicaid Services (CMS) has announced that more seniors now have access to higher quality Medicare Advantage plans as there has been a 28% increase in plans receiving four or more quality star ratings for the 2014 open enrollment period beginning on October 15th.

Medicare Advantage plans improve in quality

MA quality continues to improve as over one-third of MA contracts will receive four or more stars, which is an increase from 28 percent in 2013. Over half of MA enrollees are enrolled in plans with four or more stars, a significant increase from 37 percent of enrollees last year. The Centers for Medicare & Medicaid Services (CMS) calculates star ratings from 1 to 5 (with 5 being the best) based on quality and performance for MA and Medicare prescription drug plans to help beneficiaries, their families, and caregivers compare plans. - CMS

Obamacare preventive office visits for seniors

The proposed 2.3% reduction to Medicare Advantage plans was actually eliminated and the plans received a 3.3% increase in monthly reimbursements. Medicare Advantage plans have to comply with other ACA provisions such as “no cost” preventive office visits for early cancer detection, tobacco cessation and alcohol and substance abuse addiction. The plans must also cover “no cost” mammography and colonoscopies.

Marketing and coinsurance limited

Under the Obamacare, Medicare Advantage plans receive bonus payments for attaining a five star quality rating. The plans must also meet an 85% Medical Loss Ratio beginning in 2014 assuring that more dollars are spent on health care and less on marketing. The ACA provisions also prohibited plans from imposing higher cost-sharing requirements than Original Medicare for chemotherapy, renal dialysis, skilled nursing care and other services.

Medicare Advantage plans premiums stable

Not only has the quality of the Medicare Advantage plans improved the premiums for the plans have increased only a modest amount. CMS reports that MA plans increased only $1.64 on average for the 2014 year. The ACA also continues to close the “coverage gap” or “donut hole” in the Part D Prescription drug plans saving beneficiaries an estimated $7 billion since the the Obamacare provisions started.

Added features

So the doom and gloom conjecture that Medicare Advantage plans were threatened by ACA reforms seems not to have materialize and the plans are actually improving. Some of the plans are even adding extra benefits beyond Medicare coverage for hearing aids, chiropractic, acupuncture and vision care.

Health and Human Services news release -

More, higher quality options for seniors in Medicare Advantage

Thursday, September 19, 2013

More beneficiaries are choosing higher quality Medicare Advantage (MA) plans, and for the fourth straight year enrollment is projected to increase, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

The average MA premium in 2014 is projected to increase by only $1.64 from last year, coming to $32.60. Access to the Medicare Advantage program will remain strong, with 99.1 percent of beneficiaries having access to a plan. The average number of plan choices will remain about the same in 2014 and access to supplemental benefits remains stable. Since passage of the Affordable Care Act, average MA premiums are down by 9.8 percent.

MA quality continues to improve as over one-third of MA contracts will receive four or more stars, which is an increase from 28 percent in 2013. Over half of MA enrollees are enrolled in plans with four or more stars, a significant increase from 37 percent of enrollees last year. The Centers for Medicare & Medicaid Services (CMS) calculates star ratings from 1 to 5 (with 5 being the best) based on quality and performance for MA and Medicare prescription drug plans to help beneficiaries, their families, and caregivers compare plans.

“As a result of the Affordable Care Act, Medicare Advantage and Prescription Drug Plans remain strong and continue to provide improved benefits and low premiums for beneficiaries,” said Secretary Sebelius. “And as a reminder, it is business as usual when it comes to their Medicare benefits: people with Medicare do not need to enroll in the new Health Insurance Marketplaces.”

Earlier this year, CMS announced that the average estimated basic Medicare prescription drug premium plan in 2014 is projected to be $31 per month, holding steady for four years in a row. 100 percent of people with Part D will have access to a plan with lower premium than what they paid in 2013. More than 6.6 million people with Medicare have saved over $7 billion on
                              
prescription drugs as a result of the Affordable Care Act, an average of $1,061 per beneficiary. The Affordable Care Act closes the “donut hole” over time. This news comes on the heels of historically low levels of growth in Medicare spending. From 2010 to 2012, Medicare spending per beneficiary grew at 1.7 percent annually, substantially more slowly than the per capita rate of growth in the economy.

The Annual Open Enrollment period for health and drug plans begins on October 15 and endsDecember 7. Each year plans costs and covered benefits can change, and Medicare beneficiaries should look at their Medicare coverage choices and decide what options best meet their needs. For more information on Medicare Open Enrollment and to compare benefits and prices of 2014 Medicare health and drug plans, please visit: http://www.cms.gov/Center/Special-Topic/Open-Enrollment-Center.html.

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  • Charles

    Keep up the good work, Kevin. I do not have Medicare, but I forwarded this post to someone like me (read “older person”). She immediately responded that she was delighted to get your column.

    • http://Www.insuremekevin.com/ Kevin Knauss

      Thank you! I know the Medicare Advantage plans have the muscle to provide excellent quality to the members. We have a 5 star rated plan right in Sacramento. I’m excited that some of the changes from the ACA are filtering through to Medicare beneficiaries.

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