First, here are five important points about Medicare Advantage plans:
(1) A Medicare Advantage plan includes your Medicare Part A (in-patient and hospitalization coverage), Medicare Part B (out-patient and physician coverage), and may include prescription drug coverage (MAPD) or can be offered without drug coverage (MA).
(2) A Medicare Advantage plan may include supplemental healthcare benefits such as vision, dental, or fitness coverage. A Medicare Advantage plan may also include non-health related benefits such as meal delivery (in limited situations) and non-health related transportation.
(3) You cannot add a stand-alone Medicare Part D drug plan (PDP) if you are enrolled in a Medicare Advantage plan, even if it does not include drug coverage (MA) – unless your Medicare Advantage plan (MA) is a PFFS or MSA plan.
(4) Even if you are a Medicare beneficiary suffering from kidney failure or End-Stage Renal Disease (ESRD), you can join a Medicare Advantage plan. This rule that began in 2021, also applies to employer/union Medicare plans (EGHP); but, depending on your state, may not include Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) and Medicare-Medicaid Plans (MMPs). You can click here for more details.
(5) A Medicare Advantage plan is not a Medicare Supplement (Medigap plan) and cannot be used with a Medicare Supplement.
Here are highlights of the 2022 Medicare Advantage plan landscape:
(1) The total number of 2022 Medicare Advantage plans will increase.
Across the country, there will be 10% more 2022 Medicare Advantage – with 5,033 Medicare Advantage plans (MAs and MAPDs) available as compared to 4,568 Medicare Advantage plans offered in 2021 (and 4,047 plans offered in 2020).
You can click here to read more about the changes in the number (and type) of Medicare Advantage plans over the past few years.
(2) Most 2022 Medicare Advantage plans include Part D drug coverage (MAPDs) and are local HMOs.
As in past years, over 90% of 2022 Medicare Advantage plans will include prescription drug coverage (MAPDs) and the majority (65%) of 2022 Medicare Advantage plans will be local HMOs (Health Maintenance Organizations). In addition, there will be a 21% increase in 2022 Local PPO (Preferred Provider Organization) Medicare Advantage plans.
You can click here for a chart showing how the number and type of MAPDs and MAs has changed since 2018.
(3) Even with more 2022 Medicare Advantage plans, many counties across the country will see significant changes in their Medicare Advantage plan landscape.
When viewed in detail, many 2021 Medicare Advantage plans will be terminated in 2022 or merged into other 2022 plans – and new 2022 Medicare Advantage plans will be introduced. As an example, Lucas County, OH will lose 14 of the 81 currently-offered 2021 Medicare Advantage plans. However, in the same Ohio county, 22 new 2022 Medicare Advantage plans will be introduced.
As another example of the ever-changing Medicare Advantage plan landscape, in 2020, Monroe County, PA had a total of 50 Medicare Advantage plans, then in 2021, 11 plans left the county and 7 plans entered the county for a new total of 46 plans. Now in 2022, 10 Medicare Advantage plans are leaving the county and 22 plans are entering the area for a new total of 58 Medicare Advantage plans.
You can see more 2022 Medicare plan changes using our 2021/2022 Medicare Advantage plan compare tool: MA-Compare.com/2022.
And you can click here to read more about county-specific changes in Medicare Advantage plan availability.
Bottom Line: Read your Medicare Advantage plan’s Annual Notice of Change (ANOC) letter to ensure that your Medicare plan is being offered in 2022 or to see whether you are being automatically “moved” to another 2022 Medicare Advantage plan.
(4) Monthly 2022 Medicare Advantage plan premiums will remain low.
As noted in a recent CMS press release, the average Medicare Advantage plan premium is expected to decline in 2022 with 86% of all 2022 Medicare Advantage plans having a monthly premium under $50 and 52% of the 2022 Medicare Advantage plans having a $0 premium.
You can click here to read more about changes in Medicare Advantage plan premiums and see a chart of how plan premiums have changed since 2018.
(5) More 2022 MAPDs have a $0 premium and $0 drug deductible ($0/$0 plans).
In addition to overall lower-premium 2022 Medicare Advantage plans, thirty-four percent (34%) of all 2022 Medicare Advantage plans that include prescription drug coverage (MAPDs) will have a $0 premium and $0 initial drug deductible (up from 30% in 2021) – and some of these $0/$0 plans will include a Medicare Part B premium “Giveback” feature (the Giveback information will be added as more 2022 data is released by CMS).
You can click here to read more about the 2022 $0/$0 Medicare Advantage plans with prescription drug coverage.
(6) More 2022 Medicare Advantage (MAPD) plans will offer low-cost Insulin coverage.
More 2022 stand-alone Medicare Part D prescription drug plans and Medicare Advantage plans with drug coverage (MAPDs) will following the Medicare Part D Senior Savings Model offering different types of insulin for a maximum co-pay of $35 through all phases of Part D coverage: deductible, initial coverage, and the Coverage Gap (Donut Hole). As CMS noted, more than 2,100 PDPs and MAPDs will offer lower-costing insulin to plan members in 2022 as compared to 1,600 drug plans in 2021.
From our calculations, 38% of 2022 MAPDs will participate in the Senior Savings Model (SSM), as compared to 28% of MAPDs in 2021. For example, of the 88 MAPDs offered in Summit County, Ohio, 22 plans will implement the Senior Savings Model.
We will indicate 2022 Medicare Advantage plans participating in the SSM with the text “select insulin coverage $35 or less” in our Medicare Advantage Plan Finder - MA-Finder.com.
You can click here to learn more about low co-pay insulin coverage.
(7) Slightly more 2022 MAPDs will offer supplemental Donut Hole coverage.
The 2022 Donut Hole discount remains at 75% for all formulary medications -- you pay 25% of retail for both brand-name and generic medications purchased while in the Coverage Gap. However, almost 52% of MAPD plans will offer some level of additional gap coverage beyond the Donut Hole discount. For brand-name drug purchases in the Donut Hole, the 70% brand-name drug manufacturer’s Donut Hole discount is applied to this supplemental gap coverage.
You can click here to read more on the 2022 Donut Hole.
(8) Slightly fewer 2022 Medicare Advantage plans will offer a lower Medicare Part A and Part B Maximum Out-of-Pocket (MOOP) Limit.
One key benefit of a Medicare Advantage plan is that annual spending for eligible, in-network Medicare Part A (in-patient or hospitalization) and Medicare Part B (out-patient or doctor visit) coverage is capped by the plan’s Maximum Out-of-Pocket spending limit (MOOP). Once you reach the plan’s MOOP, you will no longer have a co-payment for eligible in-network Part A or Part B coverage.
Although a Medicare Advantage plan’s MOOP limit can change every year, ranging from $3,400 to $7,550 (Medicare Advantage plans designed for low-income beneficiaries have no MOOP), most 2022 Medicare Advantage plans have a MOOP over $3,450, with 40% of Medicare Advantage plans having a MOOP of either $6,700 or $7,550.
And this means: The lower the MOOP, the less you will spend per year for your Medicare Part A and Medicare Part B covered services, but if you are enrolled in a Medicare Advantage plan, your Part A and Part B expenses will not exceed $7,550 for in-network cost-sharing.
You can click here to learn more about the Maximum Out-of-Pocket Limits for 2022 Medicare Advantage plans and how MOOP limits have changed since 2018.
(9) More 2022 Medicare Advantage Special Needs Plans (SNPs).
Although about 15% of the 2021 Medicare Advantage Special Needs Plans (SNPs) will be discontinued in 2022, the number of 2021 SNPs leaving the market will be offset by the introduction of new 2022 SNPs, resulting in a 19% actual increase in the total number of 2022 SNPs, with a 34% increase in chronic illness SNPs (c-SNPs). The vast majority (61%) of SNPs remain Dual-Eligible Medicare/Medicaid plans (D-SNPs).
You can click here to learn more about 2022 Medicare Advantage Special Needs Plans and how the SNP landscape has changed since 2016.
(10) 2022 Medicare Medical Savings Accounts (MSAs) will be more widely available.
In 2022, Medicare Medical Savings Accounts (MSAs) will be available in 39 states (2,364 counties) across the country, including 27 Alaskan counties (the only Medicare Advantage plan options in Alaska). Unlike other Medicare Advantage plans, MSAs are made up of a high-deductible health plan and a medical savings account funded by an annual tax-free deposit. MSA members can use the medical savings account to pay for healthcare costs before the health plan deductible is met. MSA members can enroll in any available stand-alone Medicare Part D plan (PDP) for their drug coverage. Need an overview of Medicare Advantage plan options in your area?
To get you started with your review of 2022 Medicare Advantage plans available in your area, just click on your state and then click on your county name: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY.
You can also use our 2022 Medicare Advantage plan finder (MA-Finder) to review plans in your area -- found directly at: MA-Finder.com/2022. The MA-Finder currently displays the plan premium, prescription deductible, supplemental Gap or Donut Hole coverage, and Medicare Part A and Part B Maximum Out-of-Pocket limit (MOOP). The 2022 Medicare plan drug tier cost-sharing, heath coverage information, formulary information, and star ratings are coming soon.
You can use our 2021/2022 MA-Compare tool to see how your 2021 Medicare Advantage plan is changing in 2022. Our Medicare Advantage comparison tool can be found directly at: MA-Compare.com/2022.
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