What does Obamacare do to Medicare Advantage?

[FarCenter]

In the storm of Obamacare’s rough rollout, Michael Rossi received a letter from his insurance provider saying his policy to supplement Medicare that had no premium was ending; he could enroll in a new one for more than $100 a month.

Rossi didn’t have a lot of financial breathing room. The old insurance plan was quite a perk.

“I really don’t use it a lot, but the things that it did cover saved me some money,” Rossi, a Manalapan resident, said.

With open enrollment ending Dec. 7, Medicare recipients are finding fewer options for their supplemental health insurance through a program called Medicare Advantage.

The shift comes as the federal government pares back the money it provides for the coverage – a money-saving move that is designed to help pay for the Affordable Care Act, popularly nicknamed Obamacare, and cover millions of uninsured people.

http://www.app.com/apps/pbcs.dll/article?AID=2013311170012

Medicare insurers are canceling Medicare Advantage plans, many of which covered Part D as well. Seniors then have to shop for Part D plans and Medigap plans in order to get equivalent coverage. The remaining Medicare Advantage plans seem to be HMO only with very restricted networks.

[grasswire]

1. medigap is far superior to advantage

As far as I could see when I investigated several advantage plans, they were junk. Medigap is more clearly regulated, and more useful. Hopefully this is a plus.

[Cleita]

2. It's my understanding that those are different.

In Medicare Advantage you sign off your Medicare to a private plan. Those plans offer a variety coverage. In Medicare supplement or Medigap a private insurance pays for what Medicare doesn't or basically the 20% copay. Part D really hasn't changed.

Since Obamacare has cut the money to the private insurers that's probably why he got canceled. Trust me he's better off even if he has to pay the money out of pocket for Medigap. Once he finds he needs a lot of care like if he develops a chronic condition then the insurance companies are up to their old tricks of finding loopholes to deny coverage. It happened to my husband who had a Medicare Advantage plan. Everything was fine until he he got sick with a chronic condition.

[Lasher]

3. Technically Obamacare is not doing anything to it.

Its funding overpayments are sunsetting as planned by GWB in 2003. I posted this back in March:

Medicare Part C (AKA Medicare+Choce) was conceived in 1997 so that insurance companies could compete on a level playing field with traditional Medicare. Private sector insurers were given the same per capita amount that was being spent in the public sector (Parts A & B). The efficiencies of the private sector would drive down costs while providing enhancements to beneficiaries, or so the theory went. The problem was, this ideology is not consistent with reality.

These companies couldn't compete with traditional Parts A & B. "We need subsidies", they whined. "Then after we get established, we'll be able to function better than the public sector."

The GWB administration and his GOP lapdog Congress came to their rescue in 2003 by authorizing an unfunded per capita subsidy that is 14% greater than the one going to traditional Medicare. Part C was renamed as Medicare Advantage.

The insurance companies have predictably whined to keep their subsidies forever. Obama told them to shove it. Their overpayments will be phased out until the cost of Medicare Advantage is in line with that of traditional Medicare.

As in Greek mythology, the insurance companies are getting just what they said they wanted: a level playing field. I think 15 years is plenty of time for them to get their act together. But it just might be that every single thing does not work better in the private sector after all.

http://www.democraticunderground.com/10022494090#post7

This is proper. It was never right to throw extra money at Medicare Advantage to plaster over economic ideology that has clearly failed in this case. Medicare and its privatized counterpart should be funded at the same levels. To accomplish this, Medicare funding needs to be increased or Medicare Advantage funding needs to be decreased. The later scenario has been chosen.

[FarCenter]

4. So over 12 million Americans don't get to keep their Medicare Advantage plans either?

A lot of them are going to be upset.

[Hoyt]

5. Good point. Right now 28% of Medicare beneficiaries have selected Medicare Advantage.

I don't think all these plans are being cancelled. Just some.

From what little I know, you can save a good bit of money with some Advantage plans compared to buying a Medigap and drug plan, but you have to put up with provider networks and drug formularies.

[jwirr]

10. I am in MN and I have advantage care through Medica. So far I have not been canceled. If I had known

what I know now I would not have signed on.

[Sgent]

8. Kinda sorta

Medicare advantage plans (aka insurers) were getting paid 105% of the average costs of regular Medicare. That's being reduced to 100%.

That's the only change. People on Medicare advantage plans will no longer get more expensive plans than what regular Medicare costs. Insurance companies can still offer them, but they have to make them more attractive than regular Medicare + Supplement.

[Lasher]

9. Yes, that's correct.

Last edited Sun Nov 17, 2013, 05:50 PM - Edit history (1)

Like I said, free market advocates promised they'd eventually provide better and cheaper benefits at the same funding levels. The overpayments were to be temporary until they established themselves, they insisted. Insurance companies and their corrupt Congressional toadies lied.

These overpayments are not being cut off all at once as the 2003 sunset provision was to have provided. They are being extended somewhat but tapered off. This process is scheduled for completion by 2017. Nothing is being done by Obama or Congress to make people give up these policies. Everyone can keep their Medicare Advantage policies if their insurance providers will continue to provide them. They won't. At first, insurance policies will be changed to make them cheaper to provide. Then the insurance companies will stop providing them. That's just what happened when the same sort of privatization was called Medicare Part C.

But you are right, most Medicare Advantage beneficiaries won't know or care about any of this. Obama has not been effective in educating the public about this. But you can be sure that insurance companies and their toadies will be much more effective at spreading their version of what's happening.

This is a big problem heading our way. Most of those 12 million Americans will conclude, "Obamacare is taking away my Medicare."

[procon]

6. no problem for me

I've had Medicare Advantage thru Kaiser in So Cal for several years, and it was totalluy seamless. ACA actually improved my coverage with all the new no-copy tests that are now standard.

Remember, providers can -- and often do -- add or drop the ins plans they will accept, this is a common and industry wide practice that is not limited to the ACA.

Medigap plans are supplemental policies, but not the same as a primary insurance like the ACA. Medigap plans vary,but they pick up an amount that Medicare does not pay. This is not an issue if you choose a Medicare Advantage plan which provides comprehensive coverage.

[Blue_In_AK]

7. My other sister-in-law was complaining about this a couple weeks ago.

Medicare advantage plans aren't even offered in Alaska, so I have nothing to bitch about yet. I feel so left out.