Medicare Advantage or Disadvantage

Medicare   Advantage or Disadvantage?

Before I began exploring the impact of the Affordable Care Act (ACA) on those subscribing to Medicare Advantage Plans, I was prepared to be convinced there would be a disadvantage as the act was implemented.  I am more confused than ever.  I think the predictions have too many variables in play to be accurate at this point.  I am aware some of my friends and neighbors feel benefits such as dental care, gym memberships, lower co-pays and decreased paperwork are a few of the reasons to choose a Medicare Advantage Plan versus the traditional Medicare and a supplement policy.  Medicare Advantage Plans can never offer less coverage than traditional Medicare (Sutton, 2013) but could added benefits that draw some to these plans decrease?  One variable has to do with the bids submitted by insurers to Medicare in August which would result in plan announcements in most open enrollments in October.

Some of the impact will be subject to payments made by Medicare to these plans on behalf of the subscribers.  According to (“How Health Reform Affects Medicare”,n.d.), “These plans may get a bonus to increase benefits but may cut what they pay insurers so premiums or co-pays increase or there might be decrease benefits like dental care.”

The ACA does reduce funding for Advantage Plans over several years and includes an insurance tax for those choosing these plans.    Only 4% of the ACA law’s cuts had been implemented by fall, 2013.  (“Medicare Advantage”,n.d.).    As the insurer’s weigh costs, number of enrollees, and cuts, plans will be structured accordingly. 

One will need to evaluate the co-pays, premiums and benefits versus the traditional Medicare plus a supplement.  Now I have many more questions:  How portable are these plans when one is traveling?  What if a medicine I am taking is no longer covered but was when I selected the plan a year earlier?  When can I change from an Advantage Plan to traditional Medicare?  Would a change only be possible during the fall open enrollment?  How do local hospital based Medicare Advantage Plans compare to those hosted by large insurers?  Where is the best place to get information on which plans are best for different medication treatment options?

References:

How Health Reform Affects Medicare. (n.d.). Retrieved from http://www.webmd.com/health-insurance/insurance-basics/medicare-and-affordable-care-act

Medicare Advantage. (n.nd). Retrieved from https://www.ahip.org/Issues/Medicare-Advantage.aspx#ACAImpact

 

Sutton, C. (2013).  “Will Obamacare hurt medicare advantage?”  Retrived from http://www.politifact.com/truth-o-meter/article/2013/aug/19/will-obamacare-hurt-medicare-advantage/