South Carolina Medicare Advantage Plan Changes - Should I Stay Or Should I Go?

South Carolina Medicare Advantage plans, just like				area, or county, will be required to not offer plans
the Medicare Advantage program nationwide, are				in that area.
poised for some major changes in 2010 and				- CMS projects that 10 million Medicare Advantage
beyond. Does this affect you and, if so, how? If				customers will face monthly premium increases of
you have a Medicare Advantage plan currently,				$40-70 per person in 2010. To go along with the
should you keep the same plan, find a new MA				higher premiums, many of the South Carolina
plan or return to "original Medicare"?				Medicare Advantage plans will also be reducing
The Advantage plan program is an alternative to				services/coverage to compensate for lower
"original Medicare". With this program, Medicare				reimbursement rates from the Federal
beneficiaries enroll with a private company for the				Government.
management and administration of their Medicare				- Starting in 2011, the private MA plans are
benefits. Since the program's inception, it has been				required to develop networks for their coverage.
controversial in some circles, as the Federal				Currently, the private-fee-for-service (PFFS) plans
Government pays the private companies a large				are not required to have networks. This
amount of money per person, per year to				elimination of the PFFS plans as they are now is
manage each individual's Medicare benefits through				already having an impact for 2010. Coventry
the private company.				Health Care, Well Care Health Plans and Health Net
In early 2009, the Obama administration, in				all have announced the end to their PFFS plans as
conjunction with the Centers for Medicare &				of 1/1/2010 - between these three companies,
Medicaid Services (CMS), announced plans to				this affects 428,000 people nationwide.
overhaul the way these plans are handled. These				Without a doubt, it is apparent that the
changes will affect the companies that administer				marketplace for South Carolina Medicare
the private plans, as well as those enrolled in				Advantage plans is changing. Each individual must
them. Some of the major changes include:				look past any pre-existing notions of the
- As a large part of an announced $316 billion				differences in "original Medicare" and the MA
Medicare funding cut, funding to the private				program and re-examine how these plans are
Medicare Advantage plans will be reduced. To go				going to work for them moving forward. While
along with this, there will be a competitive bidding				some may find it advantageous to stay with the
process for these private plan contracts.				government's Medicare Advantage program, even
- Annual out-of-pocket expenses will be required				after all of the changes; however, others may
to be capped in 2010. The anticipated cap amount				find more reasonable and comprehensive Medicare
is $3,400.				Insurance coverage elsewhere.
- Plans with 10 or fewer enrollees in a certain