Medicare Advantage May Not Be the Better Option for All

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<p>Beneficiaries in poor health can pay more out-of-pocket for care in some Medicare Advantage managed care plans than in traditional, fee-for-service Medicare with Medigap supplemental coverage, a new Commonwealth Fund analysis finds.<br><br>In the issue brief <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=22227&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D373489%26%23doc373489">Medicare Beneficiary Out-of-Pocket Costs: Are Medicare Advantage Plans a Better Deal?,</a> researchers Brian Biles, M.D., and Lauren Hersch Nicholas of George Washington University and the Fund's Stuart Guterman report that costs for beneficiaries in good or fair health are lower in most of the Medicare Advantage plans studied, compared with fee-for-service Medicare. But in 19 out of 88 plans examined, beneficiaries in poor health would spend up to $2,195 more in annual out-of-pocket costs for their care than if they had traditional Medicare plus Medigap.<br><br>"These findings raise questions about what Medicare is achieving with extra payments to private Medicare Advantage plans, which totaled more than $2.7 billion in 2005 over fee-for-service costs," said Fund President Karen Davis. "While the payments were designed to help improve benefit packages, the most vulnerable enrollees in MA plans are facing high cost burdens for their health care, leaving them at risk for not getting needed health care services."</p>