With Medicare Advantage (Part C) and prescription drug (Part D) open enrollment beginning October 15th, this briefing took a close look at what to expect, including trends in premiums and cost sharing, plan availability and benefit design.
The day following the briefing, Medicare beneficiaries will be able to enroll in the Medicare Advantage and prescription drug programs. About one-third of beneficiaries now opt for private health plans – mostly HMOs and PPOs – through the Medicare Advantage program. And, about 69 percent of beneficiaries get prescription drug coverage, either through their Medicare Advantage plans, or by purchasing stand-alone plans.
This briefing was also useful for congressional district staff and caseworkers.
If you were unable to attend the briefing, here are some key takeaways:
Despite Medicare Advantage payment cuts implemented by the ACA, enrollment continues to grow. By 2016, Medicare Advantage is expected to have 17 million enrollees, Sean Cavanaugh said. MedPAC estimates that there is still about 3 percent extra payment being made to Medicare Advantage plans due to coding intensity, he continued.
Newly-eligible Medicare beneficiaries and those who are eligible for both Medicare and Medicaid are the most likely to be subject to the impending increase in Part B premiums, and Congress would likely have to intervene to mitigate the effects, said Sean Cavanaugh.
Gretchen Jacobson, associate director of the Kaiser Family Foundation’s Program on Medicare Policy
Medicare Advantage enrollment has tripled over the past decade, increasing from 5.6 million people in 2005 to 16.8 million in 2015, while premiums have remained relatively stable since 2010, Gretchen Jacobson stated. However, enrollment varies depending on geographic location. For example, Baltimore enrollment is far below the national average, whereas more than half of Medicare beneficiaries are enrolled in Medicare Advantage plans in Portland and Miami, she added.
Jack Hoadley, health policy analyst and researcher at Georgetown University
The average Medicare beneficiary can choose from 26 stand-alone drug plans and 16 Medicare Advantage drug plans in 2016, Jack Hoadley stated. Premiums for Part D stand-alone drug plans are expected to go up by 13 percent in 2016 if nobody switches plans.
Mark Hamelburg, senior vice president of federal programs at America’s Health Insurance Plans, addressed both successes and challenges, including high cost drugs, the upcoming Medicare Part B premium increase, and the star quality rating system.
Ed Howard of the Alliance for Health Reform and Tricia Neuman of the Kaiser Family Foundation introduced the panel and co-moderate.
Beneficiaries are encouraged to shop for plans or consider switching between traditional Medicare and Medicare Advantage, but very few do. By not shopping around they could be leaving a lot of money on the table, Tricia Neuman stated.
Follow the briefing on Twitter: #MedicareOE
Contact: Samantha Feller, firstname.lastname@example.org or (202)789-2300
Full Transcript (Adobe Acrobat PDF)