MA enrollment to expand, premiums to drop in 2019
Medicare Advantage premiums will decline in 2019, according to CMS, while benefits and plan choices are expected to rise. MA enrollment is also on pace to a reach a new all-time high next year with more than 36 percent, or 22.6 million Medicare beneficiaries, according to the agency.
MA plans are private insurers that contract with Medicare to provide the same level of care as traditional Medicare but with more options and flexibility to offer population health management and coordinated care.
Premiums and benefits
Premiums next year will be the lowest in three years and are estimated to decrease 6 percent to $28 on average, from an average of $29.81 in 2019. About 83 percent of MA enrollees who will remain in their current plan will have the same or lower premium in 2019, the agency stated. Almost half of enrollees–46 percent–in their current plan will have a zero premium.
CMS has recently expanded supplemental benefits for MA plans that could include more initiatives to address social determinants of health that can lead to adverse health events and increase healthcare utilization and costs. While these benefits could help attract more enrollees, questions remain about overall cost impacts.
About 270 plans will provide nearly 1.5 million enrollees with access to adult day care services, in-home support services, caregiver support services, home-based palliative care and therapeutic massage. Plans may also offer reduced cost sharing and condition-specific benefits. Some of these benefits are not typically covered by Medicare for the long term or at all. CMS first proposed expanding the supplemental benefits to add flexibility for MA plans in February 2018.
“Medicare Part D and Medicare Advantage demonstrate the successes possible when we harness consumer choice and private-sector innovation to improve care and lower cost,” HHS Secretary Alex Azar said in a statement. “Efforts to strengthen negotiation and competition in Medicare Part D are bearing fruit in the form of lower drug costs for American seniors, a key priority for President Trump. Meanwhile, the significant steps taken to maximize competition among Medicare Advantage plans and support and empower Medicare beneficiaries are a crucial piece of allowing patients to define and drive value, which the Trump Administration has made a priority.”
CMS also touted more options for MA enrollees. There will be 600 additional MA plans in 2019, increasing from about 3,100 total plans to about 3,700. More than 91 percent of people with Medicare will be able to choose between 10 or more MA plans, compared to 86 percent in 2018.
“The popularity of programs, such as Medicare Advantage, and with the various new supplemental benefits and policy changes that have been adopted, we expect plan choices to be even more robust moving forward,” CMS Administrator Seema Verma said in a statement.
Access to Medicare Part D prescription drug plans will remain universal in 2019, and premiums are expected to fall to $32.50 from the 2018 average of $33.59.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."