Medicare+ Choice

Medicare+ Choice

An expanded set of options for delivering healthcare under Medicare (US), which was established by the 1997 Balanced Budget Act, under which most Medicare beneficiaries can choose to receive benefits through the original fee-for-service program or through one of three M+C plans.

Medicare+ Choice
• Co-ordinated care plans—e.g., HMOs, provider sponsored organisations, PPOs;
• Medical Savings Account (MSA)/High Deductible plans—available to up to 400K beneficiaries;
• Private fee-for-service plans.
References in periodicals archive ?
(2000) Making Medicare+ Choice Real: Understanding and Meeting the Information Needs of Beneficiaries at the Local Level.
"The Effect of Health Plan Characteristics on Medicare+ Choice Enrollment." Health Services Research 38 (1, part 1): 113-35.
Therefore, rising drug costs are a major concern for Medicare and the for-profit and non-profit managed care plans (e.g., Medicare+ Choice) enrolling Medicare-aged patients.
After peaking in 1999 with roughly 7 million members, enrollment in the Medicare+ Choice (M+C) Program has been dropping.
The CMS also will spend $35 million to bring more beneficiaries into the Medicare+ Choice program.
One division, the Center for Beneficiary Choices, will focus on the Medicare+ Choice program.
She has lectured extensively on the Medicare+ Choice appeals process and currently practices with the Washington, DC office of Vinson & Elkins.
Paul also previewed a separate effort in which Medicare will pay qualifying Medicare+ Choice organizations more to reflect the additional costs of providing high-quality care to their enrollees with congestive heart failure (CHF).
"That's something we've seen in the Medicare+ Choice program, and people have different opinions on how well it's worked," said Kristin Stewart, director of private market issues, American Association of Health Plans.
This past summer, 65 Medicare+ Choice HMOs chose not to renew their Medicare+Choice contracts, and 53 reduced their service areas.
Under the 1997 legislation, however, Medicare beneficiaries will be able to avoid such rationing by picking the new Medicare+ Choice option of a "private fee-for-service plan." In order to do so, they will be permitted to add their own money on top of the government payment to pay a premium high enough to provide treatments without rationing.
The Health Care Financing Administration is proceeding to implement all five health coverage options--"Medicare+ Choice"--adopted by Congress in 1997 as part of the Balanced Budget Act.