{"id":12830,"date":"2024-09-02T12:05:10","date_gmt":"2024-09-02T12:05:10","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=12830"},"modified":"2024-09-02T12:05:10","modified_gmt":"2024-09-02T12:05:10","slug":"medicare-advantage-contracts-terminate","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/medicare-advantage-contracts-terminate\/","title":{"rendered":"Maximize Benefits After Medicare Advantage Contracts Terminate"},"content":{"rendered":"\r\n<div id=\"rank-math-toc\" class=\"wp-block-rank-math-toc-block has-pale-ocean-gradient-background has-background\"><nav>\r\n<ul>\r\n<li><a href=\"#introduction\">Introduction<\/a><\/li>\r\n<li><a href=\"#understanding-medicare-advantage-and-contract-terminations\">Understanding Medicare Advantage and Contract Terminations<\/a>\r\n<ul>\r\n<li><a href=\"#what-is-medicare-advantage\">What is Medicare Advantage?<\/a><\/li>\r\n<li><a href=\"#why-are-contracts-terminated\">Why Are Contracts Terminated?<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#impact-on-beneficiaries-when-contracts-are-terminated\">Impact on Beneficiaries When Contracts Are Terminated<\/a>\r\n<ul>\r\n<li><a href=\"#switching-to-traditional-medicare\">Switching to Traditional Medicare<\/a><\/li>\r\n<li><a href=\"#choosing-new-medicare-advantage-plans\">Choosing New Medicare Advantage Plans<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#demographic-variations-in-plan-switching\">Demographic Variations in Plan Switching<\/a>\r\n<ul>\r\n<li><a href=\"#dual-eligible-beneficiaries\">Dual-Eligible Beneficiaries<\/a><\/li>\r\n<li><a href=\"#impact-on-marginalized-communities\">Impact on Marginalized Communities<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#consequences-of-contract-terminations-on-healthcare-access\">Consequences of Contract Terminations on Healthcare Access<\/a>\r\n<ul>\r\n<li><a href=\"#access-to-care\">Access to Care<\/a><\/li>\r\n<li><a href=\"#health-outcomes\">Health Outcomes<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#conclusion\">Conclusion<\/a><\/li>\r\n<li><a href=\"#frequently-asked-questions-fa-qs\">Frequently Asked Questions (FAQs)<\/a>\r\n<ul>\r\n<li><a href=\"#q-1-what-should-i-do-if-my-medicare-advantage-plan-is-terminated\">Q1: What should I do if my Medicare Advantage plan is terminated?<\/a><\/li>\r\n<li><a href=\"#q-2-how-does-switching-from-medicare-advantage-to-traditional-medicare-affect-my-healthcare-costs\">Q2: How does switching from Medicare Advantage to traditional Medicare affect my healthcare costs?<\/a><\/li>\r\n<li><a href=\"#q-3-are-there-any-benefits-to-switching-to-a-new-medicare-advantage-plan\">Q3: Are there any benefits to switching to a new Medicare Advantage plan?<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/nav><\/div>\r\n\r\n\r\n\r\n<h3 id=\"introduction\" class=\"wp-block-heading\">Introduction<\/h3>\r\n\r\n\r\n\r\n<p>When Medicare Advantage (MA) contracts are terminated, it significantly impacts the beneficiaries enrolled in these plans. According to a study published on August 20 in <a href=\"https:\/\/jamanetwork.com\/journals\/jama-health-forum\/fullarticle\/2821204\" target=\"_blank\" rel=\"noopener\">JAMA Network Open<\/a>, about 1 in 5 beneficiaries switch to traditional Medicare when their Medicare Advantage plans are shut down. This article explores what happens when these contracts are terminated, the choices beneficiaries make, and the broader implications for healthcare access and outcomes.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"understanding-medicare-advantage-and-contract-terminations\" class=\"wp-block-heading\">Understanding Medicare Advantage and Contract Terminations<\/h3>\r\n\r\n\r\n\r\n<h4 id=\"what-is-medicare-advantage\" class=\"wp-block-heading\">What is Medicare Advantage?<\/h4>\r\n\r\n\r\n\r\n<p><a href=\"https:\/\/www.medicareinteractive.org\/get-answers\/medicare-basics\/medicare-coverage-overview\/original-medicare\" target=\"_blank\" rel=\"noopener\">Medicare Advantage<\/a>, also known as Part C, is an alternative to traditional Medicare, offering beneficiaries an all-in-one plan that includes hospital (Part A), medical (Part B), and often prescription drug coverage (Part D). These plans are offered by private insurers that contract with the Centers for Medicare &amp; Medicaid Services (CMS).<\/p>\r\n\r\n\r\n\r\n<h4 id=\"why-are-contracts-terminated\" class=\"wp-block-heading\">Why Are Contracts Terminated?<\/h4>\r\n\r\n\r\n\r\n<p>Contract terminations can occur for various reasons, including poor performance, financial instability of the insurance provider, or strategic decisions by the insurer. From 2016 to 2018, CMS was prohibited from terminating MA contracts for poor performance, meaning that terminations during this period were likely initiated by the insurers themselves.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"impact-on-beneficiaries-when-contracts-are-terminated\" class=\"wp-block-heading\">Impact on Beneficiaries When Contracts Are Terminated<\/h3>\r\n\r\n\r\n\r\n<p>When a Medicare Advantage contract is terminated, beneficiaries are forced to make important decisions regarding their healthcare coverage.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"switching-to-traditional-medicare\" class=\"wp-block-heading\">Switching to Traditional Medicare<\/h4>\r\n\r\n\r\n\r\n<p>The study found that 20.1% of beneficiaries whose contracts were terminated opted to switch to traditional Medicare. Traditional Medicare offers broader access to healthcare providers, but it may come with higher out-of-pocket costs, especially if beneficiaries do not have supplemental coverage.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"choosing-new-medicare-advantage-plans\" class=\"wp-block-heading\">Choosing New Medicare Advantage Plans<\/h4>\r\n\r\n\r\n\r\n<p>Among those who chose to stay within the Medicare Advantage program, the majority selected new plans with higher star ratings, which typically indicate better performance and beneficiary satisfaction. Interestingly, 66.5% of these enrollees found plans with the same or lower premiums, indicating that switching did not necessarily lead to increased costs.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"demographic-variations-in-plan-switching\" class=\"wp-block-heading\">Demographic Variations in Plan Switching<\/h3>\r\n\r\n\r\n\r\n<p>The study also highlighted significant variations in how different demographic groups responded to the termination of their Medicare Advantage contracts.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"dual-eligible-beneficiaries\" class=\"wp-block-heading\">Dual-Eligible Beneficiaries<\/h4>\r\n\r\n\r\n\r\n<p>Dual-eligible beneficiaries\u2014those who qualify for both Medicare and Medicaid\u2014were more likely to switch to traditional Medicare, with 32.7% making this change. This group often has complex healthcare needs and may prefer the flexibility of traditional Medicare.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"impact-on-marginalized-communities\" class=\"wp-block-heading\">Impact on Marginalized Communities<\/h4>\r\n\r\n\r\n\r\n<p>The study found that Black enrollees and those with prior use of hospitals, nursing homes, or home healthcare were also more likely to switch to traditional Medicare. These findings suggest that certain marginalized groups, possibly due to their higher healthcare needs or previous experiences with the healthcare system, prefer the broader provider access that traditional Medicare offers.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"consequences-of-contract-terminations-on-healthcare-access\" class=\"wp-block-heading\">Consequences of Contract Terminations on Healthcare Access<\/h3>\r\n\r\n\r\n\r\n<p>Contract terminations can have significant implications for beneficiaries&#8217; access to care and overall health outcomes.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"access-to-care\" class=\"wp-block-heading\">Access to Care<\/h4>\r\n\r\n\r\n\r\n<p>The shift from Medicare Advantage to traditional Medicare can affect beneficiaries&#8217; access to care, particularly if they were previously enrolled in a high-performing MA plan with a strong network of providers. On the other hand, traditional Medicare offers access to a wider range of providers, which may be beneficial for those with specific healthcare needs.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"health-outcomes\" class=\"wp-block-heading\">Health Outcomes<\/h4>\r\n\r\n\r\n\r\n<p>The study&#8217;s authors emphasized the need to examine the long-term effects of contract terminations on health outcomes, especially for marginalized groups. The disruption caused by switching plans or transitioning to traditional Medicare could lead to gaps in care or changes in the quality of care received.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"conclusion\" class=\"wp-block-heading\">Conclusion<\/h3>\r\n\r\n\r\n\r\n<p>The termination of Medicare Advantage contracts can lead to significant changes in beneficiaries&#8217; healthcare coverage, with about 20% switching to traditional Medicare. Demographic factors, such as dual-eligibility and race, play a crucial role in these decisions. The broader impact of these terminations on healthcare access and outcomes underscores the importance of monitoring and supporting beneficiaries through these transitions.<\/p>\r\n\r\n\r\n\r\n<p><span class=\"ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\" dir=\"ltr\">Discover the latest <a id=\"menurhl\" class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/distilinfo.com\/healthplan\/\" href=\"https:\/\/distilinfo.com\/healthplan\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link payers&#039; news updates\"><strong>payers&#8217; news updates<\/strong><\/a> with a single click. Follow <a id=\"menurhn\" class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/distilinfo.com\/healthplan\/\" href=\"https:\/\/distilinfo.com\/healthplan\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link DistilINFO HealthPlan\">DistilINFO HealthPlan<\/a> and stay ahead with updates. Join our community today!<\/span><\/p>\r\n\r\n\r\n\r\n<h3 id=\"frequently-asked-questions-fa-qs\" class=\"wp-block-heading\">Frequently Asked Questions (FAQs)<\/h3>\r\n\r\n\r\n\r\n<h4 id=\"q-1-what-should-i-do-if-my-medicare-advantage-plan-is-terminated\" class=\"wp-block-heading\">Q1: What should I do if my Medicare Advantage plan is terminated?<\/h4>\r\n\r\n\r\n\r\n<p>A. If your plan is terminated, you will receive a notice from your insurer. You can either switch to traditional Medicare or choose a new Medicare Advantage plan. It&#8217;s important to review your options and select a plan that meets your healthcare needs.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"q-2-how-does-switching-from-medicare-advantage-to-traditional-medicare-affect-my-healthcare-costs\" class=\"wp-block-heading\">Q2: How does switching from Medicare Advantage to traditional Medicare affect my healthcare costs?<\/h4>\r\n\r\n\r\n\r\n<p>A. Switching to traditional Medicare may increase your out-of-pocket costs unless you have supplemental coverage. However, it offers broader access to healthcare providers.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"q-3-are-there-any-benefits-to-switching-to-a-new-medicare-advantage-plan\" class=\"wp-block-heading\">Q3: Are there any benefits to switching to a new MA plan?<\/h4>\r\n\r\n\r\n\r\n<p>A. Yes, many beneficiaries who switch to a new Medicare Advantage plan after a contract termination find plans with higher star ratings and similar or lower premiums.<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Introduction When Medicare Advantage (MA) contracts are terminated, it significantly impacts the beneficiaries enrolled in these plans. According to a&#8230; <a href=\"https:\/\/distilinfo.com\/healthplan\/medicare-advantage-contracts-terminate\/\" style=\"white-space: nowrap;\">Continue Reading <i class=\"fas fa-long-arrow-alt-right\" style=\"vertical-align: middle;\"><\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":12833,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[62],"class_list":{"0":"post-12830","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-distilinfo-originals","8":"tag-medicare-advantage","9":"entry"},"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12830"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=12830"}],"version-history":[{"count":4,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12830\/revisions"}],"predecessor-version":[{"id":12835,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12830\/revisions\/12835"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/12833"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=12830"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=12830"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=12830"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}