Your Weekly Medicare Consumer Advocacy Update
Medicare is Still a Good Deal for Seniors
Medicare at the Center of Recent Budget Proposals
The Kaiser Family Foundation (KFF) recently updated an issue brief comparing Medicare cost-savings proposals in the budget plans provided by President Obama, the Senate and the House. In 2012 and 2013, Medicare had the lowest rate of growth in spending since 2000. Over the next 10 years, Medicare spending is projected to grow at a slower rate per capita than private insurance. Still, there is ongoing talk to reduce Medicare spending, including by shifting added costs to people with Medicare.
In the issue brief, KFF looks at the most recent budget proposals and breaks down how each would address reductions in Medicare spending. The proposals include:
- Raising in the age of Medicare eligibility;
- Reforming private plan payment, including premium support and competitive bidding;
- Increasing Part B and Part D premiums; and
- Increase Medicare cost sharing for beneficiaries.
In response to proposals that seek Medicare by shifting costs to beneficiaries, the Medicare Rights Center outlined several proposals to save costs, without worsening the economic and health status of people with Medicare. “Build on What Works: Medicare Cost Savers,” outlines solutions that eliminate wasteful spending and promote the delivery of high value care.
The cost savers outlined in Medicare Rights’ latest fact sheet do not increase costs or decrease benefits for the 50 million older adults and people with disabilities who rely on Medicare.
These cost savers include:
- Restoring drug rebates for low-income Medicare beneficiaries;
- Introducing a public Medicare drug benefit;
- Maximizing the use of generic prescription drugs;
- Creating a public Medicare supplement;
- Eliminating wasteful overpayments to Medicare Advantage plans;
- Expanding the competitive bidding program; and
- Advancing innovative delivery and payment system reforms.
Medicare and the Health Insurance Marketplace
Medicare Rights Center President Joe Baker recently contributed to a blog post for the New York Times, Q & A: Medicare and the Insurance Exchanges. The post featured questions about the online health insurance exchanges (also known as marketplaces) created by the Affordable Care Act (ACA), and how it works with Medicare. According to the blog post, here are some shopping tips for people with Medicare and caregivers:
- The health insurance exchanges are for people without health insurance, and are not for Medicare beneficiaries.
- Medicare supplemental insurance plans, or Medigaps, will not be sold in the health insurance exchanges.
- Beneficiaries who have Medicare Part A and Medicare Part B meet the ACA’s requirement that most adults have health insurance in 2014.
- It is illegal for anyone to sell health insurance exchange policies to Medicare beneficiaries. However, people who are eligible for Medicare, and may have to pay for Medicare Part A, may be able to purchase a policy in the health insurance exchange. However, these people may be subject to a penalty should they decide to enroll in Medicare later.
- People with Medicare do not need to re-enroll or get new Medicare cards as a result of the ACA.
- Seniors shouldn’t ignore the exchanges; instead, they should talk about the health insurance exchanges with their family members who don’t have health insurance.
Volume 4, Issue 41
It is very important that you review your drug plan every year. Medicare private drug plans can change their costs and the list of drugs that they cover every year.
Most people can only change Medicare drug plans during Fall Open Enrollment (sometimes called the Annual Coordinated Election Period – ACEP, or the Annual Election Period – AEP), which runs from October 15 to December 7 each year.
You may also be able to change your Part D plan during the Medicare Advantage Disenrollment Period (MADP) if you have a Medicare private health plan (also known as a Medicare Advantage plan). The MADP occurs every year, from January 1 to February 14. If you have a Medicare private health plan, you will be able to switch to Original Medicare with or without a stand-alone prescription drug plan during the MADP. Changes made during this period will become effective the first of the following month. For example, if you switched from a Medicare Advantage plan to Original Medicare and a stand-alone prescription drug plan in February, your new coverage would begin March 1.
Even if you are satisfied with your current plan, you should check if there is another plan in your area that offers better coverage at a lower price.
When choosing a Medicare private drug plan, make sure to look at all the costs, not just the premium. Your costs throughout the year will depend on what drugs you take, whether your plan covers them, and whether there are any coverage restrictions. Another plan may have lower copays, cover more of your drugs, have fewer restrictions or offer some coverage during the coverage gap.
If you are considering joining a Medicare Advantage plan (Medicare private health plan), like an HMO or PPO, to get drug coverage, remember that you will get all of your Medicare benefits from that plan. Look beyond the drug coverage; make sure the plan covers the doctors, hospitals and pharmacies you prefer to use at a cost you can afford.
Last week, Elizabeth Rosenthal, a volunteer for the Medicare Rights Center’s Seniors Out Speaking (SOS) program, wrote a letter to the New York Times responding to an article about the rising costs of prescriptions drug costs, particularly medications to treat asthma.
Ms. Rosenthal points out “how successful Big Pharma has been in protecting its bottom line.” She says, “Through its tremendous lobbying power, this consistently profitable industry has punished American consumers with drug prices way above those of any other country.” Ms. Rosenthal concluded by calling on Congress to “have sensible negotiation of drug prices.”