The insurance industry and those on Medicare Advantage plans
have won a major victory after the Obama administration backtracked on
an earlier plan to cut Medicare Advantage payments to insurers by 2.2
percent in 2014 and instead decided to give them a 3.3 percent increase.

It had been projected that Medicare Advantage plan beneficiaries in Florida would have had a loss in benefits or an increase in premiums in 2014 of $50-$60 per month.

“Health insurers stand to get significantly more money for running Medicare
Advantage plans next year than they had feared, reported The Wall Street Journal.

“The final announcement appeared to significantly improve on a mid-February
proposal that featured unexpectedly sharp cuts and prompted a busy
lobbying effort from health insurers.

“Companies that sell the plans, such as Humana Inc., warned that cutting funding too much would hurt benefits for seniors while driving plans out of some markets. The warnings and the lobbying push drew substantial support in Congress, where at least 160 lawmakers signed letters to regulators urging
industry-friendly changes.”

In its announcement CMS (the Centers for Medicare and Medicaid Services) also revealed slight improvements in the Medicare Part D prescription program.

In 2014, the allowed annual deductible amount that companies may charge will lower from $325 to $310.

Other Part D reductions for 2014 include the initial spending limit of $2970 to $2850 (the combined amount you and your insurance company pay for medications) before hitting the “Donut Hole” coverage gap and the total out-of-pocket amount threshold lowered to $4550 from this year’s $4750.

While in the Donut Hole, generics will be discounted a minimum of 28 percent (up from 14 percent in 2013)  and brand name drugs dicounted 52.5 percent for 2014.

Other benefits revealed by CMS include:
▪As authorized by the Affordable Care Act, to protect enrollees in Medicare Advantage plans from significant increases in costs or cuts in benefits from one year to the next, the amount of any permissible
increase to total beneficiary costs is limited to $34 per member per month for 2014 (down from $36 per member per month in previous years).

▪To avoid unnecessary and unwanted prescriptions being delivered and charged to Medicare enrollees because of “auto-ship” services, Part D plans will require their network pharmacies to obtain enrollee consent prior to each delivery, unless the enrollee personally requests the refill. CMS strongly encourages Part D plans to implement this consent requirement for the remainder of this year.