Medicare Advantage Fact sheet

Medicare Advantage Fact sheet - FACT SHEET MEDICARE...

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O VERVIEW Medicare provides health benefits to nearly 42 million elderly and disabled Americans. Most (88%) have their health bills paid by the traditional fee-for-service (FFS) program, while 12% are covered by private health plans, primarily HMOs. HMOs have been an option under Medicare since the 1970s. The Balanced Budget Act (BBA) of 1997 expanded the role of private plans under “Medicare+Choice” to include preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), private fee-for-service (PFFS) plans, and medical savings accounts (MSAs) coupled with high- deductible insurance plans. Private plan options have been offered primarily at the county level. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) renamed the program “Medicare Advantage” (MA), created new regional PPOs, “special needs plans” for dual eligibles, the institutionalized, or those with severe and disabling conditions, and new private drug plans that will go into effect January 2006. The Henry J. Kaiser Family Foundation: 2400 Sand Hill Road, Menlo Park, CA 94025 (650) 854-9400 Facsimile: (650) 854-4800 Washington, D.C. Office: 1330 G Street, N.W., Washington, DC 20005 (202) 347-5270 Facsimile: (202) 347-5274 Website: The Henry J. Kaiser Family Foundation is an independent national health philanthropy and is not associated with Kaiser Permanente or Kaiser Industries. FACT SHEET MEDICARE ADVANTAGE September 2005 MEDICARE P LAN P ARTICIPATION AND E NROLLMENT Plan participation and enrollment have fluctuated over the past decade. After a period of rapid growth from 1992–1998, the number of plans declined by half. In July 2005, there were 247 plans (mostly HMOs) with 4.9 million enrollees (12% of the Medicare population), down from a high of 6.3 million (16%) in 2000. In 2004, over three-fourths of beneficiaries had access to a private Medicare plan including PFFS plans; 62% had access to a Medicare HMO, PPO, or POS plan, down from 71% in 1999. By 2013, the Administration estimates 30% of Medicare beneficiaries will enroll in Medicare Advantage plans, while CBO projects an enrollment rate of 16%. 96
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This note was uploaded on 04/28/2008 for the course CH 2 taught by Professor Mckissick during the Fall '07 term at Tufts.

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Medicare Advantage Fact sheet - FACT SHEET MEDICARE...

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