Medicare Advantage is Doing Fine

By ELIZABETH FESTA

Published 9/15/2011 

WASHINGTON BUREAU -- Average Medicare Advantage premiums will be 4% lower in 2012 than they are this year, and enrollment is on track to increase 10%.

The Center for Medicare & Medicaid Services (CMS), the agency in charge of the program, was able to bargain for lower average premiums for the second year in a row, according to officials at CMS’ parent, the U.S. Department of Health and Human Services (HHS).

The Patient Protection and Affordable Care Act of 2010 (PPACA) is making Medicare Advantage “stronger than ever,” according to HHS Secretary Kathleen Sebelius.

The Medicare Advantage program gives private health insurers a chance to sell alternatives to traditional Medicare coverage to Medicare enrollees.

When PPACA was signed into law, some Medicare Advantage supporters predicted that PPACA provisions meant to hold down program costs, and other recently enacted Medicare Advantage cost-control provisions, would push insurers away and cause the program to suffer the same kind of rapid decline that a predecessor program, the Medicare plus Choice program, had faced.

This year, Medicare Advantage open enrollment will start Oct. 15. Beneficiaries will have to make their elections for 2012 Medicare coverage by Dec. 7, not the usual Dec. 31, so that they can have membership cards in hand Jan. 1, 2012, officials say.

Because of PPACA, all beneficiaries enrolled in Medicare in 2012 will have access to Medicare-covered preventive services, including an annual wellness visit with their physicians, without paying a co-pay or deductible, officials say.

Beneficiares who reach the donut hole – the gap between where routine Medicare Part D prescription drug coverage ends and where catastrophic prescription coverage starts -- will get discounts on brand-name drugs and expanded coverage for generic drugs because of PPACA, officials say.