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Despite Significant Changes to the Medicare Advantage Program: The Right of Seniors to Add Their Own Money to Save Their Own Lives Preserved.
Medicare is the U.S. government's health insurance program for all people 65 and over. Seniors can either choose to be on "Traditional Medicare" or to enroll in "Medicare Advantage," which allows them to receive their Medicare benefits through private health insurance plans.
As a result of National Right to Life-supported legislative changes in 1997 and 2003, there now exists an option within Medicare Advantage known as "private fee-for-service [PFFS] plans." Under PFFS plans senior citizens can choose health insurance whose value is not limited by what the government may pay toward it.
On July 16, both Houses of Congress overrode a veto by President Bush and the Medicare Improvements for Patients and Providers Act of 2008 became law.
The Senate had passed the measure on July 9 with a veto proof margin of 69-30. The bill was identical to the one passed in the House by 35549 several weeks earlier. While it makes substantial changes to the PFFS alternative within Medicare Advantage, it retains the right of older Americans to add their own money so as to get insurance less likely to ration lifesaving treatment. Most critically, these plans provide that government officials cannot impose price controls which lead to rationing.
Currently, the PFFS plans operate as indemnity plans within Medicare Advantage. This means that the plan's administrator need not make contracts with doctors because doctors who take Medicare patients generally will accept the insurance. The plans are automatically "deemed" to have enough medical providers.
However, under the new law, there will be changes, beginning in 2011, in areas that have two or more "network insurance plan" choices for seniors (basically the non-rural areas). These PFFS plans will be able to continue to exist, but in a modified way.
The plans will no longer automatically be "deemed" to have enough doctors. They will have to provide evidence that enough health care providers in the area are willing to serve plan members to meet seniors' needs.
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...and B. "CIGNA's Medicare Advantage PFFS plans are simple, affordable...Services (CMS), Medicare Advantage PFFS plans have seen a 75 percent...certain physicians, in Medicare Advantage PFFS plans, beneficiaries may...
- CIGNA Adds Medicare Advantage Private Fee-for-Service Plans to Its Low Cost...
- Press release article from: Business Wire December 21, 2007 700+ words
...and B. "CIGNA's Medicare Advantage PFFS plans are simple, affordable...Services (CMS), Medicare Advantage PFFS plans have seen a 75 percent...certain physicians, in Medicare Advantage PFFS plans, beneficiaries may...
- CIGNA Adds Medicare Advantage Private Fee-for-Service Plans to Its Low Cost...
- Press release article from: Business Wire December 21, 2007 700+ words
...and B. "CIGNA's Medicare Advantage PFFS plans are simple, affordable...Services (CMS), Medicare Advantage PFFS plans have seen a 75 percent...certain physicians, in Medicare Advantage PFFS plans, beneficiaries may...
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...and into the more lucrative Medicare Advantage PFFS plans. Wisconsin State Insurance...beneficiaries to enroll in a Medicare Advantage plan. Twice now, AHIP and...initiatives that targeted the PFFS plans. In both instances, the groups...
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...plans is largely because of the Medicare Advantage payment policy. PFFS plans are paid, on average, 19...with roughly $13 billion on PFFS plans. While PFFS plans fall under the Medicare Advantage umbrella, the plans operate...
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...contracts to offer Medicare Advantage private fee-for-service ("PFFS") plans in 2010. As of...WellCare does not offer Medicare Advantage PFFS plans in Connecticut...2010, WellCare Medicare Advantage PFFS members will...
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...marketing of individual Medicare Advantage Private Fee-for-Service (PFFS) Plans. The approval was...six other leading Medicare Advantage health plans, temporarily...marketing of individual Medicare Advantage PFFS Plans to facilitate the...