Changes to Medicare Coverage Options

June 15, 2015

Some changes to Medicare coverage options have occurred as a result of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

What is the impact of MIPPA?

MIPPA affects many parts of the Medicare program. Here's how it has affected Medicare Advantage plans:

  • Tighter regulations around sales and marketing practices
  • As of 1/1/2011, group Medicare Advantage PFFS plans were  required to have a contracted provider network. “Deeming” went away, resulting in the termination of the vast majority of group PFFS plans.
  • Individual PFFS plans may still be available in select markets.

In addition, MIPPA includes new regulations to modernize Medicare supplement plans that became effective June 1, 2010.  These changes included:

  • Standardized plans E,H, I, J and High Deductible J have been eliminated 
  • Two new standard plans have been created:  Plan M and Plan N to provide new options for higher cost sharing with a lower premium
  • The preventive care and at-home recovery benefits have been eliminated from standard plan designs
  • Hospice is added as a core benefit to all standard plan designs

How does this affect employers?

While UnitedHealthcare no longer offers group Medicare Advantage PFFS plans, we have developed alternatives for our clients who need national coverage solutions and want to continue providing cost effective Medicare insurance solutions. Our National PPO and Senior Supplement products offer national coverage with a single premium rate and plan design.

How is UnitedHealthcare responding?

We're committed to the future of our employer group Medicare Advantage plans. We plan to expand our networks and to work closely with the Centers for Medicare & Medicaid Services (CMS)to develop new programs to meet our clients’ needs.