Many people like
Original Medicare because it doesn't limit which doctors you can use.
The study showed that Medicare Advantage plans had higher proportions of minorities, people of low income and people with disabilities as compared to
Original Medicare. People who chose Medicare Advantage also had a 57 percent higher rate of serious mental illness and a 16 percent higher rate of substance abuse disorders.
The inclusion (in some plans) of a hearing and vision benefit not available in
Original Medicare.
The extra effort issuers put into documenting Medicare Advantage enrollees' health problems means that Medicare Advantage enrollees' risk scores are creeping up, and are growing less easy to compare with
Original Medicare enrollees' risk scores, according to CMS officials.
Medicare Advantage plans provide high value because they include additional benefits to improve retiree health and manage cost (as compared to
original Medicare).
Original Medicare is run by the Federal Centers for Medicare and Medicaid Services (CMS).
The law also stipulates that plans can no longer charge members more for than
original Medicare for certain services such as chemotherapy and skilled nursing.
They opt out of
original Medicare and enroll in a Medicare Advantage plan.
For example, under some of the retrospective payment models, CMS and the providers would agree on a target payment amount for the episode of care and providers would be paid under the
original Medicare fee-for-service system, but at a negotiated discount of 2%-3% or greater.
Under the proposed regulation, Medicare will continue to pay individual providers and suppliers for specific items and services on a fee-for-service basis under the
Original Medicare payment systems.
It will be either
original Medicare and a supplement or
original Medicare only.
(16) The
original Medicare repayment scheme enabled hospitals to receive reimbursements for actual inpatient medical expenses incurred using a "reasonable cost" method.
