Medicare Advantage

Two years ago, Ruth Collins found herself in a quandary. The primary-care doctor she'd been seeing for 17 years was not covered by her Medicare Advantage plan, a private Medicare plan. Instead, her health insurer tried to send her to other physicians and the insurers wouldn't accept some charges by the provider. FOR THE RECORD: Medicare: An article in the Nov. 29 Health section on Medicare Advantage plans said that enrollees who wanted to shift back to original Medicare during open enrollment (Jan.

Health Net Inc.shares plunged 25% as the Woodland Hills insurer posted disappointing first-quarter results and slashed its full-year profit outlook. The company surprised analysts and investors by disclosing an additional $67 million in medical claims that hadn't been reported in the fourth quarter because of errors in processing claims. Health Net said outside vendors that handle those claims for the company experienced problems with a new industrywide billing format. Health Net also cut its 2012 profit forecast to a range of $2.35 to $2.50 a share, excluding certain items.

President Obama, struggling to discredit bogus charges that his healthcare overhaul would create "death panels," soon could face another emotionally charged obstacle -- a plan to trim the federal subsidy for a program used by nearly a quarter of Medicare beneficiaries. The program, known as Medicare Advantage, pays insurance companies a hefty premium to enroll senior citizens and provide their medical services through managed-care networks. But whether the higher payments are worth it is a matter of dispute.

The budget that President Obama unveiled Monday is, at its heart, a political document, laying out his priorities and, not incidentally, reflecting the strategy he plans to pursue in his reelection bid. It underscores Obama's hopes of turning the election into a choice -- as he sees it -- between a vision based on economic fairness and broad opportunity and Republican proposals that would hurt the neediest and further reward the already well-to-do....

Health insurer Cigna Corp. will buy HealthSpring Inc. for $3.8 billion to jump-start its business selling Medicare plans as more elderly Americans become eligible for the U.S. government program. Medicare is an enticing market for U.S. health insurers, even as Congress weighs cuts to the program to rein in the country's debt. In particular, the entry of the postwar baby boom generation into retirement is expected to swell the ranks of privately run Medicare Advantage plans, which account for 25% of Medicare enrollment, compared with 75% for government-run plans.

Nobody likes to deal with their medical plan choices ? possibly least of all seniors. About 80% of older Americans remain in whatever Medicare plan they started with, even when unhappy with the care, according to a recent survey by Allsup, an Illinois-based Social Security and Medicare consulting firm. This year, 3.5 million seniors won't have the option of just keeping the status quo. About 13% of Medicare Advantage plans are being phased out, forcing those who have them to make new choices.

Here are some readers' questions on the national healthcare debate: People have been telling me that payment for President Obama's healthcare plan will come from the Medicare Advantage funds. Is this true? Medicare Advantage, a private insurance plan that covers a quarter of Medicare recipients, is a target of Democratic budget-cutters. Obama has characterized the program, which costs the government $17 billion annually, as a wasteful bonanza for private insurers. The White House maintains that enrollees of Medicare Advantage would see no changes in services as a result of any cuts.

Health Net Inc.shares plunged 25% as the Woodland Hills insurer posted disappointing first-quarter results and slashed its full-year profit outlook. The company surprised analysts and investors by disclosing an additional $67 million in medical claims that hadn't been reported in the fourth quarter because of errors in processing claims. Health Net said outside vendors that handle those claims for the company experienced problems with a new industrywide billing format. Health Net also cut its 2012 profit forecast to a range of $2.35 to $2.50 a share, excluding certain items.

Republican lawmakers rebuked the Obama administration Tuesday for telling health insurance companies to stop warning the elderly they would lose benefits in healthcare legislation. At least one prominent insurer has misrepresented the pending bills to frighten older Americans, the administration said. But GOP leaders said the companies, whose income could be reduced by the legislation, were entitled to free speech and political debate. The Senate's GOP leader, Mitch McConnell of Kentucky, said citizens and companies had "a fundamental right to talk about legislation they favor or oppose."

The Bush administration says its newly announced 17% increase in next year's Medicare premiums, on top of the 13.5% hike it imposed this year, will actually help seniors. "Medicare beneficiaries are ... paying a little more in premiums," said Medicare/Medicaid head Dr. Mark McClellan, "but they're getting more savings." McClellan's assumption is, to put it politely, hypothetical.

Health insurer Cigna Corp. will buy HealthSpring Inc. for $3.8 billion to jump-start its business selling Medicare plans as more elderly Americans become eligible for the U.S. government program. Medicare is an enticing market for U.S. health insurers, even as Congress weighs cuts to the program to rein in the country's debt. In particular, the entry of the postwar baby boom generation into retirement is expected to swell the ranks of privately run Medicare Advantage plans, which account for 25% of Medicare enrollment, compared with 75% for government-run plans.

Consumers receive their fair share of sucker punches from big corporations. But this one's a real beauty. And it affects all California seniors with Medicare Advantage plans offered by Anthem Blue Cross. Melvin Salse, 71, of North Hollywood received a letter from the insurance giant recently stating that "it has been our pleasure to provide you with Medicare Advantage coverage. " Salse, a retired TV producer, was assured that he's "a valued member" of the company and that "we look forward to providing you with outstanding service for years to come.

Two years ago, Ruth Collins found herself in a quandary. The primary-care doctor she'd been seeing for 17 years was not covered by her Medicare Advantage plan, a private Medicare plan. Instead, her health insurer tried to send her to other physicians and the insurers wouldn't accept some charges by the provider. FOR THE RECORD: Medicare: An article in the Nov. 29 Health section on Medicare Advantage plans said that enrollees who wanted to shift back to original Medicare during open enrollment (Jan.

Nobody likes to deal with their medical plan choices ? possibly least of all seniors. About 80% of older Americans remain in whatever Medicare plan they started with, even when unhappy with the care, according to a recent survey by Allsup, an Illinois-based Social Security and Medicare consulting firm. This year, 3.5 million seniors won't have the option of just keeping the status quo. About 13% of Medicare Advantage plans are being phased out, forcing those who have them to make new choices.

As one of their last official acts in 2009, members of Congress are debating whether to let the federal government go more deeply into debt. The issue is the country's debt ceiling, or the statutory limit on the amount Washington can borrow. The exercise may be familiar, given that Congress has raised the debt ceiling three times in the past two years. But the context is different. The deficit in the fiscal year that ended Oct. 31 was $1.4 trillion, or almost 10% of the country's gross domestic product -- the highest level since World War II. And the national debt, which didn't reach $6 trillion until 2002, now stands at $12 trillion.

After days of delay, Senate Democrats pushed ahead Thursday with their drive to pass a healthcare bill by Christmas, approving the first amendment to their giant bill: a measure to expand women's access to preventive services such as mammograms. The proposal by Sen. Barbara A. Mikulski (D-Md.), which passed on a largely party-line 61-39 vote, would authorize the federal government to require insurers to cover women's preventive care and screenings without co-payments. The amendment is expected to cost about $940 million over 10 years.

After days of delay, Senate Democrats pushed ahead Thursday with their drive to pass a healthcare bill by Christmas, approving the first amendment to their giant bill: a measure to expand women's access to preventive services such as mammograms. The proposal by Sen. Barbara A. Mikulski (D-Md.), which passed on a largely party-line 61-39 vote, would authorize the federal government to require insurers to cover women's preventive care and screenings without co-payments. The amendment is expected to cost about $940 million over 10 years.

Big changes are coming to Medicare benefits received through some private plans, so experts urge participants not to wait for enrollment season this fall to learn what they'll need to do. The changes affect private insurers that provide coverage to Medicare enrollees under programs known as Medicare Advantage plans, which can sometimes offer a larger array of benefits for certain enrollees.

Senate Democrats had to delay votes on the first set of amendments to the healthcare bill Tuesday in the face of stiff Republican opposition, underscoring the fiercely partisan floor debate and threatening the tight timeline for passage. Party leaders, scrambling to pass a bill by Christmas, had hoped to approve a proposal to expand access to mammograms and other preventive services. Instead, lawmakers spent much of Tuesday tussling over the bill's potential impact on Medicare. Democratic leaders propose to offset the cost of expanding insurance coverage to some 31 million people in part by cutting future Medicare payments to hospitals, nursing homes and other providers.

Some reader questions about the healthcare legislation in Congress: If the Senate bill is estimated to cost $ 848 billion over the next decade, how can Democrats say it will cut the federal budget deficit by $130 billion? The Congressional Budget Office says that the government will take in more in revenues from taxes and fees -- and save money by trimming the fat out of Medicare -- than it will spend extending health coverage to more Americans. Under the Senate plan, a tax on high-cost insurance plans is expected to generate about $150 billion over the next decade.