April 1, 2020

Medicare’s Private Option Is Gaining Popularity, and Critics

Advantage plans have had more flexible enrollment rules than original Medicare since 2019. People who sign up for Advantage during regular fall enrollment can also take advantage of an additional enrollment period, during the first three months of each year, when they can switch or drop out of Advantage plans.

“It gives people in Advantage plans more flexibility to make changes in their coverage,” said David Lipschutz, an associate director at the Center for Medicare Advocacy. “People enrolled in traditional Medicare with a stand-alone prescription drug plan don’t have that flexibility.”

The government has taken other steps that favor Advantage. Since 2011, all plans have been required to cap out-of-pocket expenses at $6,700, but most H.M.O. or P.P.O. plans have a somewhat lower ceiling — last year, it was $5,059 for in-network services, according to Kaiser. Yet there is no built-in cap on out-of-pocket costs in original Medicare; the only way to get that is to obtain supplemental coverage.

Another example of what critics see as an uneven playing field for Advantage plans are the extra, albeit limited, benefits.

“We want to see equity and parity between original Medicare and Medicare Advantage plans,” said Frederic Riccardi, president of the Medicare Rights Center, a nonprofit advocacy group that provides counseling to Medicare enrollees.

Under President Trump, some critics contend, the Centers for Medicare and Medicaid Services, which administers Medicare, has become a cheerleader for Advantage plans at the expense of original Medicare.

Advocates and some lawmakers have complained about bias in educational and outreach materials on enrollment, and in public statements about Advantage by the agency’s administrator, Seema Verma.

Article source: https://www.nytimes.com/2020/02/21/business/medicare-advantage-retirement.html

Speak Your Mind