Some Medicare+Choice Beneficiaries Forego Treatment to Avoid ‘Steep’ Copayments
Facing "steep" new copayments for some medical services, some Medicare+Choice patients say they will have to forego treatments, USA Today reports. Beginning Jan. 1, several Medicare managed care plans nationwide added copayments for chemotherapy, dialysis, radiation therapy and hospitalization (Appleby, USA Today, 1/28). Health plans have also boosted copayments for prescription drugs. For example, California-based PacifiCare Health Systems is raising drug copayments for its M+C plans in the eight states in which it operates (California Healthline, 1/25). PacifiCare CEO Howard Phanstiel said, "Health care costs recently have increased 10% a year, whereas the reimbursement for Medicare (HMOs) has averaged 2% to 3%. We are put in the position, given that Congress is paying us less, of having to reduce benefits." Although traditional Medicare does not offer prescription drug benefits and charges beneficiaries roughly 20% of the cost of medical treatments, some M+C patients are considering returning to the traditional program. Health insurers say that "on average" Medicare managed care plans are still less expensive than traditional Medicare. According to USA Today, however, "average costs mean little" to cancer patients, for example, who can pay $100 daily for radiation, $25 for dialysis and between $100 and $500 for each chemotherapy drug. Though Medicare officials approved the copayments, CMS Administrator Tom Scully said he will "soon" meet with "one or more insurers" to discuss the cancer treatment charges after a "growing number" of complaints from patients (USA Today, 1/28).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.