Medicare Advantage premiums fall for 2011 even as some benefits added

WASHINGTON – Premiums for Medicare Advantage – privately managed plans that usually provide some supplemental benefits to seniors – will be, on average, 1 percent lower in 2011 than this year, while enrollment is expected to rise by 5 percent, officials said last week.
Open enrollment for Medicare Advantage and for Part D prescription drug plans runs from Nov. 15 to Dec. 31. The Centers for Medicare & Medicaid Services offered a preview as well as a reminder of changes to the program that will expand benefits in 2011.
The majority of Medicare beneficiaries should find “little or no change” in their benefits, CMS said, except that more plans will offer coverage in the “doughnut hole” and, as required by the federal health care reform law, all will get preventive care with no out-of-pocket costs.
The lower Medicare Advantage premiums, meanwhile, suggest that insurers are still aggressively pursuing that market, despite cuts to their reimbursements that some, including Blue Cross & Blue Shield of Rhode Island, have said could force them to cut back on benefits.
“Despite the claims of some, Medicare Advantage remains strong and a robust option for millions of seniors who choose to enroll or stay in a participating plan today and in the future,” said Dr. Donald Berwick, the CMS administrator. “The Affordable Care Act gave us new authority to negotiate with health plans in a competitive marketplace. As a result, our beneficiaries will save money and maintain their benefits.”
Specifically, CMS officials said, the reform law allowed them to protect beneficiaries from excessive premium and cost-sharing hikes through “aggressive” bid reviews; consolidate low-enrollment and duplicative plans; limit out-of-pocket expenses; and limit plan cost-sharing for skilled nursing care, chemotherapy and renal dialysis to the rates for original Medicare.
The reform law also added benefits such as free wellness visits, some new free health screenings, and a 50-percent discount on brand-name drugs for seniors who enter the Part D coverage gap. At the same time, Medicare Advantage plans will be a bit more generous in 2011, with an average of $13 in extra benefits per member per month (a 5 percent increase).
CMS officials are encouraging seniors to carefully review their current coverage and their options even if the costs are lower or similar to ensure their needs are well served.
About 5 percent of non-employer beneficiaries enrolled in Medicare Advantage and stand-alone Part D plans will have to choose a new plan for 2011 because their current plan isn’t renewing its contract with Medicare, officials said.
Most of those “non-renewals” involve a type of plan that isn’t common in Rhode Island, private fee-for-service, CMS said. Several plans chose to leave Medicare in certain areas of the country due to new requirements from a 2008 law.
More information is available on the Medicare open-enrollment website.