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Home » A Fresh Look at Medicare Advantage

A Fresh Look at Medicare Advantage

June 27, 2014 by Ellen LaPlante

Even as the nation as a whole is settling into the new healthcare laws – whether it’s ACA or the HIPAA laws that, while aren’t necessarily new, are beginning to affect families. Then there are the expanded Medicaid programs and the massive 6 million new enrollees as a result of the Affordable Care Act. This is definitely a transition for the country as we move forward. There has been one surprising result, however.

We now know that there are far more Medicare beneficiaries in Medicare private plans than expected. As of now, there are close to 16 million beneficiaries as of current day, marking an all-time high. It’s also 6 million more than the Congressional Budget Office anticipated. In 2010, when CBO began running the numbers and because it didn’t expect this record number, it also means shifts are being made to cover what is now believed to be 22 million by the year 2020. This is twice the number than planned when ACA was put into place.

In fact, it was believed that the Medicare Advantage enrollment numbers would actually decrease because of the payment reductions required to balance ACA. One report suggested a 14 percent decrease in payments, which were scheduled for two year reduction increments.

From a national perspective, Medicare Advantage enrollment has increased by 41 percent since 2010. Frankly, this took everyone by surprise.

Interestingly enough, even insurance companies were concerned that these payment reductions would mean a slashing of benefits or even opting out of the Medicare Advantage program. Instead, Medicare beneficiaries have at least 18 Medicare Advantage plans they may select from – which is a record high. Even those that appeared to have dropped out of the market actually were merged with another plan to better strengthen it. Suddenly, there were choices no one expected and as a result, better and more choices mean better treatment options.

Some say this enrollment increase is due to efforts being made by the Centers for Medicare and Medicaid Services, specifically the quality bonuses that were awarded to most plans. The incentive, apparently, was worth it and played a significant role in offsetting many of the payment reductions over the past few years. Provided those plan administrators that accepted the bonuses actually used them, this ended up being ideal for Medicare beneficiaries. As a result, more seniors and the elderly turned to the Medicare Advantage plans. It’s a trend experts now say will continue.

Further sweetening the deal is the drop in monthly premiums. In 2010, the average premium was around $44. Today, the premium many Medicare recipients pay is less than $35.

Ah, but there are signs that these could be more about shifts than actually saving money for beneficiaries. Out of pocket limits have increased slightly and the number of provider networks have lessened in previous months. Still, though, these adjustments are less about offsetting the lower premiums and more about expanding the options.

Ultimately, and if the numbers are telling the tale, it would appear the Medicare Advantage changes are benefiting today’s seniors, which is always a good thing and if CBO’s projects are right, those numbers will only increase in coming years.

Have questions about Medicaid, Medicare or VA enrollment? Our team of experienced estate planning lawyers can help you navigate the sometimes overwhelming waters associated with the application process. Give us a call today to learn more about your options.

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Ellen LaPlante
Ellen LaPlante
Ellen LaPlante is an attorney whose mission is to provide clients with guidance in Estate Planning, Elder Law, and Medicaid Preparation. She is barred in Vermont and New York. Ellen helps clients put together unique estate plans, including assistance with Trusts, Wills, Powers of Attorney, and Advance Directives. She also works with clients on Medicaid Planning and qualifying for Medicaid assistance.
Ellen LaPlante
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