Medicaid/Medicare Medicare Advantage

What’s new for Medicare Advantage in 2015

A KFF article provides some highlights of changes to Medicare Advantage for 2015:

  • Near universal access to an MA plan.  99% of Medicare beneficiaries will have access to a Medicare Advantage plan as an alternative to traditional Medicare in 2015.  The only individuals without access to an MA plan are concentrated in a few rural areas.
  • Lots of Choice: Beneficiaries will be able to choose from 18 Medicare Advantage plans, on average, in 2015, the same number of plans as in 2014.  About 480,000 beneficiaries – less than 5 percent of all enrollees – will need to find new plans because their 2014 plan will no longer be available in 2015.
  • “Free” plans widely available: About 78 percent of MA beneficiaries will have access to zero-premium plans in 2015.
  • Out-of-pocket max rises.  All Medicare Advantage plans will include a limit on enrollees’ out-of-pocket expenses for services covered under Medicare Parts A and B, but the plans’ limits will be about $240 higher, on average, in 2015 than in 2014.
  • The decline of PFFS plans.  In 2015, 69 PFFS plans will be offered compared to 120 in 2014 and a high of 801 in 2008.
  • Plan premiums rise.  In 2015, the average premium for MA-PDs will be $53 per month – an increase of $2 from 2014. Premiums for HMOs will average $38 per month, up $3 from 2014. Similar to prior years, HMOs will continue to have lower premiums than regional PPOs ($68 per month), local PPOs ($81 per month) and PFFS plans ($88 per month).
  • Significant market concentration.  UnitedHealthcare, Humana, Blue Cross and Blue Shield (BCBS) affiliated companies (including Wellpoint BCBS plans), Kaiser Permanente, Aetna, Wellcare, and Cigna control over 60% of plan offerings.

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