Medicare+Choice Beneficiaries to Face More Cost-Sharing Requirements, Fewer Benefits in 2002
Medicare+Choice beneficiaries will face increased out-of-pocket costs under their health plans in 2002, and sicker beneficiaries will "bear the brunt of big changes" as more Medicare HMOs restrict prescription drug coverage and increase cost-sharing requirements, according to a new Commonwealth Fund study conducted by Mathematica Policy Research Inc. In the study, researchers analyzed data from Medicare Health Plan Compare, information provided by CMS on benefits and cost-sharing requirements in Medicare+Choice plans, as well as county enrollment data from CMS' September 2001 Quarterly State/County/Plan Market Penetration Report. The study focused on "basic" Medicare+Choice plans -- the plans offered by Medicare HMOs with the lowest premiums -- and found:
- Monthly premiums for Medicare+Choice beneficiaries will increase "significantly" this year, from about $22.94 in 2001 to $32.38 in 2002.
- The number of Medicare+Choice beneficiaries in plans with a monthly premium higher than $50 will increase from 19% in 2001 to 33% in 2002.
- The percentage of Medicare+Choice beneficiaries in a basic plan that provides prescription drug coverage will increase from 70% in 2001 to 71% in 2002, but 51% of the plans will only cover generic drugs, compared with 18% in 2001.
- About 80% of Medicare+Choice beneficiaries will have a cost-sharing requirement for inpatient hospital care in 2002, compared with only 33% in 2001, a trend that will "particularly affect" sicker beneficiaries.
- Medicare+Choice beneficiaries in urban areas will face the largest reductions in benefits in 2002 (Achman/Gold, "Medicare+Choice: Beneficiaries Will Face Higher Cost-Sharing in 2002," March 2002).
The study, titled "Medicare+Choice: Beneficiaries Will Face Higher Cost-Sharing in 2002," is available online. Note: You must have Adobe Acrobat Reader to view the study. 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.