The Centers for Medicare and Medicaid Services has just released new information about Medicare Advantage Plans, or MA-plans. Among other things, they revealed that MA Plans have a higher quality of care than traditional Medicare programs.
An MA plan is an alternative to traditional Medicare, and Medicare Advantage plans are not subject to the same rules and regulations as traditional Medicare. Instead, they receive a set amount of funds from the government per enrollee. The government pays an additional amount for members who fall into specific categories.
Found to be More Efficient
Medicare Advantage Plans are more efficient than traditional Medicare in providing health care for the elderly. The government pays private health insurance companies or Medicare Advantage Organizations (MAO).
A set amount of money each month for each recipient enrolled in the plan must pay an additional premium based on income. The government also pays private health insurance companies an additional sum if a patient falls into specific categories, such as being impoverished or disabled.
Better Quality Care
Medicare Advantage Plans are found to provide better quality care than traditional Medicare. For example, they receive an overall rating of 3.7 on a scale of 5 compared to the 3.2 rating on traditional Medicare. It is based on the ratings given by patients in surveys done by the Centers for Medicare and Medicaid Services (CMS).
They also receive an overall rating of 3.6 on a scale of 5 regarding having improved access to care over traditional Medicare. The government has found that the MA plans can provide equivalent services to traditional Medicare while having lower administrative costs. It is the result of the competition among private health insurance companies.
Greater Patient Satisfaction
- Medicare Advantage Plans are found to have a higher level of satisfaction among patients than traditional Medicare.
- Patients who received services through Medicare Advantage Plans rated their overall experience as 4 out of 5 compared to 3.7 for traditional Medicare.
- The reasons cited were the convenience and flexibility of being able to see a convenient provider, the overall experience with providers, and fewer paperwork requirements when seeing doctors.
Bigger Range of Insurers
Medicare Advantage Plans have a more extensive range of insurers than traditional Medicare, which encourages competition and lowers costs. The government estimates 2,500 MA plans in the US in contrast to the 1,400 traditional Medicare plans available. Over one-fifth of all 66 million Medicare beneficiaries are enrolled in an MA plan.
More Choice Among Plans
- Medicare Advantage Plans have a more comprehensive range of providers and more patient choices than traditional Medicare.
- In addition to traditional Medicare, which offers a single plan from one health provider, MA plans also offer plans from other organizations, including local hospitals and clinics.
- Patients are free to enrol in the plan that best meets their needs, with the patient’s choice of plans being based on convenience and price.
Six-Month Waiting Period for New Enrollees
Medicare Advantage Plans are subject to a six-month waiting period for new enrollees. The government also pays private health insurance companies an additional sum if the patient has multiple chronic conditions, is impoverished, or is disabled.
Available to Private Insurers Only
Private health insurance companies can only offer Medicare Advantage Plans. At the same time, traditional Medicare can be offered by non-profit organizations, state and local governments, and private health insurance companies. However, they are not available to providers, both insurers and providers of health care.
They Are Not Subject to the same Rules and Regulations as Traditional Medicare.
- Medicare Advantage Plans are not subject to the same rules and regulations as traditional Medicare.
- They are free from specific requirements of traditional Medicare, such as paying for follow-up visits, home health services, and ambulance transports for emergency care.
- Health insurance companies do not have to pay a portion of their funds into a pool used to pay doctors and hospitals under the traditional Medicare program.
Medicare Advantage Plans can charge a lower premium to low-income enrollees than traditional Medicare. They also pay an additional amount into a pool for those who fall into categories such as impoverished or disabled. In addition, the government pays an additional amount to Medicare Advantage Plans that treat certain chronic conditions and those who are elderly.
No Deductible or Out-of-Pocket Expenses
Medicare Advantage Plans do not have deductibles or other out-of-pocket expenses. Instead, their annual premium is received by the health insurance company, and they also receive an additional sum of money if a patient falls into specific categories, such as being disabled.
Patients must pay only the Medicare Part B premium of $115 per month. In addition, the Medicare Advantage Plans do not have a deductible, in contrast with traditional Medicare, which requires enrollees to pay a copayment and a deductible before the insurer starts to cover any costs.
- Medicare Advantage Plans have lower copayments than those traditional Medicare. In addition, they receive additional money from the government if a patient falls into specific categories, such as being impoverished or disabled.
- For the health insurance company to maintain a net profit, it must charge a lower premium than traditional Medicare.
- The government pays private health insurance companies an additional amount for members who fall into specific categories, such as impoverished or disabled.
The Medicare Advantage Plans are private, for-profit organizations and can be operated by any for-profit or non-profit organization. The government has no ownership in the Medicare Advantage Plans, and the health insurance companies choose the providers they work with to provide services to enrollees.
In contrast with traditional Medicare, which is operated by a federal agency and is managed by non-profit organizations? It allows health insurance companies to utilize a more efficient operating model and reduce fraud and abuse compared to traditional Medicare.
Medicare Advantage Plans are a way for the government to increase competition among private health insurance companies and lower administrative costs. In addition, these plans expand choice for consumers and make it easier for patients to find a doctor or a convenient hospital that offers services at a lower cost than traditional Medicare plans.