Just Out of The Box: Medicare's 2015 Advantage Plans

This annual opener to the holiday season is as much like Halloween or Christmas depending on your plan. After an overall  3% cut for 2015 plans nothing appeared too bad and nothing appeared too good.

The good: we did not see the huge hemorrhage of doctors being cut from networks (although some plans showed a small bleed off during the year). Plans showed benefit cuts but none were drastic considering there was less money to go around. Medicare Advantage plans have a maximum allowable out of pocket of $6700 which  we are seeing pretty frequently, especially those plans with a Part B premium give backs. One plan achieved a five star rating meaning it will have open enrollment beyond December 7th. This was not one of those tiny plans either. That plan did focus on making its network very tight and monitored high performance according to the way CMS scores.

Even better CMS got rid of the side by side  presentation showing regular Medicare from the year before compared to the Advantage plan because Medicare benefits for the current year are not released until the later part of open enrollment. Now you will only see the plan benefits and won't have to look at last year's Medicare. Also the dreaded enrollment verification call has now turned into an enrollment verification letter you will receive after you have enrolled in a plan. Often members would not answer or would hang up the phone thinking this was a solicitation. Everyone is glad this practice is dying. However there will still be calls to confirm if an enrollee has a chronic illness for the purpose of disease management programs.

The bad: Instead of premium give backs some plans are now charging premiums, you will see this more in PPO plans. This will be a bit of a shock for Floridians. We are just not used to paying premiums unlike the rest of the states where paying a premium for your Advantage plan is pretty common. Primary doctors saw slight co-pay changes but  office visits went up all over for specialist.

Dental and vision benefits are growing slim or just going away. Ancillary benefits and discounts are now barred from the being part of the Medicare presentation according to CMS who wants to see the focus of the presentation to be a healthcare decision process.  

And yes there is no Santa Claus: the benefits are a little less than last year in most cases, so if you feel the water slowly boiling you may want to jump out and go to a Medicare Supplement and stand alone drug plan. A Medicare Supplement is a choice with a premium, but it is not as variable as the yearly benefit changes of an Advantage plan.

Betsy Vipond is CEO of The Senior Health Advisor and has been in insurance for over 38 years. She is a board member of Tampa Bay Health Underwriters part of the National Association of Health Underwriters and specializes in Medicare products. You may contact her at 800.603.0901.