Showing posts with label Medicare Advantage. Show all posts
Showing posts with label Medicare Advantage. Show all posts

Saturday, August 21, 2010

Health Insurance Reform: ACTUARIAL IMPACT ON MEDICARE

UPDATE: 7 September -  

Steep rate hikes on way for individual health insurance

Double-digit rate increases are hitting most individual health-insurance plans in Washington state, hurting jobless workers and worrying insurance regulators.
http://seattletimes.nwsource.com/html/localnews/2012827665_ratehikes07m.html

UPDATE: How Health Care Is Hampering Economic Recovery

by GoozNews ~ 27 Aug 2010 09:02am

Reed Abelson over at the New York Times' Prescription blog has an interesting reporton a new study questioning Detroit's strategy of relying on health care to bolster its lagging economy. I posted the following comment:
Detroit is merely a microcosm of the nation as a whole. Health care is the only sector that has added jobs throughout the Great Recession, just as it added jobs throughout the previous two decades (see my article in The Fiscal Times here).
What nobody wants to look at is how it continues to do so regardless of economic conditions. The answer is simple. There are no constraints on spending. Providers through insurers pass on rising costs to businesses and consumers in a marketplace where demand elasticity is very low because demand is dictated by the supply side (i.e., doctors/hospitals/input industries prescribe, patients obey).
It's like Keynesian stimulus with one vital exception, which turns it into its opposite. When the government engages in deficit spending to stimulate demand, it borrows from the future. When the health care sector engages in automatic demand-driven cost increases, it takes its cash in real time from every other sector of the economy, including the government. That may be acceptable when the rest of the economy is growing. During recessions, like now, it becomes a major drag that hampers economic recovery.

UPDATE: 25 August
Anthem Blue Cross allowed to move ahead with rate hikes

California insurance regulators cleared the way Wednesday for Anthem Blue Cross to implement scaled-back rate hikes after a previous rate increase was canceled amid an uproar over its size.
Anthem said it intends to put the new rates -- averaging 14% and as high as 20% -- into effect Oct. 1 for nearly 800,000 individual California policyholders.
The Woodland Hills company backed off its initial plan to increase premiums in March as much as 39% after consumers, regulators, lawmakers and even President Obama criticized it. Insurance regulators say the six-month delay saved policyholders $180 million. Anthem is the state's largest for-profit insurer.
from John Goodman's Health Policy Blog, 21 August
For the first time in Medicare history, the Medicare Chief Actuary has called the projections in a Medicare Trustees Report “unreasonable” and “implausible” and encouraged everyone to ignore them and view instead an “Illustrative Alternative” report. The alternative opens this way:
The Trustees Report is necessarily based on current law; as a result of questions regarding the operations of certain Medicare provisions, however, the projections shown in the report do not represent the “best estimate” of actual future Medicare expenditures.

and from the FDA


Slight Increase for Medicare Drug Premiums Next Year
Medicare beneficiaries enrolled in Part D will pay an average of $30 per month for their prescription drug benefit premiums in 2011, a $1 increase over what they paid this year, according to Centers for Medicare and Medicaid Services (CMS) officials.
Premiums stayed relatively stable because of a discount program in the the healthcare reform law, Jonathan Blum, deputy administrator of CMS' Center for Medicare, told reporters Wednesday.Cost will remain about steady, and so will benefits, said CMS Administrator Don Berwick, MD.
The low rates will "add stability" to the Medicare Part D program, which has an enrollment of about 27 million seniors, Berwick said.
When Part D first began, the program was projected to cost $634 billion for fiscal 2004 through 2013. Instead, it will cost $373 billion for those same years, Paul Spitalnic, of CMS' Office of the Actuary told reporters.
The main reason for the program coming in $261 billion under projected costs is that the rising costs of prescription drugs slowed in the early 2000s and more people switched to generics, explained Spitalnic.
In addition, Part D plans have been able to negotiate more drug rebates than anticipated, and fewer beneficiaries enrolled than the government originally predicted.

Saturday, October 10, 2009

While the debate rages, Seniors get hit with higher costs

Some Medicare Rates to Rise
Find out what changes to expect -- and what you can do -- if you have a prescription-drug plan or Medicare Advantage plan.

By Kimberly Lankford. October 8, 2009

What is going to happen to rates for Medicare Part D prescription-drug plans next year? Can I switch plans?

Prices for both Medicare Part D prescription-drug plans as well as Medicare Advantage plans are going to rise in 2010. And you have from November 15 to December 31 to decide whether you want to stay in the same plan or switch plans for 2010.

Average premiums for Part D plans are increasing by 7% in 2010, to $30 per month, and average premiums for Medicare Advantage plans are jumping by 22%, to $39 per month. These price hikes may be particularly tough to stomach next year, when Social Security will not have a cost-of-living increase.

And premium increases are only part of the picture. More than 60% of Part D plans will charge an annual deductible in 2010 ($310 is standard) before covering any drug costs, up from the 45% that charged a deductible in 2009, according to the Kaiser Family Foundation. Fewer Part D plans will provide coverage in the so-called doughnut hole, which begins after you reach $2,830 in total drug spending and extends until your total drug costs for the year reach $6,440 in 2010; within that gap, you generally have to pay all the bills yourself. The plans that do provide some coverage in the doughnut hole cover only the cost of generic drugs; otherwise, you’re on your own.
And be sure to check how each Part D plan treats your specific medications: Co-payments are rising, and many insurers are changing formularies. For example, you could end up with higher out-of-pocket costs if your insurer switches your drug from preferred to co-pay nonpreferred. Ask your doctor whether you can switch any of your drugs to a generic or lower-cost medication; the policy with the best deal for brand-name drugs may not be the best deal for generics.


The Medicare prescription-drug-plan finder is an excellent tool to analyze the costs of Part D plans for your situation. Type in your drugs and dosages, and you’ll see total out-of-pocket costs -- premiums as well as co-payments -- for your medications throughout the year. Or call 800-633-4227 for personalized assistance.

This year’s premium increases come on top of previous cumulative price hikes. Premiums for AARP MedicareRx Preferred, the most popular Part D plan, have risen by 50% since 2006, according to Avalere Health, a health-care consulting firm. Premiums for Humana Enhanced, also a popular plan, have increased by 180% over the same time period.

If you’re struggling to afford the premiums for Medicare Part B, a Part D prescription-drug plan and a medigap policy, consider going with Medicare Advantage, which provides medical as well as prescription-drug coverage through a private insurer (it may also include dental and vision care). Almost 87% of Medicare beneficiaries will have access in 2010 to a low-cost Medicare Advantage plan that charges no premium above the cost of Medicare Part B.

These plans, too, have their drawbacks. Many are boosting premiums and increasing co-payments for doctor’s visits, hospital stays and prescription drugs. You may have to pay much more out of pocket for certain types of treatments, such as chemotherapy, than you would with Medicare and medigap. And be sure to find out whether your providers participate in the plan (the least-expensive plans, Medicare HMOs, have the tightest restrictions on doctors and hospitals).

If you are already enrolled in a Medicare Advantage plan, you should receive an annual notice of change in late October that outlines any differences in your plan’s coverage and costs from 2009 to 2010, which should be a key piece of your research, says Donna Burtanger, senior director of Medicare for SilverLink. To find out about prices and coverage for plans available in your area, as well as customer-service ratings, go to the Medicare Options Compare tool at Medicare.gov.

Many people are concerned that Medicare Advantage plans will leave the business if Congress passes a health-care reform plan that cuts back on subsidies to private insurers. If your plan does shut down, you may switch to another Medicare Advantage plan or move back to traditional Medicare. If you do, insurers must offer you medigap plans A, B, C or F regardless of your health (otherwise, the price of a new medigap policy may be based on your health, unless you signed up for Medicare Part B in the past six months).
--------------------------------------------------------------------------------
This page printed from: http://www.kiplinger.com/columns/ask/archive/some-medicare-rates-to-rise-.html
All contents © 2009 The Kiplinger Washington Editors