Kevin Knauss: Health, History, Travel, Insurance
Posts related to Medicare Advantage plans which are original Medicare health benefits provided by private companies.
Health Net and several other administrators of Medicare Advantage plans were issued fines from the Center for Medicare and Medicaid Services (CMS) for errors in their updates to people enrolled in the MA-PD plans. The penalties, issued in October 2013, were for incorrectly stating plan information in annual notices to Medicare beneficiaries enrolled in the Advantage plans and ranged from $23,410 up to $86,530.
If a Medicare Advantage plan has been awarded a 5 Star rating from Medicare you’ll see that trumpeted in TV commercials and print advertising. The star rating that either the Medicare Advantage or Part D Prescription Drug plan must display is a composite of 35 different measurements. Perhaps the most important rating for most beneficiaries is the level of customer service if there is a problem.
Medicare beneficiaries who suffer from chronic and debilitating illnesses such as cancer, dementia, HIV/AIDS or have suffered a stroke may be eligible for a Medicare Advantage Special Needs Plan (SNP). These SNPs may offer transportation to and from doctor appointments, hearing aids and special language interpreters for doctor appointments.
Thousands of Medicare Advantage plan members in California are receiving letters that their health plans are closing from carriers such as Anthem Blue Cross and Health Net. Some of the health insurance companies will be leaving some counties completely while others will be offering new Medicare Advantage (MA) plans to their members. Regardless of the reasons, the plan closure triggers a Special Enrollment Period for Medicare beneficiaries to select a new plan offered in their county.
Numerous Medicare Advantage (MA) plans will be offered in 2014 throughout California. All MA are county specific and may have additional reduced availability by zip code within the designated county. Most of the MA plans also include the Part D Prescription Drug plan (MA-PD), but not all.
Medicare Advantage plans have been encouraged by the Centers for Medicare and Medicaid Services (CMS) to include $0 copay prescription costs for medications that work to reduce heart attacks and strokes in the plans for 2014. Some plans will be including $0 copay drugs that fight high cholesterol and high blood pressure.
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.
The Centers for Medicare and Medicaid (CMS) have announced enforcement actions against two Medicare Advantage Program for All-Inclusive Care for the Elderly (PACE) contractors. Both Silver Star Health Network in Lubbock, TX, and Alexian Brothers Community Services in St. Louis, MO, received civil monetary penalties of $25,000 each for non-compliance of Medicare regulations. Formal letters notifying the Medicare Advantage Plans of the penalty were sent out August 1, 2013.
CMS cited numerous failures on the part of SmartD Rx to properly handle member’s prescription drug and enrollment transactions.
The contradictory nature of Washington lawmakers was on full display this past week as they lobbied the Centers for Medicare and Medicaid (CMS) not to cut reimbursements to privately run Medicare Advantage plans while allowing the budget sequester to curtail funding for Medicare cancer patients.
