If the Medicare fee-for-service program offered
enrollees the kind of annual out-of-pocket spending cap that Affordable Care Act-compliant private major medical plans now provide, "the addition of an annual cap would reduce the need of some beneficiaries to purchase supplemental insurance," James Cosgrove, a GAO director, writes in a new GAO report.
The company recognized that its system was not working properly for 476
enrollees in its Exchange plans.
Enrollees with issues sometimes waited hours after calling with complaints.
Plans that improve the quality of care they deliver to
enrollees will see higher updates and can grow and enhance the benefits they offer to
enrollees.
the issuer with the second biggest share, served about 17 percent of the program
enrollees.
This paper answers three specific research questions: What type of health insurance coverage, if any, did HIFA
enrollees report just prior to enrollment in the HIFA program?
We find that new
enrollees had first-month claims experience that was nearly $29 lower per
enrollee than that for those who were continuously enrolled.
To what extent do Medicaid
enrollees move across states, causing national Medicaid enrollment estimates to be artificially high and uninsured estimates to be artificially low?
Costs for
enrollees have been higher than anticipated, possibly because of deferred health care prior to their enrollment, he said.
Key findings include that nearly one of every five Part D non-LIS
enrollees reached the coverage gap in 2009 and that among Part D non-LIS
enrollees who filled one or more prescriptions in 2009 about one in five had spending high enough to reach the coverage gap.
The private organizations that run Medicare Advantage plans are supposed to avoid using premium rates, plan features, or other underwriting techniques to "cherry pick," or attract healthier
enrollees and repel
enrollees with health problems.
The Insurance Department urges
enrollees covered through Fox to look for letters being mailed to them this week by CMS explaining the agency's decision to cancel Fox and the options now available to them.
