By John Reichard, CQ HealthBeat Editor
February 17, 2012 -- Relatively low premium charges and stable benefits have been a hallmark of the private health care plans and prescription drug plans in the Medicare program of late, and that trend will continue, federal officials said last week.
Officials released a "growth percentage" for per capita expenditures in Medicare and said it will be used to set 2013 rates for Medicare Advantage plans, the private managed care health plans in Medicare. The figure—2.47 percent—"will help ensure that beneficiaries maintain a choice of plans without significant increases in premiums or decreases in benefits," said a Centers for Medicare and Medicaid Services (CMS) news release. CMS will publish a rate announcement for 2013 on April 2.
The CMS news release did not discuss the impact of a 2 percent reduction of Medicare rates that would occur if the terms of the budget control law President Obama signed last summer are not changed. Presumably these automatic cuts—known as a "sequester"—would lop off 2 percent from the rates. But as long as rates aren't actually reduced and Medicare Advantage plans continue to charge relatively attractive premiums, enrollment in Medicare Advantage plans next year seems likely to continue growing.
CMS said it will exercise its authority under the health care law (PL 111-148, PL 111-152) to deny health plan bids for 2013 that propose too great an increase in out-of-pocket charges or too much of a decrease in benefits.
The agency added that if either a Part D prescription drug plan or a Medicare Advantage plan in 2013 does not achieve a three-star quality rating—and it is the third year in a row the plan has not done so—members will be offered a special enrollment period during which they can sign up for another plan.