This editorial is written by Jeff Russell, president and CEO of BCBSNE
The Medicare Annual Enrollment Period has begun, the time for seniors to review their options and make coverage decisions.
Unfortunately, it’s also the time for some to spread misleading and inaccurate information about Medicare Advantage.
Seniors lose when misinformation about Medicare Advantage is circulated, causing worry and confusion. Seniors lose when hospitals decide not to participate in Medicare Advantage, making it difficult for patients who want to choose this coverage. Not only do seniors lose the ability to decide for themselves what’s best for their situation, but they also may be priced out of the ability to have coverage at all.
Seniors have different needs and it’s important that they have choices in selecting the kind of Medicare plan that fits them and their situation the best. Both Medicare Advantage and Original (also called Traditional) Medicare with supplements are valid coverage options. The choice should be up to consumers, and their decisions should be based on accurate facts from a trusted source, such as a licensed broker or agent.
Why is it so important to preserve Medicare Advantage as a coverage choice for seniors?
Medicare Advantage saves seniors money. According to the Better Medicare Alliance, 53% of Medicare Advantage beneficiaries in the U.S. live below 200% of the Federal Poverty Level. Without the option of Medicare Advantage, many seniors, most of whom live under a fixed budget, likely couldn’t afford the out-of-pocket costs of Original Medicare.
Seniors covered under a Medicare Advantage plan spend 40% less in out-of-pocket costs and premiums than those covered by Original Medicare. The difference is even greater for seniors living in rural areas. The average senior covered by Original Medicare living in rural America spends nearly 50% more on premiums and out-of-pocket health care costs compared to rural seniors covered by a Medicare Advantage plan.
Medicare Advantage enrollees are protected by a yearly out-of-pocket limit for covered Part A and Part B services. This means that Medicare Advantage members pay no more out-of-pocket each year than this limit for covered Part A and Part B services.
Medicare Advantage focuses on patient outcomes. Medicare Advantage enrollees have fewer readmissions, fewer preventable hospitalizations and lower rates of high-risk medication use than people in Original Medicare, according to a study published by Harvard Medical School and Inovalon.
According to an AHIP report, Medicare Advantage provides “better access to preventive health care, helping to reduce disease risk and detecting illnesses at an early stage” compared to Original Medicare.
Seniors want Medicare Advantage coverage—and the demand for it is growing. KFF reports that more than half of eligible Medicare beneficiaries in the U.S.—54%—are enrolled under a Medicare Advantage plan. In Nebraska, enrollment in Medicare Advantage is outpacing the national average, increasing 5.1 percent this year.
Medicare Advantage enrollment has more than doubled since 2010 and is predicted to grow to 60% of the eligible population by the end of the decade.
Walking away from Medicare Advantage hurts Nebraska seniors. While a small number of Nebraska hospitals have opted to not participate in Medicare Advantage, many more have made the decision to remain in network and serve their patients who depend on this coverage.
Great Plains Health in North Platte has announced that it is ending its participation in Medicare Advantage starting Jan. 1. We are disappointed by their decision, but the good news is that hospitals in surrounding communities continue to participate in Medicare Advantage and are ready to take care of these North Platte seniors. Additionally, it’s important to note that not all North Platte-area providers have turned their backs on Medicare Advantage patients. More than 40 local health care providers continue to participate in our Medicare Advantage network.
We must work together to make Medicare Advantage stronger and viable for years to come.
Ultimately, it’s about choice.
Medicare Advantage may not be for every senior. But every senior deserves the ability to make that decision for themselves.
To learn more about your Medicare options, visit NebraskaBlue.com/Medicare-Advantage.