Greetings! I hope this finds you well and in good spirits.
Please find the following information on maximizing Medicare. We need to all be prepared to manage this government program to our maximum advantage. After all, you pay for it.
One of every three U.S. residents is insured by Medicare or another government health care program. And about 30 percent of the 52 million Americans enrolled in Medicare opt out of “traditional Medicare” in order to choose a private Medicare Advantage insurance plan – a number that has more than doubled in the last nine years. With Medicare Advantage, the health insurer is paid by the government on a per-person per-month basis and the insurer coordinates the member’s care.
While traditional Medicare tends to have more money providers in the network, individual Advantage plans may contract with high-quality physicians who don’t contract with traditional Medicare. Plus, those plans may offer more coverage and benefits than traditional Medicare, such as gym memberships or vision care. Currently, the government reimburses the insurance companies at a higher rate for Medicare coverage under Advantage plans.
The more the government reimburses health insurers, the more likely health insurers are to enter this market. This creates more competition for Medicare recipients, which has resulted in higher enrollment. We also see more money spent by insurers to market these plans – but a recent study revealed that paying plans substantially more does not necessarily lead to much better quality. Instead, the study’s analysis points to greater profits among the participating health insurers.
This finding is important when you consider that a key feature of the Affordable Care Act calls for lower reimbursements to the Advantage plans. The study concluded that reimbursement cuts would not cause significant harm to consumers in terms of quality of care and coverage as previously thought – even by the researchers who conducted this study.
“There’s a general view that as government pays more for health care or for many services, that this is likely to benefit the people enrolled in the program, the people attending the school, the people driving on the road or what have you,” commented Mark Duggan, a Wharton professor and co-author of the study. “Our findings pretty clearly indicate that paying somewhat less doesn’t necessarily harm consumers. And conversely, paying somewhat more doesn’t necessarily benefit consumers all that much.”
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