HHS News: People with Medicare Have More High Quality Choices

Health and Human Services Secretary Kathleen Sebelius announced today that people with Medicare have more high quality choices and the performance of Medicare Advantage plans is improving. HHS also released the 2013 quality ratings for Medicare health and drug plans on the web-based Medicare Plan Finder. During Medicare Open Enrollment, people with Medicare can use the star ratings to compare the quality of health and drug plan options and select the plans that are the best value for their needs for 2013.

“In 2013, people with Medicare will have access to a wide range of plan choices, including more four and five star plans than ever before,” said Secretary Sebelius.

In 2013:

  • People with Medicare will have access to 127 four- or five-star Medicare Advantage plans. These plans currently serve 37 percent of Medicare Advantage enrollees, and may attract more with their improved quality ratings. In 2012, people with Medicare had access to 106 four or five star plans, which served only 28 percent of enrollees.
  • People with Medicare will have access to 26 four or five star prescription drug plans, which currently serve 18 percent of enrollees.  This is an improvement from 2012, in which 13 four or five star plans are serving only 9 percent of enrollees.

Medicare plans are given an overall rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance. Users of the Plan Finder will also see a gold star icon designating the top rated 5-star plans, and a different icon for those plans who are consistently poor performers.

As a result of provisions in the Affordable Care Act, Medicare is doing more to promote enrollment in high quality plans and alert beneficiaries who are enrolled in lower quality plans.  Now, persons with Medicare enrolled in consistently low performing plans (those receiving less than 3 stars for at least the past 3 years) will receive notifications to let them know how they can change to a higher quality plan if they choose to do so.  In addition, 5-star plans are rewarded by being allowed to continuously market and enroll beneficiaries throughout the year.  In 2012, thousands of people with Medicare took advantage of this opportunity to join a top performing plan.

The Affordable Care Act also added new benefits to Medicare, including in the Medicare Advantage program.  The health care law phases out the Medicare prescription drug coverage gap also known as the “donut hole.” In 2013, people with Medicare who reach the “donut hole” will receive approximately 53 percent off the cost of brand name drugs and 21 percent off the cost of generic drugs.  Medicare beneficiaries will also continue to benefit from Medicare-covered preventive services at zero cost-sharing, including a yearly Wellness visit.

At the same time that quality is improving and benefits are increasing, premiums in the Medicare Advantage program are remaining steady.    Since the Affordable Care Act was passed in 2010 through 2013, Medicare Advantage premiums have fallen by 10 percent and enrollment is increasing by 28 percent.  The average estimated basic Medicare prescription drug plan (PDP) premium is projected to hold steady from last year, at $30 for 2013.

Medicare Plan Finder users can search for MA and Prescription Drug Plans being offered in their areas by inserting their home zip code. The Medicare Formulary Finder is also available online to help people with Medicare find local plans that cover their specific medications. Both Finders and other helpful Medicare tools are available at www.medicare.gov.

For details about the 2013 Part C and D Plan Quality Ratings released today, please visit http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/PerformanceData.html.

Medicare Open Enrollment runs from October 15th through December 7th. For more information about Open Enrollment, please visit http://www.cms.gov/Center/Special-Topic/Open-Enrollment-Center.html?redirect=/center/openenrollment.asp

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