What’s new with Medicare Advantage – and what you need to know during open enrollment

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Boasting a higher quality of care at lower consumer costs, Medicare Advantage plans are quickly edging out traditional fee-for-service Medicare, says the Better Medicare Alliance (BMA) State of Medicare Advantage report.

naviHealth Essential Insights - What's new with Medicare Advantage and what you need to know during open enrollment
The Medicare open enrollment period ends December 7.

In fact, Congresswoman Allyson W. Schwartz, President and CEO of BMA, reports a “record-setting 99% satisfaction rate” for Medicare Advantage. The cost savings are impressive too: Medicare Advantage plans provide an average $1,598 in cost savings when compared to its traditional counterpart.

October 17 marks the beginning of open enrollment for Medicare until December 7, 2020. Here are some key trends and updates to know.

Medicare Advantage participation continues to increase

Released this July, the report states more than one in three Medicare beneficiaries are currently enrolled in Medicare Advantage.

This high rate of participation correlates with a 49% jump in the number of plans available since 2017, according to Health Payer Intelligence. Also, nearly all Medicare beneficiaries—99%—now have access to at least one Medicare Advantage plan.

With so much positive data around health care quality and savings—and such a tremendous uptick in enrollment—it’s no surprise many experts believe Medicare Advantage plans are the future of Medicare. Since 2017, Medicare Advantage has grown by more than 30%, and by 2030, Medicare Advantage is projected to increase to nearly 51% of total Medicare enrollment.

CMS announces lower premium costs expected for 2021 Medicare Advantage plans

With open enrollment currently underway through December 7, the Centers for Medicare & Medicaid Services (CMS) and White House leadership announced that the average 2021 premiums for Medicare Advantage plans are “expected to decline 34.2% from 2017.”

CMS said that the average monthly premium will be the lowest it’s been since 2007. Also, seniors who use insulin will “have over 1,600 Medicare Advantage and Part D prescription drug plans to choose from that will offer insulin at no more than a $35 monthly copay beginning in January.”

The role Medicare Advantage plays during COVID-19

The coverage of supplemental benefits like vision or hearing have become increasingly important during this time of COVID-19. Going forward in our new normal of continued protective measures and health precautions, seniors should leverage the opportunity to choose a Medicare Advantage plan that offers these additional benefits.

Lower costs may grab the headlines, but what everyone wants—patients, providers and plan administrators alike—is better health overall. Without a corresponding improvement in outcomes, the decreasing costs only have value in terms of dollars saved. But the value of lives improved through better health? That kind of win is invaluable. Here are a few stats of significance around improved health outcomes from the report:

  • Medicare Advantage beneficiaries had lower rates of potentially avoidable hospitalizations than traditional Medicare beneficiaries.
  • A large-scale report that examined care for individuals with multiple chronic conditions found that Medicare Advantage beneficiaries experienced 23% fewer inpatient hospital stays and 33% fewer emergency room visits than in traditional Medicare.

Another impact that COVID-19 will have for Medicare will be during the current open enrollment, which starts today and ends on December 7. Medicare currently covers the costs associated with COVID-19 lab testing, antibody testing, medically necessary hospitalizations and hospital quarantines, as well as a potential vaccine. According to Healthpayer Intelligence, COVID-19 treatment potentially costing between $9,000 to more than $20,000. However, an August brief from the Peterson-Kaiser Family Foundation states that coronavirus waivers for a little over 31% of payers on the individual and fully-insured markets will end in December 2020.

With more plan choices, lower premiums and increased access to additional benefits, the expansion of Medicare Advantage is welcome news in uncertain times. As the country moves towards an historic election in the midst of a global pandemic, the strength of Medicare Advantage in meeting the needs of today’s older Americans is reassuring. Its continued growth bodes well for tomorrow’s seniors.

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