A recent Health Affairs study, “Medigap-Guaranteed Issue Associated with Medicare Advantage Disenrollment for Beneficiaries Administered a Part B Drug,” looked at beneficiaries receiving physician-administered drugs, to see if disenrollment from MA for these beneficiaries varied based on the state-level Medigap consumer protections.
The study concluded:
“[a]s enrollment in MA continues to grow, and with MA currently providing coverage for the majority of Medicare beneficiaries, it is increasingly important to address the ‘Medicare Advantage Trap.’ In this paper, we find evidence that those who receive a top 10 highest-spending per beneficiary physician-administered drug are more likely to disenroll from MA in guaranteed issue states compared with states with no Medigap protections. When examining individual drugs, we find a larger association between MA disenrollment and Medigap state-level type for higher spending per beneficiary drugs with greater beneficiary out-of-pocket responsibility. To ensure Medicare coverage choice for high-need beneficiaries, state- and federal-level policies should make it easier for beneficiaries to switch between Medicare coverage.” [Emphasis added.]
December 5, 2024 – K.Kertesz