By MARY AGNES CAREY
KHN Staff Writer
DEC 01, 2011
Despite predictions that last year’s health law would doom Medicare’s private insurance plans, it’s not happening – at least not yet. Enrollment in Medicare Advantage plans continues to grow at a brisk pace, rising to 8.4 million beneficiaries by April 2011, about a 6 percent increase from April 2010, according to a new report from the Government Accountability Office.
Enrollment in health maintenance organizations (HMOs), which account for about two-thirds of total Medicare Advantage enrollment this year, increased by 9 percent, from about 5.2 million beneficiaries to about 5.6 million.
While local and regional preferred provider organizations (PPOs) make up a smaller portion of total Medicare Advantage enrollment, they experienced the highest percentage growth in enrollment, with local PPOs increasing by 38 percent and regional PPOs up by 58 percent, GAO reported.
The GAO report also found that on average, beneficiaries in Medicare Advantage (MA) plans actually paid lower premiums this year, falling to $24 from $28 last year, about a 14 percent reduction. These premiums are paid in addition to the Medicare Part B premiums that the beneficiaries pay each month.
As part of the 2010 health law, federal payments were frozen to Medicare Advantage plans this year and will drop by less than 1 percent in 2012. Larger payment declines are set to kick in later this decade.
The plans were targeted by Democrats, who complained that the government pays more per capita for beneficiaries in the private plans than it spends on those in traditional Medicare. According to the Medicare Payment Advisory Commission, this year Medicare will spend on average 10 percent more for beneficiaries enrolled in MA plans than if those beneficiaries were in fee-for-service Medicare.
The billions of dollars cut from the MA plans were allotted by Congress to help pay for the cost of expanding coverage to 32 million uninsured Americans through expanded Medicaid eligibility and subsidies for people buying coverage in new insurance exchanges starting in 2014.
MA plans generally provided coverage in 2010 and 2011 for additional benefits, such as hearing and vision, beyond those offered by traditional Medicare. But there were some changes in the percentage of beneficiaries with certain benefits, according to GAO. The percentage of MA beneficiaries with coverage for vision services decreased from 84 percent to 79 percent.
While the health law’s changes had little impact on MA enrollment this year, more changes may be in store. The GAO report notes that the Congressional Budget Office has predicted that those $136 billion in cuts to MA plans would decrease enrollment by about 35 percent through 2019. The Office of the Actuary at the Centers for Medicare and Medicaid Services has found that the reduction in MA payments would eventually lead to those plans offering less-generous benefit packages.
But the GAO report adds: "It is uncertain what impact, if any, these payment changes have had thus far on MA plan enrollment, the premiums and cost sharing they require from beneficiaries, and the additional benefits they offer."
At Medicare is Simple, we look to educate and enable you to choose among Medicare plans to help find the policy that may best fit your needs. Get free quotes using our advanced quoting technology. HealthCare Reform is also a hot topic of interest to people of all ages, and we look to keep you updated on the issues relevant to learning more. Medicare Is Simple 800-442-4915
Monday, December 19, 2011
Quote of the Day
“Five tier [formularies] has become the dominant design in Medicare Part D. Over time, we expect to see this design shift to the commercial marketplace as well. The split of the generic tier has become a cost control imperative since some generic medications are expensive and compete with lower cost products. And high cost sharing for specialty tier products has emerged as a reality for most seniors.”
— Dan Mendelson, CEO of Avalere Health, told AIS’s Specialty Pharmacy News.
— Dan Mendelson, CEO of Avalere Health, told AIS’s Specialty Pharmacy News.
Quote of the Day
“What emerged is what Congress usually creates…sausage.”
— Michael Cannon, director of health policy studies at the Cato Institute, discussing the health reform law’s provisions on tax credits and subsidies to help low-income people purchase health coverage.
— Michael Cannon, director of health policy studies at the Cato Institute, discussing the health reform law’s provisions on tax credits and subsidies to help low-income people purchase health coverage.
Today's Datapoint
37 …fewer Medicare Advantage plans will be available in 2012, just a 2% decline, with the number of MA HMOs actually increasing for the first time since 2009, according to an analysis released by the Kaiser Family Foundation
Thursday, December 15, 2011
Twitter Tells All: What Seniors Really Think About Medicare
By Nichole Morford
NOVEMBER 30, 2011
The social media stats for seniors are impressive: they’re the fastest growing group of users on sites like Facebook, LinkedIn, and Twitter. They’ve expanded their share of the social networking community by more than 150 percent over the past two years. And as Boomers begin to graduate into this age group, the numbers will vastly increase.
For Medicare agents, this opens a valuable window into the way seniors think. What are their questions about Medicare? Do they understand the products available? How effective are private Medicare marketing efforts? The online community provides answers to all of these questions, in a way that is arguably more valuable than traditional research. Thoughts shared on Twitter or Facebook are inherently unfiltered, not subject to scrutiny the way those same thoughts would be in a focus group or survey. In short, social media conversations are real.
The conversation
So, what are people saying? A recent study by KBM Group Health Services, Online Listening About Medicare: Process, Insights, and Strategies, showed that, despite occasional rants, seniors are largely positive about their Medicare experiences. But it’s not all good. In many cases, they’re also missing critical pieces of information. LifeHealthPro talked with Deborah Stewart, vice president of strategic planning at KBM, to find out how agents can help fill this education gap. Here are her five essential tips:
1. Become a trusted source.
The number one thing seniors want is education. Often, they go online to seek advice about a program that is constantly changing – and this is one area where agents can provide value by doing the hard work for their clients. Stewart says there is great opportunity for health providers and agents to become trusted sources and quality content providers. Too many seniors feel overwhelmed at all there is to learn. As one participant expressed online: “Who can explain and simplify all the rules and restrictions [and] be trustworthy?”
2. Talk about health care reform.
Always an unwieldy topic, since health care reform has entered the picture, seniors are more confused than ever about how Medicare works. Stewart has heard a lot of misguided opinions over the past year and a half, many stemming from consumers who are aging into the program and trying to grasp the implications of health care reform all at once. “The real impact of health care reform on Medicare is still to be seen,” she says, “The five-star ratings and more of a reimbursement model based on customer satisfaction is absolutely a positive, but on the other side, we still don’t know whether coverage will be there at the level consumers are expecting.” No one knows exactly what to expect, but staying informed on the latest reform developments and sharing these with your clients is deeply valuable to consumers.
3. Differentiate between plans.
Seniors spend a lot of time talking about Medicare plan types and supplements. The online topics mentioned most include Medicare Part D (32.8%), Part C (31.3%), and Medicare supplements (8.9%). Some of these sentiments are negative: Seniors are constantly confused by changes to private plans, and upset when plans are eliminated. Says Stewart: “There is unbelievable confusion between traditional Medicare, Medicare Advantage, and Med Supp.” What’s really exciting, she shares, is the advent of special-needs plans that target diabetes and other chronic diseases. These new plans focus on the individual and can dramatically improve someone’s quality of life and longevity.
4. Focus on customer service.
Remarkably, given the confusion that surrounds the program, Medicare customers are largely satisfied with their coverage. This goes against the stereotype, says Stewart. “We know from research … that Medicare has scored higher than [other] health plans. So, although we think that there’s a negative impression of Medicare, seniors are really very appreciative of having that health coverage.” Still, there’s room for improvement. Because the service consumers most want is education, agents should strive to communicate clear, simple communication that is highly relevant to their target market. And recognize that confusion doesn’t point to a lack of intelligence. “Confusion doesn’t mean that seniors aren’t smart, it might just mean that something needs to be explained more clearly,” concludes Stewart.
5. Look at the 12-month picture. Although the marketing season is contained, consumers today don’t just think about Medicare during enrollment period. To fully meet your clients’ needs, it’s important that you communicate with them year-round. In part, this is because people aren’t always aging in as they turn 65. Some wait longer, which means that advisors must work harder to anticipate when prospects or clients might need information. One way to do this is simply to join the online conversation. “I was very impressed with that sense of community,” Stewart notes in closing, “and let me say that it was not just consumers. There were a lot of professional bloggers and broker-agents [who were joining the conversation] and trying to support one another.”
NOVEMBER 30, 2011
The social media stats for seniors are impressive: they’re the fastest growing group of users on sites like Facebook, LinkedIn, and Twitter. They’ve expanded their share of the social networking community by more than 150 percent over the past two years. And as Boomers begin to graduate into this age group, the numbers will vastly increase.
For Medicare agents, this opens a valuable window into the way seniors think. What are their questions about Medicare? Do they understand the products available? How effective are private Medicare marketing efforts? The online community provides answers to all of these questions, in a way that is arguably more valuable than traditional research. Thoughts shared on Twitter or Facebook are inherently unfiltered, not subject to scrutiny the way those same thoughts would be in a focus group or survey. In short, social media conversations are real.
The conversation
So, what are people saying? A recent study by KBM Group Health Services, Online Listening About Medicare: Process, Insights, and Strategies, showed that, despite occasional rants, seniors are largely positive about their Medicare experiences. But it’s not all good. In many cases, they’re also missing critical pieces of information. LifeHealthPro talked with Deborah Stewart, vice president of strategic planning at KBM, to find out how agents can help fill this education gap. Here are her five essential tips:
1. Become a trusted source.
The number one thing seniors want is education. Often, they go online to seek advice about a program that is constantly changing – and this is one area where agents can provide value by doing the hard work for their clients. Stewart says there is great opportunity for health providers and agents to become trusted sources and quality content providers. Too many seniors feel overwhelmed at all there is to learn. As one participant expressed online: “Who can explain and simplify all the rules and restrictions [and] be trustworthy?”
2. Talk about health care reform.
Always an unwieldy topic, since health care reform has entered the picture, seniors are more confused than ever about how Medicare works. Stewart has heard a lot of misguided opinions over the past year and a half, many stemming from consumers who are aging into the program and trying to grasp the implications of health care reform all at once. “The real impact of health care reform on Medicare is still to be seen,” she says, “The five-star ratings and more of a reimbursement model based on customer satisfaction is absolutely a positive, but on the other side, we still don’t know whether coverage will be there at the level consumers are expecting.” No one knows exactly what to expect, but staying informed on the latest reform developments and sharing these with your clients is deeply valuable to consumers.
3. Differentiate between plans.
Seniors spend a lot of time talking about Medicare plan types and supplements. The online topics mentioned most include Medicare Part D (32.8%), Part C (31.3%), and Medicare supplements (8.9%). Some of these sentiments are negative: Seniors are constantly confused by changes to private plans, and upset when plans are eliminated. Says Stewart: “There is unbelievable confusion between traditional Medicare, Medicare Advantage, and Med Supp.” What’s really exciting, she shares, is the advent of special-needs plans that target diabetes and other chronic diseases. These new plans focus on the individual and can dramatically improve someone’s quality of life and longevity.
4. Focus on customer service.
Remarkably, given the confusion that surrounds the program, Medicare customers are largely satisfied with their coverage. This goes against the stereotype, says Stewart. “We know from research … that Medicare has scored higher than [other] health plans. So, although we think that there’s a negative impression of Medicare, seniors are really very appreciative of having that health coverage.” Still, there’s room for improvement. Because the service consumers most want is education, agents should strive to communicate clear, simple communication that is highly relevant to their target market. And recognize that confusion doesn’t point to a lack of intelligence. “Confusion doesn’t mean that seniors aren’t smart, it might just mean that something needs to be explained more clearly,” concludes Stewart.
5. Look at the 12-month picture. Although the marketing season is contained, consumers today don’t just think about Medicare during enrollment period. To fully meet your clients’ needs, it’s important that you communicate with them year-round. In part, this is because people aren’t always aging in as they turn 65. Some wait longer, which means that advisors must work harder to anticipate when prospects or clients might need information. One way to do this is simply to join the online conversation. “I was very impressed with that sense of community,” Stewart notes in closing, “and let me say that it was not just consumers. There were a lot of professional bloggers and broker-agents [who were joining the conversation] and trying to support one another.”
Friday, December 9, 2011
UnitedHealth Deal to Buy XLHealth Is Said To Be High Priced
UnitedHealth Deal to Buy XLHealth Is Said To Be High Priced, Mainly About Dual SNPs (with Chart: XLHealth’s Care Improvement Plus MA Plan Averages 39% Annual Growth)
Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in MA and Medicaid managed care.
December 1, 2011 Volume 17 Issue 23
In the latest and perhaps most costly Medicare Advantage acquisition this year in terms of price per member, UnitedHealth Group on Nov. 22 unveiled an agreement to acquire XLHealth Corp. While the two companies did not disclose the price in the all-cash deal, Bloomberg reported that a source familiar with the transaction said it was about $2 billion, which would put the price per member at above $17,000. That would be far higher than the estimated $10,000 per member in the recent Cigna Corp. deal to acquire HealthSpring, Inc. (MAN 10/27/11, p. 1) and even above the estimated $15,000 WellPoint Inc. agreed in June to pay for CareMore Health Group (MAN 6/16/11, p. 3).
There are, however, some particular reasons XLHealth was able to garner such a high price, sources tell MAN. One is that there apparently were multiple deep-pocketed insurers interested in the sale process run for the privately held company by investment banking firm Jefferies Group Inc. Second, XLHealth has demonstrated increasing success, as shown by a steadily improving profit margin and strong revenue and enrollment growth (see chart, p. 7), in running MA Special Needs Plans (SNPs). Third, XLHealth’s skills in managing SNPs for Medicare-Medicaid dual eligibles, in particular, will help United in what is expected to be explosive growth of managed care for duals.
“United likely views XLHealth as a platform to launch a more comprehensive offering for dual eligibles over the next few years,” says analyst Carl McDonald of Citigroup Global Markets in a Nov. 22 research note.
Duals Attract United to XLHealth
“I think the story is the centrality of the duals to the business plans of many health plans,” agrees Nathan Goldstein, executive vice president of consulting firm Gorman Health Group, LLC, which has done work for XLHealth for several years. He tells MAN that XLHealth “was an early adopter of the very best risk-adjustment strategies” and has been an innovator in managing and marketing to chronically ill and poor populations.
But it has been a convoluted and difficult journey for XLHealth to have gotten to this point of market leadership in the growing SNP field.
The Baltimore-based company began as a disease management (DM) firm, then known as Diabetex, in 1998. Its focus from the start, XLHealth Executive Vice President Paul Serini stresses, has been “management of chronically ill Medicare beneficiaries, particularly those with diabetes and heart failure.” The firm’s first contracts as a “fee-based” DM and care management services provider began in 1999, and it then adopted the name XLHealth.
As was the case for many other DM firms, it was difficult for the company to grow strongly and profitably in just that field. So XLHealth started health plans, and its first Care Improvement Plus SNP for chronic conditions began in 2006. “In the 2010 plan year we expanded our product line to include dual Special Needs Plans and traditional Medicare Advantage plans,” Serini notes.
The company now serves about 113,000 MA members in Arkansas, Georgia, Maryland, Missouri, South Carolina and Texas, about 12,000 of them in dual SNPs, the company notes (MAN 11/10/11, p. 2), up sharply from 7,826 at the end of 2010. And it will add six states — Illinois, Indiana, Iowa, New Mexico, New York and Wisconsin — to its SNPs in 2012, when XLHealth expects its revenues to exceed $2 billion, states the news release announcing the deal, which is expected to close in the first half of next year.
Company Moved to Profitability This Year
Figures in a Nov. 22 research note from Goldman Sachs & Co. securities analyst Matthew Borsch and drawn from state insurance reports show the company had revenues of $628 million and a net loss of $72 million in 2007. That’s the year when private-equity firm MatlinPatterson Global Opportunities Partners III LP bought a majority interest in the firm, which also has substantial management ownership. In 2008, revenues shot up to $1.12 billion, although the net loss widened to about $90 million, the Goldman Sachs figures show. The loss, though, narrowed substantially in 2009, and the company posted net income, Goldman Sachs says, of about $62 million and revenues of $917 million for the first two quarters of 2012.
Serini declines to confirm or deny either those or McDonald’s figures and analyst estimates of the purchase price “at this time.”
Asked why the company decided to sell now versus years ago or in future years, Serini tells MAN, “XLHealth’s ongoing goal has been to grow its capabilities and expand its reach. UnitedHealthcare recognizes the value of the care management model XLHealth has built, and seeks to build on the XLHealth model of care to better serve Medicare Advantage members in markets across the country. For those reasons, it was logical timing for both organizations to form this union.”
That leaves the question of whether XLHealth’s highly regarded management team — headed by Chairman and CEO Fred Dunlap, who has a consulting as well as health plan executive background, and Serini, who has been there since the company’s early days — will stay after the acquisition closes. Serini’s response on this question is just that “UnitedHealthcare has expressed that they are looking forward to working with our leadership, and we share that enthusiasm.”
It is interesting, says Gorman Health Group’s Goldstein, that XLHealth is selling to a large health plan operator rather than to “private equity.” He suggests this is partly a reflection of price and partly that the acquirer wants XLHealth to teach it the SNP management business. And from a prospective seller’s standpoint, he adds, “this is the moment to sell,” especially since “this industry is consolidating very, very quickly.”
Praising the company’s understanding of risk adjustment, in which it was an early user of algorithms developed by Leprechaun, LLC, Goldstein says the deal with United “was about the duals.” The growth in the number of duals and the opportunities for managed care in those populations, he predicts, will be explosive, beginning now but particularly after the Medicaid expansion under the health reform law starts in 2014.
Duals are especially difficult to manage since they’re “claims and transaction intense” because of not only their poor health status but also difficulties in communicating with them, he adds. Health plans need to be very “hands on” in their care management with this population, according to Goldstein, and United in the XLHealth deal is buying the “know-how” for dealing with that.
However, only 11% of XLHealth’s membership now is duals, while the vast majority of the rest is in chronic care SNPs. Securities analyst Scott Fidel of Deutsche Bank estimates that the company has a 53% market share in chronic SNPs and about 8% of the total SNP market, which is dominated by dual SNPs in terms of enrollment.
The difficulty of this market shows through in some of the operating figures securities analysts point to for XLHealth. The company’s selling, general and administrative ratio, for instance, is in the unusually high “mid-teens” after being a lofty 18.3% in 2009, says McDonald, but that could go down to 10% as a result of economies of scale stemming from the United purchase. XLHealth’s medical loss ratio was a high 94.7% as recently as 2008, he notes, but since then it generally has declined, to 82.8% last year and 77.7% for the first half of 2011.
Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in MA and Medicaid managed care.
December 1, 2011 Volume 17 Issue 23
In the latest and perhaps most costly Medicare Advantage acquisition this year in terms of price per member, UnitedHealth Group on Nov. 22 unveiled an agreement to acquire XLHealth Corp. While the two companies did not disclose the price in the all-cash deal, Bloomberg reported that a source familiar with the transaction said it was about $2 billion, which would put the price per member at above $17,000. That would be far higher than the estimated $10,000 per member in the recent Cigna Corp. deal to acquire HealthSpring, Inc. (MAN 10/27/11, p. 1) and even above the estimated $15,000 WellPoint Inc. agreed in June to pay for CareMore Health Group (MAN 6/16/11, p. 3).
There are, however, some particular reasons XLHealth was able to garner such a high price, sources tell MAN. One is that there apparently were multiple deep-pocketed insurers interested in the sale process run for the privately held company by investment banking firm Jefferies Group Inc. Second, XLHealth has demonstrated increasing success, as shown by a steadily improving profit margin and strong revenue and enrollment growth (see chart, p. 7), in running MA Special Needs Plans (SNPs). Third, XLHealth’s skills in managing SNPs for Medicare-Medicaid dual eligibles, in particular, will help United in what is expected to be explosive growth of managed care for duals.
“United likely views XLHealth as a platform to launch a more comprehensive offering for dual eligibles over the next few years,” says analyst Carl McDonald of Citigroup Global Markets in a Nov. 22 research note.
Duals Attract United to XLHealth
“I think the story is the centrality of the duals to the business plans of many health plans,” agrees Nathan Goldstein, executive vice president of consulting firm Gorman Health Group, LLC, which has done work for XLHealth for several years. He tells MAN that XLHealth “was an early adopter of the very best risk-adjustment strategies” and has been an innovator in managing and marketing to chronically ill and poor populations.
But it has been a convoluted and difficult journey for XLHealth to have gotten to this point of market leadership in the growing SNP field.
The Baltimore-based company began as a disease management (DM) firm, then known as Diabetex, in 1998. Its focus from the start, XLHealth Executive Vice President Paul Serini stresses, has been “management of chronically ill Medicare beneficiaries, particularly those with diabetes and heart failure.” The firm’s first contracts as a “fee-based” DM and care management services provider began in 1999, and it then adopted the name XLHealth.
As was the case for many other DM firms, it was difficult for the company to grow strongly and profitably in just that field. So XLHealth started health plans, and its first Care Improvement Plus SNP for chronic conditions began in 2006. “In the 2010 plan year we expanded our product line to include dual Special Needs Plans and traditional Medicare Advantage plans,” Serini notes.
The company now serves about 113,000 MA members in Arkansas, Georgia, Maryland, Missouri, South Carolina and Texas, about 12,000 of them in dual SNPs, the company notes (MAN 11/10/11, p. 2), up sharply from 7,826 at the end of 2010. And it will add six states — Illinois, Indiana, Iowa, New Mexico, New York and Wisconsin — to its SNPs in 2012, when XLHealth expects its revenues to exceed $2 billion, states the news release announcing the deal, which is expected to close in the first half of next year.
Company Moved to Profitability This Year
Figures in a Nov. 22 research note from Goldman Sachs & Co. securities analyst Matthew Borsch and drawn from state insurance reports show the company had revenues of $628 million and a net loss of $72 million in 2007. That’s the year when private-equity firm MatlinPatterson Global Opportunities Partners III LP bought a majority interest in the firm, which also has substantial management ownership. In 2008, revenues shot up to $1.12 billion, although the net loss widened to about $90 million, the Goldman Sachs figures show. The loss, though, narrowed substantially in 2009, and the company posted net income, Goldman Sachs says, of about $62 million and revenues of $917 million for the first two quarters of 2012.
Serini declines to confirm or deny either those or McDonald’s figures and analyst estimates of the purchase price “at this time.”
Asked why the company decided to sell now versus years ago or in future years, Serini tells MAN, “XLHealth’s ongoing goal has been to grow its capabilities and expand its reach. UnitedHealthcare recognizes the value of the care management model XLHealth has built, and seeks to build on the XLHealth model of care to better serve Medicare Advantage members in markets across the country. For those reasons, it was logical timing for both organizations to form this union.”
That leaves the question of whether XLHealth’s highly regarded management team — headed by Chairman and CEO Fred Dunlap, who has a consulting as well as health plan executive background, and Serini, who has been there since the company’s early days — will stay after the acquisition closes. Serini’s response on this question is just that “UnitedHealthcare has expressed that they are looking forward to working with our leadership, and we share that enthusiasm.”
It is interesting, says Gorman Health Group’s Goldstein, that XLHealth is selling to a large health plan operator rather than to “private equity.” He suggests this is partly a reflection of price and partly that the acquirer wants XLHealth to teach it the SNP management business. And from a prospective seller’s standpoint, he adds, “this is the moment to sell,” especially since “this industry is consolidating very, very quickly.”
Praising the company’s understanding of risk adjustment, in which it was an early user of algorithms developed by Leprechaun, LLC, Goldstein says the deal with United “was about the duals.” The growth in the number of duals and the opportunities for managed care in those populations, he predicts, will be explosive, beginning now but particularly after the Medicaid expansion under the health reform law starts in 2014.
Duals are especially difficult to manage since they’re “claims and transaction intense” because of not only their poor health status but also difficulties in communicating with them, he adds. Health plans need to be very “hands on” in their care management with this population, according to Goldstein, and United in the XLHealth deal is buying the “know-how” for dealing with that.
However, only 11% of XLHealth’s membership now is duals, while the vast majority of the rest is in chronic care SNPs. Securities analyst Scott Fidel of Deutsche Bank estimates that the company has a 53% market share in chronic SNPs and about 8% of the total SNP market, which is dominated by dual SNPs in terms of enrollment.
The difficulty of this market shows through in some of the operating figures securities analysts point to for XLHealth. The company’s selling, general and administrative ratio, for instance, is in the unusually high “mid-teens” after being a lofty 18.3% in 2009, says McDonald, but that could go down to 10% as a result of economies of scale stemming from the United purchase. XLHealth’s medical loss ratio was a high 94.7% as recently as 2008, he notes, but since then it generally has declined, to 82.8% last year and 77.7% for the first half of 2011.
Thursday, December 8, 2011
PEOPLE WITH MEDICARE SEE SIGNIFICANT SAVINGS IN 2011 AS TIME TO SELECT 2012 PLANS ENDS
DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
Room 352-G
200 Independence Avenue, SW
Washington, DC 20201
Office of Media Affairs
OPEN ENROLLMENT ENDS TOMORROW; PEOPLE WITH MEDICARE SEE SIGNIFICANT SAVINGS IN 2011 AS TIME TO SELECT 2012 PLANS ENDS
Nearly three million people with Medicare receiving discounts on prescription drugs,
24.2 million receiving free preventive care
Today, the Centers for Medicare & Medicaid Services (CMS) announced that as of the end of October, more seniors and people with disabilities on Medicare have seen significantly lower costs for important health care – through both discounts on brand-name drugs in the Medicare Part D "donut hole" coverage gap and free preventive care.
“Thanks to the Affordable Care Act, millions of Americans are receiving free preventive services and getting cheaper prescription drugs,” said Acting CMS Administrator Marilyn Tavenner. “The open enrollment period ends tomorrow. People with Medicare should review their current plans before midnight December 7, so they can make sure that the plan they will have in 2012 is the best one for their health care needs.”
Data show that 2.65 million people with Medicare have saved more than $1.5 billion on their prescriptions – averaging about $569 per person.
And, as of the end of November, more than 24.2 million people with Medicare have taken advantage of at least one free preventive benefit – including the new Annual Wellness Visit – made possible by the Affordable Care Act.
Building on savings in 2011, Medicare also recently announced that the Part B deductible will be $22 lower in 2012 and average Medicare Advantage premiums are projected to drop four percent in 2012. Part B premiums, which cover outpatient services including doctor visits, are estimated to increase by only $3.50 per month for most beneficiaries in 2012, and some will see a decrease. These changes will be more than offset by the average Social Security cost of living increase ($43 per month for retired workers).
People with Medicare can now review their drug and health plan coverage options for 2012 as part of the annual Medicare Open Enrollment Period. CMS is highlighting plans that have achieved an overall quality rating of five stars with a high performer or “gold star” icon on Medicare’s Plan Finder – www.medicare.gov/find-a-plan.
For more information about how the Affordable Care Act closes the donut hole over time, go to: http://www.medicare.gov/Publications/Pubs/pdf/11493.pdf
For State-by-State information on the number of people who are benefiting from discounts in the donut hole in 2011, go to https://www.cms.gov/Plan-Payment/
For State-by-State information on utilization of free preventive services and the Annual Wellness Visit, go to http://www.cms.gov/NewMedia/02_preventive.asp
For more information on Medicare’s prevention benefits, go to the Share the News. Share the Health! website: http://www.medicare.gov/share-the-health/or contact 1-800-MEDICARE.
Centers for Medicare & Medicaid Services
Room 352-G
200 Independence Avenue, SW
Washington, DC 20201
Office of Media Affairs
OPEN ENROLLMENT ENDS TOMORROW; PEOPLE WITH MEDICARE SEE SIGNIFICANT SAVINGS IN 2011 AS TIME TO SELECT 2012 PLANS ENDS
Nearly three million people with Medicare receiving discounts on prescription drugs,
24.2 million receiving free preventive care
Today, the Centers for Medicare & Medicaid Services (CMS) announced that as of the end of October, more seniors and people with disabilities on Medicare have seen significantly lower costs for important health care – through both discounts on brand-name drugs in the Medicare Part D "donut hole" coverage gap and free preventive care.
“Thanks to the Affordable Care Act, millions of Americans are receiving free preventive services and getting cheaper prescription drugs,” said Acting CMS Administrator Marilyn Tavenner. “The open enrollment period ends tomorrow. People with Medicare should review their current plans before midnight December 7, so they can make sure that the plan they will have in 2012 is the best one for their health care needs.”
Data show that 2.65 million people with Medicare have saved more than $1.5 billion on their prescriptions – averaging about $569 per person.
And, as of the end of November, more than 24.2 million people with Medicare have taken advantage of at least one free preventive benefit – including the new Annual Wellness Visit – made possible by the Affordable Care Act.
Building on savings in 2011, Medicare also recently announced that the Part B deductible will be $22 lower in 2012 and average Medicare Advantage premiums are projected to drop four percent in 2012. Part B premiums, which cover outpatient services including doctor visits, are estimated to increase by only $3.50 per month for most beneficiaries in 2012, and some will see a decrease. These changes will be more than offset by the average Social Security cost of living increase ($43 per month for retired workers).
People with Medicare can now review their drug and health plan coverage options for 2012 as part of the annual Medicare Open Enrollment Period. CMS is highlighting plans that have achieved an overall quality rating of five stars with a high performer or “gold star” icon on Medicare’s Plan Finder – www.medicare.gov/find-a-plan.
For more information about how the Affordable Care Act closes the donut hole over time, go to: http://www.medicare.gov/Publications/Pubs/pdf/11493.pdf
For State-by-State information on the number of people who are benefiting from discounts in the donut hole in 2011, go to https://www.cms.gov/Plan-Payment/
For State-by-State information on utilization of free preventive services and the Annual Wellness Visit, go to http://www.cms.gov/NewMedia/02_preventive.asp
For more information on Medicare’s prevention benefits, go to the Share the News. Share the Health! website: http://www.medicare.gov/share-the-health/or contact 1-800-MEDICARE.
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