government
Private plan growth in Medicare to continue in 2013
NEWS IN BRIEF — Posted Feb. 27, 2012
Patient participation in private Medicare plans is expected to increase slightly in 2013 after robust growth in 2012.
The Centers for Medicare & Medicaid Services estimates that the Medicare Advantage program will grow nearly 2.5% next year, according to a proposed payment and policy notice published on Feb. 17. In 2012, Medicare Advantage enrollment increased by 10%, while premiums dropped by an average of 7%.
The agency will deny insurer proposals that increase patient premiums or decrease benefits significantly in 2013, CMS said. The 2010 health system reform law gives the Medicare program the authority to reject such plans during a competitive bidding process.
The law also reduces patient liability in the Medicare drug benefit's coverage gap, known as the "doughnut hole." In 2013, the draft proposal states that the initial coverage limit would be set at $2,970, after which patients would receive a 50% discount on covered brand-name drugs and a 2.5% reduction in cost-sharing. For generic drugs, beneficiary cost-sharing for medicine purchased in the gap drops from 86% in 2012 to 79% in 2013. Catastrophic coverage would kick in once an enrollee spent $4,750 out of pocket on drugs.
Final 2013 rates are scheduled to be published on April 2.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2012/02/27/gvbf0227.htm.
