Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.18 million in April, an increase of 23,000 beneficiaries since January. The April MA enrollment is spread across 46 MA plans that are currently operating in the state, with approximately 56 percent of Michigan’s 2.1 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 31 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on April enrollment.  In addition to the 46 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Katie Jaskolski at the MHA.

Medicare to Cover Over-the-counter COVID-19 Tests for Beneficiaries

The Centers for Medicare & Medicaid Services is developing an initiative that will provide free access to eight over-the-counter (OTC) COVID-19 tests per month for Medicare beneficiaries. The initiative will apply to individuals enrolled in both traditional Medicare and Medicare Advantage (MA) plans. The new initiative will result in tests approved by the U.S. Food and Drug Administration being available through eligible pharmacies and other participating entities with payment directly from Medicare. Until the initiative is implemented, which is anticipated in early spring, Medicare beneficiaries can access free tests through other channels, including:

  • Requesting four free OTC tests for home delivery at the government’s dedicated webpage.
  • Accessing COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. The Department of Health and Human Services provides a webpage to search for community-based testing sites.
  • Accessing PCR tests and antigen tests performed by a laboratory at no cost when the test is ordered by a physician, nonphysician practitioner, pharmacist or other authorized healthcare professional. In addition, Medicare beneficiaries can access one lab-performed test without an order, also without cost sharing, during the public health emergency.

MA plans may also offer coverage and payment for OTC COVID-19 tests as a supplemental benefit; MA beneficiaries should check with their plan on whether it includes this benefit. More information is provided in a frequently asked question document on the CMS website. Members with questions may contact Vickie Kunz at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.12 million in October, an increase of 13,000 beneficiaries since July. The October MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 49 percent of Michigan’s 2.3 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 28 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on October enrollment.  In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,107,000 in July, an increase of 12,000 beneficiaries since April. The July MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 48% of Michigan’s 2.3 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 27 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county based on July enrollment. In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,095,000 in April, an increase of 22,000 beneficiaries since January. The April MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 48 percent of Michigan's 2.3 million Medicare beneficiaries covered by an MA plan. Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 26 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues. 

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on April enrollment. In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,073,000 in January, an increase of 58,000 beneficiaries since October. The January MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 47% of Michigan's 2.3 million Medicare beneficiaries covered by an MA plan. Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 26 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on January enrollment. In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,003,000 in July, an increase of 9,000 beneficiaries since April. The July MA enrollment is spread across 43 MA plans that are currently operating in the state, with approximately 44 percent of Michigan’s 2.3 million Medicare beneficiaries covered by an MA plan. Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 25 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on July enrollment. In addition to the 43 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.