Enrollment Season Opens For Medicare Advantage And Drug Plans

Today, Medicare beneficiaries can begin choosing their drug and medical coverage for 2013, and most seniors are expected to stick with the same policies they have already, despite price changes and a rating system that shows some plans may be better than others.

Seniors have been reluctant to change plans, even if there are cheaper or better-rated alternatives, according to recent studies and seniors advocates.  Beneficiaries also tend to stay with the same insurers: This year more than a third of those in Medicare Advantage plans, which provide medical and drug coverage, chose policies from just two insurers, UnitedHealthcare or Humana.

For those who are actively shopping,  however, a Medicare website  offers a consumer-friendly rating system that assigns one to five stars to each plan.  Eleven Medicare Advantage plans offered next year earned the top five-star rating and 97 earned four and four-and-a-half stars, compared to 9 and 116, respectively, this year. Four prescription drug plans available in 2013 received five stars, the same number as this year, and 22 drug plans earned four and four-and-a-half stars next year compared to 9 this year. 

The ratings are based on information reported by the plans, from Medicare records, and a yearly survey of some beneficiaries. Participation in the surveys is voluntary and anonymous but insurers are concerned that too many seniors opt out.   This year about a million seniors were randomly selected to receive one of two surveys and 495,366 responded.  Although that is generally a good response rate for most consumer surveys,  insurers are encouraging seniors to do better.  Medicare Advantage plans serve 13 million beneficiaries, and drug-only plans 17 million.

“When these critical surveys arrive in your mailbox, you may be tempted to throw them in the trash,” Scott Latimer, Humana’s Central Florida senior products markets president, wrote in a letter published in three Florida newspapers earlier this year.  In his letter-to-the-editor, Mike Jones, UnitedHealthcare’s regional vice president in St. Louis, urged seniors to share their opinions about their health care plans: “It’s rare that average Americans get the chance to provide input that could shape the future of a program as important as Medicare.”

The health care overhaul law and other payment changes also give bonuses totaling $8 billion over 10 years to Medicare Advantage plans, based on the number of stars they earn.

Dr. Rhonda Medows, UnitedHealthcare’s executive vice president and chief medical officer, said seniors shouldn’t mistake the survey, mailed in February, March and April, for just another piece of junk mail. “It gives them an opportunity to provide input, to speak from their heart and from their experience about their health plan and health care providers,” she said.

It is also a serious undertaking: one of the two surveys asks 91 questions, and another version has 64 questions.  Although the surveys are anonymous, the name of the member’s insurance plan is included so that the results can be linked to it.  The surveys don’t tell seniors that their answers will be used in determining plan ratings and extra payments.  

The public grading system does more than create incentives for plans to improve their quality of care, said Brian Cook, a Medicare spokesman.  “Patients’ health care experiences provide helpful guidance to others when choosing a Medicare Advantage or Part D [drug] plan.”

Enrollment for 2013 coverage ends Dec. 7 for most seniors.

Contact Susan Jaffe at Jaffe.KHN@gmail.com