Medicare Advantage: 20 years, 20 million people and 4 factors
In 1997, the federal government created the Medicare + Choice program — later renamed Medicare Advantage — to enhance consumer choice and more efficiently deliver Medicare benefits to older Americans.
You may have heard of Medicare Advantage, but maybe you don’t know exactly what it is, what it offers and how it can help you.
Today, Medicare Advantage serves almost 20 million people — a nearly 50 percent increase from even five years ago, according to the Centers for Medicare & Medicaid Services.
Here are four important factors in why people choose Medicare Advantage:
1. Simplicity and convenience. Medicare Advantage plans combine all your Medicare coverage, including Original Medicare (Parts A and B), and often prescription drug coverage, into one plan so you only have one card to carry.
2. Predictable costs. Managing your health care costs can be especially important if you are living on a fixed budget. Many Medicare Advantage plans offer additional benefits for a $0 premium beyond the premium for Original Medicare and have set limits on what you have to pay out of pocket. Brian Thompson, CEO of UnitedHealthcare Medicare & Retirement, explains, “Original Medicare generally covers about 80 percent of a person’s costs for doctor visits and other outpatient care, leaving the individual responsible for the rest, with no limit to what that cost may be. Medicare Advantage, on the other hand, offers peace of mind and helps you plan your health care expenses by capping how much you may have to pay out of your own pocket in a given year.”
3. Care Coordination. Boston Consulting Group (BCG) analyzed 3 million Medicare claims and found that Medicare Advantage members have shorter hospital stays and fewer readmissions within 30 days of leaving. Medicare Advantage plan members are also more likely to receive preventive care to keep chronic illnesses in check, according to researchers.
A possible explanation for the favorable outcomes: care coordination. Thompson says, “The health care system is complex. With Medicare Advantage plans, doctors work as a comprehensive team, led by a primary care doctor, and together with the health plan, they help members receive the care they need. This can create more convenience and value for the member and ultimately lead to better health.”
4. Choice. Thompson also points out that “every day more than 10,000 baby boomers turn 65, and they expect to have choices.” Medicare Advantage plans come in a wide variety of options, so people can choose one that meets their unique health and budget needs. Many offer programs to support people with diabetes and other chronic conditions, and most offer additional benefits not covered by Original Medicare. Perks may include prescription drug, dental, vision and hearing coverage, home visits, 24/7 access to health care professionals and gym memberships.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.