More 2022 Medicare Advantage plans in many areas across the country with continued low monthly premiums
The 2022 Medicare Advantage plan information
recently released by the Centers for
Medicare and Medicaid Services (CMS) shows that Medicare beneficiaries can
expect more Medicare Advantage plans in many areas across the country with
continued low monthly premiums. However,
more Medicare Advantage plans are increasing Medicare Part A and Part B maximum
out-of-pocket spending limits (
MOOP).
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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