It’s hard to believe, but Medicare’s open enrollment season began last week.
And this year, as a result of the federal health reform law, seniors will have to brace for several changes.
Seniors who rely on privately administered Medicare Advantage plans for their benefits will face the biggest adjustments. That’s too bad, as Medicare Advantage has a strong track record of delivering health benefits that meet or even exceed those of conventional Medicare.
Medicare Advantage offers enrollees a different way of receiving their Part A hospital and Part B physician care. Under the program, private insurers offer competing plans, and patients themselves choose which coverage option works best for their particular health and financial needs.
MA insurers must provide at least the same benefits as traditional Medicare, but most offer more. The government reimburses insurers at a preset rate per enrollee.
More than 12 million seniors participate in Medicare Advantage, about one-fourth of all those eligible for Medicare. The pool of MA beneficiaries has more than doubled since 2005.
The program has grown popular thanks in large part to its competitive structure, which encourages insurers to vie with one another for seniors’ health care dollars and thus provides them more choices.
But some policymakers believe the MA program to be wasteful. They cite the fact that Medicare Advantage costs the government more per enrollee than does traditional Medicare. They believe seniors would be better served if everyone were enrolled in the traditional Medicare program.
To aid in that pursuit, the PPACA law included a provision that changes the special Medicare Advantage open enrollment period that occurs each year in January. Previously, Medicare beneficiaries were allowed to either change from one Medicare Advantage plan to another Medicare Advantage plan or to change from Medicare Advantage to traditional fee-for-service Medicare.