Medicare Advantage Plans Obamacare

Obamacare includes changes to Medicare Advantage Plans:

The following changes to Medicare Advantage plans will be effective January 2014.

  • Advantage plans will be held to a minimum loss ratio of 85%
  • Requires restructuring the funding levels to Advantage plans in order to reduce payments closer to traditional Medicare (i.e. remove the 14% “overpayment”)

As a result, the following budget changes have been announced:

            1)  Congressional Budget Office estimates this will cut $145 billion over 10 years

           2)  The payment restructuring was designed to be implemented in 2011.

However, CMS had expanded “quality” payments to Medicare Advantage plans in 2012 through a demonstration program (outside of Obamacare).  These payments effectively mitigated most of the impact of the Medicare Advantage funding cuts from Obamacare.  The demonstration program is targeted to continue through 2014, at which time the additional bonus payments will end unless other measures are put in place.

MedicareBob Explains Medicare Advantage Plan Changes

Robert Bache says, “Medicare Advantage Plans are receiving less money from the Government, therefore the insurance companies are going to have to do better with less money. I look for the smaller Medicare Advantage companies to either go out of business, or be purchased by one of the bigger insurance companies.”

For Example, Care Improvement Plus has been purchased by United Healthcare, and Coventry has been purchased by Aetna.

What does Advantage Plan Consolidation mean?

For people with Medicare Advantage Plans, less companies means:

·         Less options

·         Less benefits

·         Maybe more of a monthly premium

Robert Bache says, “The days of paying a $0.00 premium and receiving a rich Medicare Advantage Plan are ending soon. However, when you compare the benefits and premium of a Medicare Advantage Plan to an Employer or Private insurance Plan, Medicare Advantage Plans are still typically going to offer better coverage. Medicare Advantage Plans over the next few years should still offer good benefits for a low monthly premium.”

Medicare Advantage Plans Obamacare

 Robert Bache aka “MedicareBob™”

Medicare and Obamacare Video

Robert Bache asks Twitter followers, “Is Obamacare destroying Medicare Advantage Plans?”

Robert Bache

Medicare Advantage Explanation

Obamacare Changes Medicare Part D

Obamacare Changes Medicare Part D:

Medicare Beneficiaries that have high drug costs now, are very familiar with what is referred to as the “The Donut Hole”.

Coverage Gap or “Donut Hole”: Once a Medicare Beneficiary and the Part D Plan have spent $2,970 on prescription medications, the Beneficiary’s cost increase.  Obamacare is requiring Medciare Part D Plans to pay more during the “Donut Hole”.

Obamacare has already started to increase what each Medicare Part D Plan is required to pay when the Medicare Beneficiary reaches the “Donut Hole”.

Below is a chart that shows Obamacare Changes Medicare Part D. You can see what has happened and what is expected to happen through 2020. As you will see, in 2020, the Medicare Part D Plan will pay 75% of each brand name medication, and the Beneficiary will be required to pay only 25%.

The table below shows the percentage of what a Medicare Beneficiary is and will pay through Medicare Part D due to Obamacare.

YEAR

Brand

Generic

2012

50%

86%

2013

47.5%

79%

2014

47.5%

72%

2015

45%

65%

2016

45%

58%

2017

40%

51%

2018

35%

44%

2019

30%

37%

2020

25%

25%

Example:  For a brand name medication that costs the $200.00.

PAST 2012: Once the Medicare Beneficiary entered the “Donut Hole”, the person had to pay $100.00 for a 30 day supply.

PRESENT 2013: This year when the Medicare Beneficiary enters the “Donut Hole”, they pay$95.00 for a 30 day supply.

FUTURE 2020: When a Medicare Beneficiary enters the “Donut Hole”, the cost will only be $50.00 for a 30 day supply.

Posted by Robert Bache aka MedicareBob™ 05/14/2013.

Read about Medicare Donut Hole in 2020.

Universal Healthcare Bay News 9

Obamacare Changes Medicare Part D

Obamacare Changes Medicare Part D:

Medicare Beneficiaries that have high drug costs now, are very familiar with what is referred to as the “The Donut Hole”.

Coverage Gap or “Donut Hole”: Once a Medicare Beneficiary and the Part D Plan have spent $2,970 on prescription medications, the Beneficiary’s cost increase.  Obamacare is requiring Medciare Part D Plans to pay more during the “Donut Hole”.

Obamacare has already started to increase what each Medicare Part D Plan is required to pay when the Medicare Beneficiary reaches the “Donut Hole”.

Below is a chart of what has happened and what is expected to happen through 2020. As you will see, in 2020, the Medicare Part D Plan will pay 75% of each brand name medication, and the Beneficiary will be required to pay only 25%.

The table below shows the percentage of what a Medicare Beneficiary is and will pay through Medicare Part D due to Obamacare.

YEAR

Brand

Generic

2012

50%

86%

2013

47.5%

79%

2014

47.5%

72%

2015

45%

65%

2016

45%

58%

2017

40%

51%

2018

35%

44%

2019

30%

37%

2020

25%

25%

Example:  For a brand name medication that costs the $200.00.

PAST 2012: Once the Medicare Beneficiary entered the “Donut Hole”, the person had to pay $100.00 for a 30 day supply.

PRESENT 2013: This year when the Medicare Beneficiary enters the “Donut Hole”, they pay$95.00 for a 30 day supply.

FUTURE 2020: When a Medicare Beneficiary enters the “Donut Hole”, the cost will only be $50.00 for a 30 day supply.

Posted by Robert Bache aka MedicareBob™ 05/14/2013.

2013 Medicare Supplement Rates

Robert Bache provides 2013 Medicare Supplement rates for the month of May.

May 2013 Medigap Rates

The table below lists Medicare Supplement insurance companies in alphabetical order. Some companies may have an effective date past May 2013. Others may have effective dates after May 2013. Some rates may vary by state. Please refer to comments for details.

Company

Effective Date

Ave. Increase

Comments

Aetna Life Insurance Co. 6/1/2013 (28.4%) Iowa
American Continental Insurance Co. 6/1/2013 (0.2%) (20%) – 10%; Varies by state
Avera Health Plans, Inc. 7/1/2013 16.8% South Dakota
Bankers Fidelity Life Insurance Co. 6/1/2013 6.8% Illinois
BlueCross BlueShield of North Carolina 6/1/2013 0% North Carolina
Central States Indemnity Co. of Omaha 6/1 – 7/1/2013 5.4% 4% – 8%; Varies by state
Colonial Penn Life Insurance Co. 1/1/2013 9.2% Maine
Continental General Insurance Co. 1/1/2013 7% New Hampshire
Continental Life Insurance Co. 6/1/2013 7.7% 6% – 9.2%; Varies by state
Equitable Life & Casualty Insurance Co. 1/1 – 4/1/2013 (0.3%) (12.2%) – 8.7%; Varies by state
Everence Association Inc. 4/1/2013 3.9% 2.1% – 5.7%; Varies by state
Family Life Insurance Co. 5/1/2013 6.5% 5% – 15%; Varies by state
Heartland National Life Insurance Co. 4/1/2013 6.4% South Carolina
Humana Insurance Co. 7/1/2013 4.9% 0% – 8.9%; Varies by state
Liberty National Life Insurance Co. 1/1/2013 0.4% Pennsylvania
Medico Insurance Co. 5/1/2013 8% 0% – 9%; Varies by state
Mutual of Omaha Insurance Co. 5/1/2013 5.2% 0% – 15%; Varies by state
Pekin Life Insurance Co. 3/1/2013 8% Indiana
Philadelphia American Life Insurance Co. 5/1/2013 6.4% Alabama
Physicians Mutual Insurance Co. 6/1/2013 6.7% 0% – 9%; Varies by state
Royal Neighbors of America 6/1 – 9/1/2013 10.3% (7%) – 26.4%; Varies by state
Standard Life and Accident Ins. Co. 3/15/2013 4.7% Maryland
State Farm Mutual Automobile Insurance Co. 3/1/2013 0% (8%) – 5.8%; Varies by state
State Mutual Insurance Co. 3/1 – 7/1/2013 12% 9% – 15%; Varies by state
Sterling Investors Life Insurance Co. 6/1/2013 7.4% 7% – 9%; Varies by state
Thrivent Financial for Lutherans 3/1 – 5/1/2013 2.3% 0% – 5.5%; Varies by state
United American Insurance Co. 2/15 – 4/15/2013 2.3% (10%) – 18.4%; Varies by state
United World Life Insurance Co. 5/1/2013 6% Kansas
UnitedHealthcare Insurance Co. 6/1/2013 2.2% Texas
USAA Life Insurance Co. 4/1 – 6/1/2013 9.5% 0% – 33.6%; Varies by state

You can find more 2013 Medicare Supplement rates by using our Medigap Rate Comparison map.