Medicare Advantage is Not Dead

[superdave]

FOR IMMEDIATE RELEASE
U.S. Department of Health & Human Services
Thursday, September 19, 2013

More, higher quality options for seniors in Medicare Advantage

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.”

 

[FLM2]

MAPD is not dead but will be on life support in many states in the next few years as seniors find that $0 premium PPO's are a thing of the past and that their only choices will be HMO plans.

I don't know about anyone else but as soon as the letters H M O come out of my mouth most seniors immediately say they don't want an HMO plan, this will have to change in the future if the program is to remain viable.

 

[yogooglethis]

MAPD is not dead but will be on life support in many states in the next few years as seniors find that $0 premium PPO's are a thing of the past and that their only choices will be HMO plans.

I don't know about anyone else but as soon as the letters H M O come out of my mouth most seniors immediately say they don't want an HMO plan, this will have to change in the future if the program is to remain viable.

Not that HMO's or even managed care is good for everyone but educating old people on the benefits of these plans is something agents can do. It can be challenging at times to help the senior overcome preconceived ideas they have about managed care plans. It can be really challenging if the prospect previously encountered a Med Supp only agent with very limited knowledge on the pros and cons of all Medicare Health plans and especially if the previous agent used scare tactics to sell a Med Supp over a MA plan. I see this happen all the time.

Everybody's situation is different but I have run in to many cases where the client has Medicare and a first dollar coverage supplement and because there is no coordination of care and no financial consequence to the oldster for visits to specialist they are going to specialist for things a PCP may be able to take of and getting test and being prescribed meds they may not really need.

The big problems arises in non managed health plans is when a senior is taking 10 different meds from 4 different doctors and none of doctors know what the other doctor is treating the patient for.

This can lead to major health problems if there is serious side effects from the interactions of different prescriptions. Seniors don't talk about these issues at their Bridge game but they will hear the horrer stories about their friend Ethel who had a hard time getting a referral on their HMO plan. Again this is where agents can help educate the senior.

 

[MrMack]

I let people HMOs were passed under Senator Edward Kennedy in the 1970s as a way of getting doctors to work together.

 

[jdeasy]

They may not be dead yet but they are on life support.

 

[xrac]

They may not be dead yet but they are on life support.

Maybe kind of like my son's 13 year old spaniel. She ain't dead yet but she staggers when she walks, is blind, and can't hear.

 

[benefits365]

Maybe someone can help me understand: why do you say MAs are dying?
There was an increase in funding of just months after word came that there would be a cut.
More 4 star and higher plans than ever before.
The majority of seniors that elect MAs have always chosen HMOs more often than PPOs, because of the cost savings.
There is a recession still in place.
CBO projects increased enrollment through 2023.

So, why is MA in trouble? I don't mean that rudely, I think I may just be reading different tea leaves...

 

[jdeasy]

Maybe someone can help me understand: why do you say MAs are dying?
There was an increase in funding of just months after word came that there would be a cut.
More 4 star and higher plans than ever before.
The majority of seniors that elect MAs have always chosen HMOs more often than PPOs, because of the cost savings.
There is a recession still in place.
CBO projects increased enrollment through 2023.

So, why is MA in trouble? I don't mean that rudely, I think I may just be reading different tea leaves...

In this area it's to basically 2 choices now. Humana or Anthem. UHC has pulled out of most counties in this area. They will still have a small presense in PFFS.

Humana's HMO is a joke in these parts and the PPO's are not much better. PFFS plans ruled the day here and now most of them are gone. Today Options still has a presense here but the premiums are about what one could get a sup for.

The two viable choices here, Anthem and Humana have announced, or should I say "hinted at", premium increases. Anthem is almost double premium what it was last year and Anthem is not part of the network of the largest healthcre provider in this region.

Maybe it's different in other parts of the country? But they are dying here and I say good riddance.

 

[Chazm]

Maybe someone can help me understand: why do you say MAs are dying? There was an increase in funding of just months after word came that there would be a cut. More 4 star and higher plans than ever before. The majority of seniors that elect MAs have always chosen HMOs more often than PPOs, because of the cost savings. There is a recession still in place. CBO projects increased enrollment through 2023. So, why is MA in trouble? I don't mean that rudely, I think I may just be reading different tea leaves...

Because agents are tired of offering ma plans and love using scare tactics. I agree with you personally

 

[FLM2]

Maybe someone can help me understand: why do you say MAs are dying?
There was an increase in funding of just months after word came that there would be a cut.
More 4 star and higher plans than ever before.
The majority of seniors that elect MAs have always chosen HMOs more often than PPOs, because of the cost savings.
There is a recession still in place.
CBO projects increased enrollment through 2023.

So, why is MA in trouble? I don't mean that rudely, I think I may just be reading different tea leaves...

I can only speak for my resident state (Florida) but there is huge pushback from seniors when the letters HMO are mentioned.

Some of this is that there are so many snowbirds who live in other states 4-6 months a year, an HMO plan doesn't really work for them if they still use their doctors up north.

The rest of it is the history of bad care under many HMO's in the past, it's going to take lots of work on the part of the major insurance companies, which are offering good HMO plans, to overcome this.