A Kaiser Family Foundation report examining the cost implications of giving Medicare recipients coverage options has found that there are “no obvious ‘right’ choices for beneficiaries.” The report, Paying for Choice: The Cost Implications of Health Plan Options for People on Medicare, estimates a range of spending for three different prototype beneficiaries in eight markets.
“Spending is often lower in Medicare+Choice plans, but this is not always the case,” the authors found. The question of whether an M+C plan will be available to beneficiaries is a complicating factor. And M+C — as is the case with all options — is subject to geographic variation. For instance, a frail, 80-year-old woman who chooses the least expensive medigap plan would spend $6,376 in Manchester, N.H., but $9,520 if she lived in Miami. On the other hand, she could spend as little as $1,342 for the cheapest M+C plan in Miami, but as much as $7,082 for the lowest-cost M+C option in Seattle. The other markets examined in the study are Oakland, Calif., Minneapolis, Chicago, Dodge City, Kan., and Baltimore.
M+C often least expensive choice
| Estimates for a 50-year-old man with disabilities | ||||
|---|---|---|---|---|
| Medigap | M+C | No supplemental insurance | Range of costs across all sources | |
| Premium range | $432-14,412 | $0-1,194 | $0 | $0-14,412 |
| Nonpremium range | $7,445-11,058 | $6,010-11,049 | $12,335-12,380 | $7,445-12,380 |
| Total range of costs | $8,541-21,857 | $6,010-11,049 | $12,335-12,380 | $6,010-21,857 |
| Estimates for a healthy 65-year-old woman | ||||
| Medigap | M+C | No supplemental insurance | Range of costs across all sources | |
| Premium range | $407-8,074 | $0-1,194 | $0 | $0-8,074 |
| Nonpremium range | $1,587-2,808 | $1,342-8,134 | $10,546-10,673 | $1,342-10,673 |
| Total range of costs | $2,683-9,661 | $1,342-8,962 | $10,546-10,673 | $1,342-12,482 |
| Estimates for a frail 80-year-old woman | ||||
| Medigap | M+C | No supplemental insurance | Range of costs across all sources | |
| Premium range | $528-8,074 | $0-1,194 | $0 | $0-8,074 |
| Nonpremium range | $4,408-8,532 | $1,342-8,134 | $10,546-10,673 | $1,342-10,673 |
| Total range of costs | $6,376-12,482 | $1,342-8,962 | $10,546-10,673 | $1,342-12,482 |
SOURCE: PAYING FOR CHOICE: THE COST IMPLICATIONS OF HEALTH PLAN OPTIONS FOR PEOPLE ON MEDICARE, KAISER FAMILY FOUNDATION, MENLO PARK, CALIF.
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.