Eric Peterson, healthcare expert at PA Consulting, is quoted in MarketWatch discussing options for US federal health insurance program Medicare. Open enrollment for Medicare, the period when people can switch their health coverage without special exclusions, began October 15 and runs until December 7.
The article notes that Medicare has three parts: Part A, for inpatient hospital care and skilled nursing facilities; Part B, for general medical coverage; and Part D, for prescription drug coverage. There is also Medicare Part C, which is known as Medicare Advantage and separate from Original Medicare (they only share a name). Medicare Advantage is administered by private insurance companies and the plans available vary by state. There are various types of plans available to choose from, just as an employee may pick an insurance program from an employer: there are Health Maintenance Organizations (HMOs), Preferred Provider Organization (PPO); Special Needs Plans (SNPs), Private Fee-for-Service plans (PFSS) and Medical Savings Accounts (MSAs).
There’s also Medigap, which is extra coverage provided by a private insurance company to supplement Original Medicare. A patient cannot be covered by Medicare Advantage and Medigap at the same time.
Eric says that having so many options for Medicare, Medicare Advantage and Medigap can be overwhelming, but it makes sense.
He adds: “The downside to a one-size-fits-all model is it is designed for the average patient. There are superior choices.”
Our new value-based care research shows why putting patients at the centre of healthcare is important and how to do it