The Sound Bite:

Medicare Advantage (Part C) is more expensive than traditional medicare and does not offer additional benefits.

Fact or Fiction?

This is partly fact and partly fiction. Medicare Advantage includes additional benefits such as vision and aural exams. However, it does cost taxpayers extra money because Medicare pays 14 percent more to provide health care for someone enrolled in Part C. 

About 25 percent of people in the Medicare system are enrolled in Medicare Advantage Plans (Part C). While people in traditional Medicare (Medicare Hospital Insurance (Part A) and Medicare Medical Insurance (Part B)) can use any doctor or hospital, those in Part C plans stay within their plan’s network of doctors and hospitals. In return, they get benefits that are not available in traditional Medicare.

“Over half (55 percent) of all Medicare Advantage plans cover some form of preventive dental care. Such benefits typically include a specified number of exams, cleanings or x-rays per year,“ according to a Kaiser Family Foundation report. "All plans provide some vision benefit, particularly glasses and contacts. Almost all (86 percent) cover exams (typically one per year) and all plans cover eyeglasses generally subject to a dollar limit ($85 per year, on average) and specified number of pairs. Nearly two thirds (65 percent) of Medicare Advantage plans cover hearing tests. Thirty-seven percent of plans cover hearing aids, generally subject to a limit.” And many plans include prescription drug benefits.

The plans cost the taxpayers extra money because Medicare pays an average of 14 percent more to provide care for someone enrolled in a Part C plan than it pays for a typical enrollee in traditional Medicare.

The Affordable Care Act will gradually reduce the payments for the extra benefits that Medicare Advantage members are receiving, and this will cut the attraction of the plans, and their membership will decline.

Because of the Affordable Care Act, “CBO’s preliminary estimate is that enacting the proposed changes would reduce federal spending by $117 billion over the 2010-2019 period,” the Congressional Budget Office reported. The CBOestimates that enrollment in Medicare Advantage plans in 2019 would be 4.8 million lower than we project under current law.”

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