2013 Medicare Advantage Guidelines

Just recently, the Obama administration sent out the 2013 payment and policy guidelines for health insurers in the United States that want to participate in the Medicare Advantage program. According to the administration, the proposed changes to the guidelines would result in lower premiums and stable or improved benefits.

Since the guidelines did not include an official preliminary estimate for the net average percentage change in reimbursements, it left a lot of insurers and financial markets clueless about the potential impact of the 2013 Medicare Advantage guidelines on the industry.

Low Premiums And Stable Benefits Will Likely Continue

Private health care plans in Medicare popularly called Medicare Advantage Plans and prescription drug plans (Medicare Part D) have reasonably low premium charges and stable benefits. Federal officials believe that this trend will likely continue for 2013.

The officials released a growth percentage for Medicare's per capita expenditures and stated that this will be used to determine and set rates for Medicare Advantage plans in 2013. According to the Centers for Medicare and Medicaid Services (CMS), the agency who manages the federal health care program for seniors, the guidelines for 2013 projects an overall annual growth rate of 2.47 percent and 2.3 percent per capita growth rate next year.

In a statement released by the agency, "This positive growth trend will help ensure that beneficiaries maintain a choice of plans without significant increases in premiums or decreases in benefits." CMS officials added that the net all-in-figure for 2013 and final rate announcements will be unveiled and published on April 2, 2012.

The CMS said that it is accepting public comments on the 2013 payment and policy guidelines for Medicare Advantage and prescription drug plans. According to the Advance Notice and draft Call Letter for 2013, the CMS will exercise its authority granted by the Affordable Care Act to deny bids from plan insurers that proposes "too significant" an increase in beneficiary cost-sharing or a decrease in benefits.

What Are Medicare Advantage Plans?

About 25 percent or 48 million of Medicare beneficiaries participate in Medicare Advantage plans (MA plans). Unlike traditional Medicare, MA plans are offered by private health insurance companies. It is meant to replace your Medicare unlike Medicare Supplement insurance plans that only supplements your Medicare Parts A and B.

MA plans are very popular among beneficiaries because it does not have any medical underwriting. All Medicare beneficiaries are guaranteed acceptance except for End Stage Renal Disease (ESRD). These plans are also called Medicare Plan C because it combines the benefits given by Medicare Parts A, B and some Part D coverage.

Another appealing part of MA plans is that they have low premiums. This is because they are subsidized by the federal government. With the low premiums, you get to save on healthcare. However, you need to take note that the list of doctors and hospitals you can use are restricted. Before deciding to enroll in MA plans, you need to weigh the pros and cons to determine if this is the best plan for your healthcare needs.