Nearly 10 million Medicare beneficiaries have elected to join Medicare Advantage plans rather than receive services through traditional Medicare. These plans offer a wide variety of "insurance products" and vary in price. It can be confusing for both the patient and provider to determine the coverage and cost-sharing arrangements these plans offer. Below are some resources which help describe the Medicare Advantage program.
2019 Contract Year
APTA put forth several recommendations, specifically in regards to CMS's proposed changes to the flexibility in uniformity requirements; the frequently abused drugs policy; and maximum out of pocket limits. APTA encouraged the agency to institute safeguards to ensure that healthier members of the population are not inappropriately harmed and recommended that the agency to develop policies that increase access to nonpharmacologic treatment options and support interdisciplinary care approaches for treatment of chronic pain, and require Medicare Part D plan sponsors to provide information to beneficiaries on nonpharmacological treatment options. APTA also urged CMS to be mindful of the cost sharing for physical therapy services and consider how increasing cost sharing for physical therapy services would impact MA enrollees' outcomes. APTA also recommended that CMS implement policies that improve MA enrollee access to physical therapy services. Review Comments (.pdf)