Shining Some Light on Traditional Medicare


Next year is expected to be Medicare managed care’s time in the sun.

The managed care plans in the Medicare Advantage program are gearing up to submit bids by June 4 to serve beneficiaries in 2019.

Enrollment is on the upswing. Plans next year will have some new leeway to offer additional supplemental benefits as the agency expands its definition of “primarily health related.” They will also be allowed to buck uniformity standards and tailor some benefits just to certain enrollees.

But beneficiary advocates want some of the rays to also shine on the traditional Medicare program, in which about two-thirds of beneficiaries remain.

Three national advocacy groups want the Medicare agency to curb its enthusiasm about Medicare Advantage when writing its Medicare handbook resource for beneficiaries, known as “Medicare and You.”

The handbook is sent to an eye-popping 43 million households in September.

The three groups, Justice in Aging, the Center for Medicare Advocacy, and the Medicare Rights Center, sent comments to the agency about its draft version of “Medicare and You.”

They said the draft version claims that Medicare Advantage is cheaper than traditional Medicare, fails to mention Medicare Advantage's limited network, and mischaracterizes prior authorization requirements.

A draft is just a draft, a Medicare program spokesman told me. “Through feedback and consumer testing, we continue to modify and improve the content to help consumers make informed health-care decisions,” he said.

We’ll know in four months if the groups’ criticisms led to changes in “Medicare and You.”

Read my article here.

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