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 refresher 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. In order to enroll with a Medicare Advantage plan, you need to have Medicare Parts A and Part B, and you may have to pay a monthly premium to your Medicare Advantage Plan for extra benefits that they offer. Advantage plans are privately provided. You should not be simultaneously enrolled in a Medicare Advantage Plan and a Medigare Supplement 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.
Seeing as next year’s payments cannot match rising health care costs, what may occur is that insurance companies will offset the loss of payment increases by increasing the premiums that their customers are required to pay.
Medicare Advantage Plans and prescription drug plans also will need to have significant differences between their products due to CMS regulation which requires the elimination of duplicate drug and health plans. These differences range from plan types, client out-of-pocket costs, premiums, and formulary offerings.
Starting in 2014, Medicare Advantage Plans will have to spend 85% of health insurance premiums collected by insurers on providing health care to their customers as an additional limiting factor to overcompensation of insurance executives.
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