MODERATOR
:
Daniel W. Bailey, FSA, MAAA
PRESENTER
(S):
Daniel W. Bailey, FSA, MAAA
Kenneth L. Clark, FSA, MAAA
Description
This session is intended for all actuaries, not only those who work with Medicare Advantage (MA). The session, the presenter will explain the medical benefits covered under the traditional Medicare A/B plan and aspects of the A and B plans, including exactly what benefits are covered. The presenter will answer the questions: What are the limits that apply? What are the circumstances under which aspects of the benefit are available? He will also look at the mandatory supplemental benefits under MA plans, both non-Medicare covered benefits and reduced member cost-sharing. In addition, the presenter will discuss, all types of MA plans, including HMO and PPO coordinated care plans, PFFS and special needs plans. He will also explain the different benefit designs under Medicare Supplement plans and how they augment and coordinate with the traditional A/B benefit.