Unraveling The Marketplace Confusion Regarding Medicare

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Our Healthcare Expert, Reagan Gray, answers your questions about the state of the healthcare industry today!

“I am the caregiver for my mother. We have always made sure she had a Medicare with Medicare Advantage (instead of a supplement). I keep hearing that the new health reform will change and she may receive less coverage, or even worse, have her coverage canceled! Is this true? If so, when should I start to panic?” Thanks Reagan. Ann, Atlanta, GA.

Dear Ann,

As if we don’t have enough to worry about taking care of our elderly parents. This is a very confusing issue. I hope to unravel the “marketplace confusion” so all of you can make informed decisions.

First of all, relax. A lot of misinformation has hit the airwaves leading to confusion and fear among an already vulnerable group of individuals. There is no reason to panic. You, like so many other women, want to make sure your parents get what they need…and what they deserve.

Here’s the situation: When you turn 65, you have a choice to enroll in a traditional Medicare plan or enroll in a Medicare Advantage Plan, usually offered by an HMO or a PPO. These plans contract directly with the government to take care of the Medicare recipient’s entire coverage. Medicare pays a higher premium to those providers for handling all the Medicare benefits, along with added services to fill in the “Medicare gaps.”

Here is the good news: It was recently announced that Medicare Advantage Plans will offer more benefits next year at a lower cost to patients. "Medicare Advantage beneficiaries will actually get more benefits from their plans, not less," Rep. John D. Dingell (D-Mich.) said in a statement (NYT Sept. 21, 2010), he continued, “and the insurers are not suffering because of the changes – they are gaining new enrollees." What that means, is all the talk about losing coverage is no longer an issue. Medicare officials were able to leverage the bulk-purchasing power of more than 11 million MA beneficiaries to negotiate lower costs for the same folks.

Insurance and managed care companies don’t have to offer Medicare Advantage Plans. So, some may opt out of offering them, but I don’t think many will. Insurers rely heavily on the Medicare enrollments. My advice? If you are happy with your Medicare Advantage Plan, stick with it. You should be seeing lower costs and an increase in benefits.

Now isn’t that a nice idea, getting more for less.

Source: [DEPT OF HEALTH AND HUMAN SERVICES], September 2010, [CONGRESS DAILY], Sept.21, 2010.

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