Exactly what do the CO$TþSHARE
REPORT findings represent?
þ The findings do
represent how cost-sharing (out-of-pocket expenses) can vary among Medicare managed care
plans that offer similar benefits and services when adjusted for enrollee health status.
þ The findings do
represent the out-of-pocket expenses for the most common services that Medicare
beneficiaries utilize, e.g., physician office visits, emergency/urgent care,
prescriptions, routine preventive care, inpatient hospital care.
þ The findings do
compare plans based on the applicable annual out-of-pocket expenses (copayments, premiums,
deductibles) that enrollees incur for selected benefits and services provided under each
plan.
þ The findings do
represent each plan's cost-sharing requirements from the Medicare Compare Database.
What do the CO$TþSHARE REPORT findings not represent?
þ The findings do not
represent a guarantee of the actual annual out-of-pocket expenses that Medicare
beneficiaries would incur upon enrolling in a plan.
þ The findings do
not include other annual out-of-pocket expenses that may apply for other plan
benefits and services that may also be utilized, e.g., mental health care, chiropractic
care, podiatry care, home health visits, medical equipment, ambulance transportation.
þ The findings do
not compare provider networks, financial stability, quality of care, enrollee
satisfaction, or other managed care plan performance measurements.
þ The findings do
not represent the cost-sharing requirements for Medicare beneficiaries enrolled in
employer-sponsored group retirement plans.
þ CO$TþSHARE REPORT findings have been verified for accuracy by
each plan. Nevertheless, certain limitations or benefit restrictions may apply that can
affect the annual out-of-pocket expenses shown in the CO$TþSHARE
REPORT examples.
þ Plan benefits,
copayments, deductibles, and monthly premiums are subject to change by the
Center for Medicare & Medicaid Services (CMS).
þ Medicare Part B
premiums ($96.40 minimum per month in 2008) are not included in the cost-sharing comparisons but
must continue to be paid as a condition for enrollment in all Medicare managed care plans.
þ Cost-sharing dollar
differences between individual plans may range from as little as $1 to over $500. Each CO$TþSHARE REPORT user should decide whether the annual cost-sharing dollar
differences are sufficient for selecting one plan over another.
þ Although CO$TþSHARE REPORT comparisons are important, they should not be
the sole basis for either selecting or not selecting a Medicare managed care plan.
