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.
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.