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CMS touts lower premiums and benefits of Medicare Advantage plans

Over 94% of Medicare Advantage plans will offer additional telehealth benefits, up from about 58% of plans offering telehealth benefits in 2020. 

Susan Morse, Executive Editor

More Medicare Advantage plans in 2021 will offer telehealth benefits.

Average 2021 premiums for Medicare Advantage plans are expected to decline 34.2% from 2017 while plan choice, benefits, and enrollment continue to increase, the Centers for Medicare and Medicaid Services said ahead of the annual Medicare Open Enrollment starting on October 15.

This will make the Medicare Advantage average monthly premium the lowest in 14 years, since 2007.

The Medicare Advantage average monthly plan premium is expected to be an estimated $21 in 2021, down from an average of $23.63 in 2020. 

In some states including Alabama, Nevada, Michigan and Kentucky, beneficiaries will see average premium decreases of over 50% since 2017, CMS said. 

Over 94% of Medicare Advantage plans will offer additional telehealth benefits, up from about 58% of plans offering telehealth benefits in 2020. 

Plan quality has improved in recent years. In 2020, the average star rating for all Medicare Advantage plans with prescription drug coverage improved to 4.16 out of 5 stars, increasing from 4.02 in 2017.

CMS anticipates releasing the Star Ratings for Medicare Advantage and Part D plans in early October. 

The average star rating for a stand-alone prescription drug plan has improved from 3.34 in 2019 to 3.50 in 2020.

More than 440 Medicare Advantage plans will be participating in the 2021 Medicare Advantage Value-Based Insurance Design Model, with over 1.6 million beneficiaries projected to receive additional benefits such as healthy foods and meals, transportation support, reduced cost-sharing and rewards and incentives aligned with Part D drugs.
This represents nearly a 20-fold increase in Medicare Advantage enrollees benefiting from the model compared to 2019.

CMS will release a request for applications, including for the hospice benefit component, for the Medicare Advantage Value-Based Insurance Design Model 2022 plan year later this fall. 

WHY THIS MATTERS

The agency for fee-for-service Medicare is touting value-based Medicare Advantage plans offered by private insurers. CMS pays MA insurers on a capitation per member, per month, basis.

Insurers are deeply invested and have realized financial success in MA as the market grows with an aging baby boomer demographic.

About 42 percent of beneficiaries are expected to be enrolled in Medicare Advantage for 2021. This is an increase from the third of all Medicare beneficiaries in an MA plan that CMS had previously reported. 

Also, MA is not experiencing the current fluctuations of an employer market  impacted by COVID-19. Insurers invested in Medicare Advantage plans are reportedly in a better financial situation than those that are not.

For consumers, Medicare Advantage plans cover all Medicare benefits and can provide additional benefits such as dental and vision. Part D plans from private health plans provide prescription drug coverage for seniors. 

For the first time in 2021, 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.  

Also, beneficiaries with end stage renal disease will have the option to enroll in a Medicare Advantage plan, giving them more affordable Medicare coverage choices, CMS said.

THE LARGER TREND
 
The trend of lower Medicare Advantage premiums means that beneficiaries have saved nearly $1.5 billion in premium costs since 2017.

Beneficiaries will have more plan choices, with about 2,100 more Medicare Advantage plans operating in 2021 than in 2017, a 76.6% increase. 

Overall, beneficiaries can choose from more than 4,800 Medicare Advantage plans during 2021 open enrollment.  

Medicare Open Enrollment begins on October 15, 2020, and ends on December 7. 

ON THE RECORD

"Today's announcement confirms that market competition works. Historically low premiums, massive savings on insulin, and more supplemental benefits represent the welcome fruit of the creative, patient-oriented policies that this administration has made its calling card. Medicare beneficiaries will feel the difference – in their health as well as their pocketbook," CMS Administrator Seema Verma said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com