One of the likely outcomes concerning the 2010 Patient Protection and Affordable Care Act (PPACA) as amended -- better known as ObamaCare -- as it affects Medicare users is that PPACA's $100-$200 billion cuts to Part C Medicare Advantage will force seniors to lose their preferred healthcare insurance coverage and preferred doctors. A related prediction is that the cuts will increase Part C Medicare Advantage premiums dramatically, taking considerably more money out of seniors' pocket. Alternatively -- according to the predictions -- the Part C Medicare Advantage premiums will rise so high that many seniors will drop the coverage and return to the less comprehensive Original Medicare, which costs seniors considerably more money out of pocket and ratchets up government spending because the seniors leave the capitated integrated-care methodology of Part C Medicare Advantage for the fee-for-service (FFS) uncoordinated-care approach of Original Medicare.
This is not right-wing conspiracy theory or partisan political rhetoric. These are the official predicted results of PPACA by the Congressional Budget Office and the Medicare actuary. And all of the above seems to be happening in Massachusetts where Tufts Health Plan, the state's third largest insurer, dropped 5,000 of its Medicare Preferred Part C beneficiaries1 in Worcester County on Tuesday October 2 by special-delivery letter.
Unlike Harvard Pilgrim, which dropped Part C Medicare Advantage in Massachusetts altogether, Tufts Health Plan seems to want to have it both ways in central Massachusetts:
- Tufts is pushing its 5,000 current Worcester County Medicare beneficiaries back on to old-fashioned Original Medicare with its less comprehensive coverage and much higher co-pays and deductibles (and higher costs to the government because of Medicare inefficiency and the FFS/uncoordinated-care approach). The special delivery letter to its 5,000 central Massachusetts customers highlighted the Medicare beneficiaries rights to buy Medigap policies, which in Massachusetts are typically much more expensive than Part C Medicare Advantage. Tufts -- conveniently -- also sells highly profitable and less regulated Medigap insurance.
- But Tufts is still selling very similar Part C Medicare Advantage policies to new senior-citizen customers in Worcester Country in 2013. But the "new" Tufts Medicare Preferred policies appear to cost 15%-35% more than the 2012 policies2 with the same or very similar names.
To be honest, I can't tell if this is incredibly devious marketing by Tufts or just incredibly bad marketing and terrible customer relationship building by Tufts. Apparently it did not want to tell its Worcester County Medicare Part C customers that the Part C Medicare Advantage policy that cost them $48 a month in 2012 (one example) now will costs them $66 a month. So Tufts just dropped these 5,000 seniors using extremely confusing correspondence that will cause considerable fear and concern among senior citizens.
Welcome to Medicare under Obamacare.
-- Dennis Byron
1 I cannot confirm the exact number or find any other information about this action on the Tufts web site. Presumably this only affects Medicare beneficiaries buying Part C Medicare Advantage policies directly from Tufts and not through former employers.
2 Tufts appears to have added a low-end no-cost Part C Medicare Advantage plan with drug coverage to its Worcester County line up but it is a plan with a $6700 out of pocket maxium; Tufts appears to have dropped its high end Preferred Prime policy entirely at least in Worcester County