KEY
POINTS
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Medicare carriers continue to improve of the bundling of access to doctors, hospitals, and drugs with Medicare Advantage plans.
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Medicare providers are rewarded by the CMS for positive patient care and productively managing healthcare costs.
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Best Medicare Advantage plans (5-Stars rated by CMS).
Medicare Advantage Plans Continue to Soar in Popularity Over Traditional Medicare
For more than ten years the proliferation of Medicare Advantage Plans (Part C) has continued to drive improvements to the Medicare system and healthcare for seniors. Medicare enrollees are choosing a simplified healthcare system that eliminates the complexity and myriad nuances for the differing components Medicare that included: hospital coverage (Part A), doctor visits (Part B), drug coverage (Part D), and the Medicare Supplement Plan (Medigap) coverage that insures for the healthcare gaps in-between the other parts and plans.
Although political pundits will cry ‘social medicine’ regarding the ‘all-in-one’ qualities of Medicare Advantage, the market shift to these plans illustrates more of an open-market story. Patients are voting with their dollar and holding the federal government and Medicare carriers accountable for continual improvements in quality of healthcare, accessibility, and lower Medicare out-of-pocket costs.
Medicare Carriers Continue to Improve of the Bundling of Access to Doctors, Hospitals, and Drugs with Medicare Advantage Plans
In simple terms, Medicare Advantage plans were created to combine Medicare Part A, Medicare Part B, and commonly Medicare Part D.
Medicare Advantage plans are essentially the private insurance and healthcare industries taking the management of senior medical care out of the government’s clunky and inefficient hands. The federal government pays carriers a fixed amount for every Medicare Advantage enrollee, and it’s up to that carrier to budget that money to deliver a quality Medicare experience to that enrollee in a financially sustainable manner.
Medicare Advantage Plans Seen by Many as Less Overwhelming and a Better Healthcare Value
The old-fashion method of shopping the perfect Medicare Supplement plans to offset the coinsurance costs, access to preferred doctors, hospitals, and healthcare networks are becoming less necessary. Popular Medicare carriers like UnitedHealthcare, Cigna, Humana, and Aetna are evolving and using Medicare Advantage networks to refine the healthcare experience for Medicare enrollees. Although Medicare advantage plans present many inconveniences, such as referrals from primary care physicians to see specialists, or relatively strict network and area restrictions, the low out-of-pocket costs, positive patient experience, and additional Medicare plan benefits outweigh the comparative disadvantages.
Medicare Advantage Insurance Companies Are Rewarded for Positive Patient Care and Healthcare Cost Controls
So, what’s to prevent these carriers from taking the government’s Medicare money and completely profiting, and not investing in a quality healthcare experience?
Answer: Medicare patient feedback and popularity (plan participation) – all captured in a 5-Star rating system.
The Centers for Medicare & Medicaid Services (CMS) has created a system for patient feedback with a 5-star rating system. If a Medicare Advantage plan is exceptional whereby patients are satisfied with their medical experience (e.g. can get a doctor appointment quickly) and the premiums are competitive, and the plan creates participation from a lot of Medicare enrollees, it’s possible to receive Five Stars. Conversely, if an Advantage plan is unpopular and receives complaints the plan will receive a low star rating.
Medicare rewards plans with high ratings using bonuses to continue to enhance the superior plan experience and value. Medicare patients are dictating the healthcare experience they expect, and Medicare carriers are incentivized to listen – a relatively open-market experience.
Most Medicare Advantage Beneficiaries Enroll in a Plan with 4 or 5 Stars
According to the Centers for Medicare and Medicaid Services (CMS), almost 80% of Medicare Advantage enrollees participate in a plan that has either 4 or 5 stars. What illustrates the progress towards Medicare Advantage’s quality of care and cost as a whole, is that only four years earlier less than 70% of enrollee were in a highly rated plan.
Trust Medicare Tip for Medicare Shoppers:
When you compare different Medicare options with an experienced licensed agent, make sure to ask – and understand the Star-Rating score of the different plans that meet your individual health needs and budget.
Best Medicare Advantage Plans (5-Stars rated by CMS)
Kaiser Permanente, UnitedHealthcare, CarePlus by Humana, Tufts Health Plan, Health Partners, Capital District Physicians’ Health Plan, KelseyCare Advantage, Quartz Medicare Advantage of Wisconsin, Cigna, Health Sun – Anthem, BCBS – Health Now New York, and Martins Point.
Reminder to Medicare shoppers: Medicare plans vary enormously by their respective service area, so the “best Medicare advantage plans” aren’t necessarily available to everyone. For example, Kaiser Permanente is a highly respected healthcare network, which is of little value to a 72 year old retiree in Houston, TX, because Kaiser Permanente does not operate in the Lone Star State.
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