Medicare Advantage Out-of-Pocket Costs To Rise Moderately, Study Finds
Elderly U.S. residents enrolled in Medicare Advantage can expect only a moderate increase in their out-of-pocket costs next year, according to a study by the Kaiser Family Foundation, CQ HealthBeat reports (Reichard, CQ HealthBeat, 10/15).
The report seemingly counters an analysis by CMS Chief Actuary Richard Foster released by Republicans last week, which found that annual out-of-pocket costs for MA beneficiaries will increase from $346 in 2011 to $923 by 2017, despite cost offsets contained in the federal health reform law. Several Republicans also said that Foster's analysis indicated that the federal health reform law will compromise beneficiaries' access to MA plans.
KFF Study Findings
The KFF study found that costs for MA plans with prescription drug coverage -- a feature that most such plans offer -- will increase by about $2 monthly in 2011 if beneficiaries stay on the same plan. In addition, it found that the number of MA plans offered in 2011 will decrease by 13%. The study found that most beneficiaries still will be able to choose from among two dozen MA plans in their county, while a small percentage of people in certain counties will have few or no choices.
In addition, the study found that nearly all Medicare beneficiaries will have at least one MA plan as an alternative to traditional plans. It also found that, for the first time, every MA plan will cap enrollees' out-of-pocket costs under new CMS regulations.
Reason for Differences in Findings
According to CQ HealthBeat, the two analyses are not as far apart as it would seem. The KFF study examines MA plans only in 2011, while Foster's findings relate to a longer timeline. Foster said his findings account for limitations placed on out-of-pocket costs by CMS, just as the Kaiser study does. However, Foster said that scheduled cuts to the MA program over the years will offset those cost limitations (CQ HealthBeat, 10/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.