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The Health Care Reform Law and Medicare

by on Mar. 27, 2010, under Health

Here is a concise summary of what the Health Care Reform Law means for Medicare and Medicare Advantage.  A change I haven’t mentioned previously concerns the time period for changing Medicare Advantage plans, which is currently allowed between November 15th and December 31st (with a focus on Part D) and January 1st to March 31st. 

Starting in 2011, people will get one period to change their Medicare Advantage plan or Part D plan between October 15th and December 7th. 

Medicare Advantage enrollees will be allowed to disenroll from their Advantage plan and go back to Medicare between January 1 and February 15th.  During this period, they would be allowed to enroll in a stand-alone Part D plan to replace the plan that was included in their Medicare Advantage plan (MAPD).

Here is the link to the very concise summary of changes for Medicare and Medicare Advantage:

http://www.medicarerights.org/pdf/Side-by-Side-Comparison-of-Health-Reform-Bills-Impact-on-Medicare-March2010.pdf


  • Jim Hunt

    “Limits plan profits and administrative expenses to 15 percent of Medicare payments and enrollee premiums.”

    No Private Insurance Company now meets these requirements.  For sure, the Federal Government does and cannot meet this requirment, but then, they don’t have to do so.

    • medicareblogger

      I must have missed your comment back in March because I surely would have replied.  Currently, most Medicare Advantage plans do have an 85% MLR (medical loss ratio), meaning 15% of their revenue goes to administrative expenses and profits. So this requirement is not a big deal for most Advantage plans.  Though there are some Advantage plans that come out way ahead, with only 70% of revenues paid out for patient expenses. These companies end up with a big profit- and this will no longer be allowed.
       
      Medicare spends about 97% of its funds (revenue, if you like) on medical bills for Medicare beneficiaries.  About 3% is spent on administration – a far cry from 15% for private, for-profit Medicare Advantage plans.  If you don’t mind billions of Medicare dollars being diverted to insurance companies, you must not be a fiscal conservative.

  • http://www.medlawplus.com medlaw

    Nice summary.  I posted a link on twitter.