(The Center Square) – Seniors account for 51% of Medicare Advantage enrollment, and a fair number of them may soon lose $30 to $50 in value of supplemental benefits.
Reevaluation of the insurer reimbursement rate cut for 2025 is being urged of the Centers of Medicare & Medicaid Services. A letter to Chiquita Brooks-Lasure, the administrator, was signed by 45 Republican members of the U.S. House of Representatives.
Medicare Advantage is chosen often because it provides lower cost, contains out-of-pocket spending limits, care coordination, and additional benefits for dental and vision. The insurer reimbursement rate cut of nearly 0.2% for 2025, coupled with analysis of medical inflation by 4% to 6% in 2025, means an average reduction in value of supplemental benefits, premiums and cost sharing of $33 per month.
Some could be $50.
In the letter, the congressional delegation writes, “In addition to lower costs for seniors, Medicate Advantage plans offer out-of-pocket spending limits, care coordination, and additional benefits such as dental, vision, and prescription coverage – often with no additional premiums. This is possible because robust competition and choices that enable our constituents to choose from among MA plans that compete to provide additional benefits and services at lower costs than government-run FFS Medicare.”
FFS is an acronymn for the Medicare Fee-For-Service program. Physicians, hospitals and other health care facilities are paid based on statutorily established payment systems. Most are updated annually through regulations.
The letter-writers say the record of success makes the cut to the insurer reimbursement rate “baffling.”
“This,” they write, “is in addition to the 1.12% cuts MA took in 2024. As a result, insurers offering MA plans are already signaling that plan benefits may be cut which will undermine the program and hurt seniors.”
Medicare Advantage plans are facing “a day of reckoning,” wrote U.S. Rep. Dr. Greg Murphy, R-N.C., over the weekend. He says it was a good idea to start, but has “become a plan for denial of patient care, lack of payment to those who deliver the care and billions” in money for insurance companies.
The practicing urologist did not sign the letter. One of his North Carolina colleagues, Rep. Virginia Foxx, R-N.C., did.
She and the others wrote in conclusion, “It is out of concern for our constituents that we request that CMS reevaluate the proposed MA cuts for 2025. The stability and quality of the hugely successful MA program should not be put in jeopardy by these proposed cuts.”
The Government Accountability Office has reported Medicare issuing $47 billion in improper payments. A letter last Tuesday to Gene Dodaro, comptroller for the GAO, from Sens. Rick Scott R-Fla., Mike Braun, R-Ind., and J.D. Vance, R-Ohio, said other groups estimate Medicare fraud at about $60 billion annually.
