The Centers for Medicare and Medicaid Services (CMS) announced rates and detailed plan payments for 2015. The government agency is expected to implement a number of policies to guarantee beneficiaries that high-quality, high-value and low-cost options will remain available.
According to the release, when the Affordable Care Act passed in 2010, it helped Medicare Advantage premiums decrease by 10 percent and increase enrollment by 38 percent. There is now a record of more than 15 million people enrolled in Medicare, 30 percent of which have a Medicare Advantage plan. More than half of those with Medicare Advantage coverage have a plan with four or more stars.
"The policies announced today will provide improved benefits in Medicare Advantage and the Prescription Drug Plans while keeping costs low for Medicare beneficiaries," Jonathan Blum, CMS principal deputy administrator, said in a statement. "We believe that plans will continue their strong participation in the Medicare Advantage program in 2015 and beneficiaries will continue to have access to a wide array of high quality and affordable Medicare health and drug plans."
Policy changes for 2015
CMS made the policy and rate changes to further assist individuals who turn to Medicare for their health insurance needs. Policy changes for 2015 include lower out-of-pocket drug spending, greater and increased protections.
Enrollees who fall in the Part D prescription drug coverage gap will now be granted coverage and discounts of 55 percent on covered brand name drugs and 35 percent on covered generic drugs. The Affordable Care Act's Coverage Gap Discount Program will provide these discounts to more than 7.9 million beneficiaries helping each individual save an average of $1,265.
In 2015, plans will only be permitted to increase by $32 per member per month and plans will be required to have more concise offerings so beneficiaries choosing plans will be better able to spot differences and make the best choice for their health needs.
Providers will have additional tools to help them comply with requirements while also establishing the best practices to follow when provider networks undergo significant changes. As a result of these tools, beneficiaries will be better protected from changes made by their healthcare provider's network.
Medicare Advantage plans are undergoing changes to dramatically decrease payments. CMS will use a new phase-in schedule for Medicare's Part C risk adjustment model that will be introduced in 2014 to improve payment accuracy.