Medicare Advantage at risk for seniors and disabled

Medicare NJ(BPT) – Nearly 15 million seniors and people with disabilities are enrolled in a Medicare Advantage plan in this country. That number adds up to almost one third of the total Medicare population.

Some provisions in the new Affordable Care Act (ACA), if implemented, could jeopardize Medicare Advantage benefits for each and every one of those 15 million Americans.

While Medicare Advantage benefits have already been reduced, they now face additional cuts, as much as $200 billion dollars over the next 10 years. Seniors and the disabled are expected to bear the brunt of these cuts, reducing the benefits they receive.

“Medicare Advantage has allowed us to provide far better overall care to our patients,” says Dr. Donald Rebhun, HealthCare Partners medical director. “And that level of care is at risk if these additional cuts go through.”

According to the Coalition for Medicare Choices, Medicare Advantage is a health benefits program available to individuals who are 65 or older or those with permanent disabilities. The coverage is provided through private health plans rather than the government and is required to meet or exceed the standards set by the original Medicare program. In addition to hospital and physician coverage, Medicare Advantage plans often include other benefits such as prescription drug, vision, hearing, dental, fitness, mental health and management of chronic illness.

The proposed cuts could mean higher out-of-pocket costs, limited choice of doctors, fewer plans managing chronic conditions and fewer plans offering dental/vision coverage and enhanced wellness/fitness services.

Data from the Medicare Current Beneficiary Survey shows that Medicare Advantage plans continue to be a vital source of coverage for low-income and minority beneficiaries. For example, 31 percent of African-American Medicare beneficiaries and 38 percent of Hispanic beneficiaries were enrolled in Medicare Advantage plans, and 41 percent of Medicare beneficiaries with Medicare Advantage plans had annual incomes of less than $20,000.

These programs are particularly critical to the well-being of thousands of low-income individuals who may not qualify for Medicaid and would therefore lack access to chronic disease management services. Because of these cuts, out-of-pocket costs for seniors and individuals with disabilities could also rise and premium-free comprehensive drug coverage would be in jeopardy.

“Thanks to the funding we receive from our risk-based contracts, we have developed creative and innovative programs and services that have delivered better clinical outcomes. These cuts will directly impact the care we can provide to our patients,” says Rebhun.

If you or a loved one has a Medicare Advantage plan, take time to research the funding cuts and reimbursement changes. Make your voice heard and tell your federal and state representatives to stop further cuts and continue to protect your benefits. To reach your representatives, visit