Medicare Advantage: Enhancing Security and Efficiency

Millions of Americans are currently enrolled in Medicare Advantage, prompting bipartisan calls for the Centers for Medicare and Medicaid Services to enhance the program's security and efficiency.

Expanding Access to Essential Benefits

Over 32 million Americans, including seniors and individuals with disabilities, rely on Medicare Advantage plans provided by private companies to supplement their Medicare coverage. While traditional Medicare does not include vision, hearing, or dental benefits, Medicare Advantage plans bridge this gap.

Protecting Medicare Advantage

In a significant development, Cigna Group has agreed to sell its Medicare Advantage business to Health Care Service Corp. for approximately $3.7 billion in cash. Recognizing the immense popularity of the program, 61 senators from both parties penned a letter to the Biden administration on Jan. 26, urging the protection of Medicare Advantage from potentially disruptive updates proposed by the Centers for Medicare and Medicaid Services.

The senators, including prominent figures like Utah Republican Mitt Romney and New York Democrat Charles Schumer, emphasized the need to combat predatory marketing practices and foster transparency in providing accurate information on costs and coverage options.

Safeguarding Medicare Beneficiaries

The letter urged the Administration to ensure payment and policy stability for the Medicare Advantage program when considering updates for plan year 2025. This measure is aimed at protecting and strengthening this crucial healthcare choice for current and future Medicare beneficiaries.

Time for Beneficiaries to Act

However, beneficiaries do not have to wait for policy decisions to ensure they receive the healthcare they require. They have a two-month window to review their current coverage, allowing them to switch to a more suitable plan that better aligns with their needs.

The Annual Enrollment Period

Medicare Advantage offers its own annual enrollment period from Jan. 1 to March 31, separate from the traditional Medicare enrollment period running from Oct. 15 to Dec. 7 each year. During this specific enrollment period, current Medicare Advantage beneficiaries can switch between plans with or without drug coverage, or revert to original Medicare if desired.

By prioritizing security enhancements and overall efficiency, lawmakers aim to enhance the Medicare Advantage program, safeguarding the well-being of millions of Americans and ensuring they receive the healthcare they deserve.

Enrollment Period Changes

During the enrollment period, any changes made will become effective on the first day of the following month. For Medicare annual enrollment in the fall, coverage begins on January 1 of the next year.

Evaluating Coverage Options

Even if enrollees are satisfied with their current insurance plan, it is essential to review their coverage options. According to a report by eHealth, about half of all Medicare Advantage enrollees have remained on the same plan for at least two years due to contentment. However, insurance companies may alter their coverage annually, and individuals may experience significant life changes that warrant a reevaluation of their options.

When considering coverage options, enrollees should carefully assess the coverage of doctors, medical facilities, prescription drugs, and procedures. Additionally, understanding how copayments and coinsurance may impact their annual expenses is crucial.

Steady Increase in Medicare Advantage

According to KFF, Medicare Advantage enrollees accounted for over half of all eligible Medicare beneficiaries in 2023. The number of beneficiaries under Medicare Advantage has been consistently rising in recent years. However, some major health insurance providers offering these plans have experienced mixed earnings results recently.

Humana reported that growth in the company's earnings release in January was not as strong as anticipated. Similarly, shares of UnitedHealth Group and Cigna also declined. Conversely, CVS, another Medicare Advantage plan provider, announced that enrollment for 2024 exceeded expectations at the beginning of the year.