--by Jeanne Ryer, EH Program Director
The holidays bring temptation to stretch analogies, and it is a long metaphorical reach from the holiday season to the current Medicare Advantage discussion. But I do confess, when I think about what happened to Medicare Advantage in the past decade, the theme song from “The Grinch” keeps running though my mind. Thankfully, it’s on its way to being fixed in the Affordable Care Act.
Medicare Advantage was originally created to “modernize” Medicare with more choices, care management, and savings for the system and the Medicare beneficiaries. But beginning just over ten years ago, Congress made changes to how they paid for Medicare Advantage with a focus on adding extras—like eyeglasses and gym memberships -- and subsidies for insurance companies. Medicare now pays Medicare Advantage insurance companies an average of more than $1,000 per person than original Medicare would cost.
Where does that money come from? Partly from increased premiums for all of the people on Medicare. In New Hampshire, where Medicare Advantage never really took hold (well under 10%) that means our Medicare premiums are going to subsidize fancier Medicare Advantage plans for people in states like Hawaii or Arizona. The image of the Grinch hauling away that over-sized sack of purloined food and presents comes to mind.
When I think that the Medicare premiums paid by my family members were going to subsidize insurance profits and someone’s gym membership in Arizona instead of covering the real cost of care – well, I start seeing that particular shade of green.
Fortunately the Affordable Care Act is going to cut the subsidies to the private Medicare Advantage insurance companies but still protect the guaranteed Medicare benefits. This should lower everyone’s Part B Medicare premiums, lower the cost of the Medicare program overall, and even keep the Medicare Trust Fund out of the red. Predictions of big premium increases or benefit cuts in Medicare Advantage plans because of the ACA have so far proved wrong. Maybe I’ll be able to switch the tune in my head that lovely Whoville anthem, “Welcome, Welcome… While We Stand, Heart to Heart and Hand to Hand…”
Reminder: December is the month when folks on Medicare can change their plans in the “open enrollment” period. It’s time to compare Medicare, Medicare Advantage and Medicare Part D drug benefit options, and change plans if needed, before the end of the year. A step-by-step guide provides suggestions on how to compare options. The Medicare Plan Finder is another useful comparison tool.
You should review your options every year. When choosing a plan, compare cost, coverage, quality and customer service. If you are confused, New Hampshire’s ServiceLink Resource Centers can help, 1-866-634-9412.
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