Affordable Care Act has many seniors paying more
The Oct. 14 article “Managed plans in Medicare show improved quality” notes that ratings for 2015 are based on 2013 data. But 2015 plans have changed, not generally for the better. For example, in Western New York a fine Blue Cross/Blue Shield 2014 zero premium plan has morphed into a 2015 plan that has a $36.90 premium and, more importantly, that excludes all Catholic hospitals in Erie County. This newly “tailored” facility network limits choice beyond its already restrictive lab network, Quest. On the positive side, BC/BS has maintained a $3,400 annual out-of-pocket maximum and a maximum for inpatient hospital charges.
Independent Health’s annual out-of-pocket maximum has been $6,700 for a number of years – a hefty $13,400 for a couple. For 2015 it has added “age limitations” on certain medications, including many analgesics and hormones, which thus are not covered for enrollees over age 64.
Moreover, in 2015 no Advantage plan available in Western New York offers reasonable co-pays for a number of expensive Part B medications; required instead is a percentage of the cost of the drugs that puts them out of reach for many on Medicare.
By cutting subsidies to Medicare Advantage plans, the Affordable Care Act has accelerated increased costs and restrictions for plan participants. This situation is not improving, so ratings based on previous years should not be relied upon by those considering 2015 plans.
Janice and Leonard Aldrich