Medicare Advantage Enrollment to Rise, Premium Costs Dip

Janice Simmons, for HealthLeaders Media , September 22, 2010

With negotiations, the plans improved their benefits by about 5% (or about $13 per member per month) on average. However, seven Medicare plans offered by three insurers declined to change their bids, and CMS denied those bids, Blum said.

Aside from the new healthcare reform bill giving CMS officials new power to negotiate, CMS now can take steps to:

  • Consolidate low-enrollment and duplicative plans so beneficiaries have "meaningful differences" between plans offered by the same organization.
  • Set limits on out-of-pocket expenses.
  • Cover preventive services with no cost sharing.
  • Limit plan cost-sharing for skilled nursing care, chemotherapy, and renal dialysis to the amounts paid by beneficiaries in original Medicare.

The projected increase in Medicare Advantage beneficiaries will occur a year before Medicare will freeze payments to the plans, as stipulated under the new healthcare reform legislation. Blum attributed the increased membership to insurers providing "better value for beneficiaries."

However, even with lower costs, all beneficiaries should review their current health and drug plans coverage and shop around for what's available and meets their needs for next year, said Blum, who is also director of CMS' Center for Medicare. The new enrollment period is open from Oct. 1 through Nov. 15.

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