Managed Care

Premiums up, benefits down for M+C











Premiums continue to rise for Medicare+Choice beneficiaries while the benefit selection gets somewhat narrower, a study funded by the Commonwealth Fund and conducted by Mathematica Policy Research finds. Monthly premiums rose from about $23 in 2001 to about $37 in 2003.

"Plans don't want to scare healthy people away with high premiums," says Marsha Gold, a senior fellow at Mathematica and one of the study's authors. "You see plans trying to raise money in different ways, like charging more for hospital stays and drug copays."

Officials at M+C plans blame the Balanced Budget Act of 1997, which mandated payments of no more than 2 percent a year while medical costs have risen between 17 percent and 18 percent a year.

M+C copayments for primary care physician services, 1999–2003

M+C copayments for specialist services, 1999–2003

Average monthly premiums for basic M+C benefit packages, 1999-2003

M+C copayments for emergency room services, 1999–2003

*Assumes all enrollees are in basic plans.

SOURCE: MEDICARE+CHOICE PLANS CONTINUE TO SHIFT MORE COSTS TO ENROLLEES, MATHEMATICA POLICY RESEARCH, APRIL 2003

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