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How Will Obamacare Affect Medicare and Advantage Plans?

What affect will ObamaCare have on Medicare Advantage plans?


We are getting closer to the time when the ACA (Affordable Care Act) will start putting into place changes to Medicare and these changes will continue to be implemented over the coming years. One of the biggest changes that most folks have heard about is that there will be a gradual reduction of payments/overpayments to Medicare Advantage plans.

This where the 5 star rating program starts to be much more important than in years past. The focus is going to be on improving and measuring the quality of care that seniors on these plans receive.  The plans that provide quality care will be eligible for bonus payments. From a consumer’s standpoint this is very good thing.

Some other benefits:

1. Prevention Plans –Your PCP will develop a plan to keep you healthy make sure you get the screening and preventative care you need

2. More help with medication costs – The “Donut Hole” is gone by 2020

3. Payment Advisory Board – experts that will recommend many ways increase benefits and reduce costs.

“I’ve heard that Advantage plans will no longer be available”

That just isn’t true and there will be many seniors that will opt for an Advantage plan as it will offer more benefits than original Medicare. Influential advisors for CMS/ Medicare, the Congressional Budget office and the Office of the Actuary have stated recently that they predict increased enrollment in Medicare Advantage plans over the next 7 years at a minimum.

The Advantage plans that do not embrace the new changes and bring their level of care up to the higher benchmarks will find themselves in a precarious position. Some experts predict that 10-30% of current Advantage companies will fall away over the next several years.

By Dave Wilson

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