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Possible Changes Effecting Medicare Advantage Plans

Written By: Richard Cantu on April 23, 2010 No Comment

Medicare Supplement Insurance is not the only Medicare-related coverage that is going through changes within the next few months due to the new health care reforms proposed by President Obama. Medicare Part C Plans, which are commonly known as Medicare Advantage plans, are also experiencing change.

Here’s a bit of background information on Medicare Advantage Plans:

Medicare Advantage Plans are Health Maintenance Organization (HMOs), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, or Medicare Special Needs Plans . To enroll in a Medicare Advantage Plan, you must have Medicare Parts A and Part B, and you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. Advantage plans are private. You should not be simultaneously enrolled in a Medicare Advantage plan and a Medigap plan as they counter one another.

Reports state that Medicare Advantage Plan payments to private health insurers will be capped at 2010 rates for all of 2011. The proposed health care laws stipulate $130 billion in cuts over the next 10 years to these plans to prevent government overpayment to insurance providers.

As next year’s payments will not be able to match rising health care costs, what could occur is that insurance companies will offset the loss of payment increases by the increasing premiums that their customers pay.

Medicare Advantage Plans and prescription drug plan sponsors also must have significant differences between their products due to CMS regulation requiring the elimination of duplicate prescription and health plans. These differences run the gamut from plan types, client out-of-pocket costs, premiums, and formulary offerings.

Beginning in 2014, Medicare Advantage Plans will need to spend 85% of insurance premiums collected on providing health care to their customers as another limiting factor to overcompensation of insurance executives.

Looking to find the best deal on a Medigap Plan, then visit www.gomedigap.com to find the best advice on a policy for you.

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