The 2023 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.
First, here are a few 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
that does not include drug coverage (MA) –
unless your Medicare Advantage plan is a
PFFS or
MSA plan.
(4) A Medicare Advantage plan
is not a Medicare Supplement (Medigap plan) and cannot be used
with a Medicare Supplement.
Our Top 10 highlights of the 2023
Medicare Advantage plan landscape:
(1) The total number of 2023 Medicare Advantage
plans will increase.
Across the country, there will be 7% more Medicare Advantage plans offered in 2023
– with 5,369 Medicare Advantage plans
(
MAs and
MAPDs) available as compared to 5,033
Medicare Advantage plans offered in 2022 (and 4,568 plans offered in 2021).
Read more about the
changes in the number (and type) of Medicare Advantage plans over the past few years.
(2) Most 2023 Medicare Advantage plans include
Part D drug coverage (MAPDs) and are local HMOs.
As in past years, over 91% of 2023 Medicare Advantage plans will include
prescription drug coverage
(
MAPDs) and the majority (63%) of 2023 Medicare
Advantage plans will be local
HMOs (Health Maintenance Organizations). In addition, there will be a 16% increase in 2023
Local
PPO (Preferred Provider Organization) Medicare
Advantage plans.
Review
changes in the number and type of MAPDs and MAs since 2020.
(3) Even with more 2023 Medicare
Advantage plans, many counties across the country will see significant changes
in their Medicare Advantage plan landscape.
When viewed in detail, many 2022 Medicare Advantage plans will be terminated in
2023 or merged into other 2023 plans – and new 2023 Medicare Advantage plans
will be introduced. As an example,
Los Angeles
County, CA will
lose 37 of the
119 currently-offered 2022 Medicare Advantage plans. However, in the same
county,
28 new
2023
Medicare Advantage plans will be introduced
As another example of the ever-changing Medicare Advantage plan landscape, in 2021,
Monroe County, PA had a total of
46 Medicare Advantage plans, then in 2022, 10
plans left the county and 22 plans entered the county for a new total of
58 plans. Now in 2023, 4 Medicare Advantage plans are leaving the county and 13
plans are entering the area for a new total of
67 Medicare Advantage plans.
You can see more 2023 Medicare plan changes using our 2022/2023 Medicare
Advantage plan compare tool:
MA-Compare.com/2023.
And 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 2023 or to see whether you are being automatically "moved" to
another 2023 Medicare Advantage plan.
(4) Monthly 2023 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 2023. Our analysis shows almost
88% of all 2023
Medicare Advantage plans have a monthly
premium
under $50 and 56% of all 2023 Medicare Advantage plans have a $0
premium.
Read more about
changes in Medicare
Advantage plan premiums and see a chart of how plan premiums have changed since
2019.
(5) More 2023 MAPDs have a $0 premium and $0 drug deductible ($0/$0
plans).
In addition to the overall lower-premium plans, forty percent (40%) of all 2023
Medicare Advantage plans that include prescription drug coverage
(
MAPDs) will have a $0 premium and $0 initial drug
deductible (up from 34% in 2022). As a
note, 235 of these $0/$0 plans will also include a Medicare Part B premium "
Giveback" or dividend feature – up from 190 plans in
2022.
Read more about the
2023 $0/$0 Medicare Advantage plans with prescription drug coverage.
(6) Slightly more 2023 MAPDs will
offer supplemental Donut Hole coverage.
The
2023 Donut
Hole discount remains 75% for all
formulary medications – you pay 25% of retail for both brand-name and generic
formulary 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.
Read more on the
2023 Donut Hole.
(7) Slightly more 2023 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) services is
capped by the plan’s Maximum Out-of-Pocket spending limit
(
MOOP). Once you
reach the plan’s MOOP you will no longer pay cost-sharing for eligible,
in-network Part A or Part B services.
A Medicare Advantage plan’s MOOP limit can change every year, ranging from $299
to $8,300 (although Medicare Advantage plans designed for low-income
beneficiaries have a $0 MOOP).
In general, most Medicare Advantage plans have a MOOP under $6,001 –
with 26% of 2023 Medicare
Advantage plans having a MOOP at, or below, $3,650. On the higher end, 30% of 2023 Medicare
Advantage plans will have a MOOP between $6,001 and $8,300.
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.
Learn more about the
2023 Maximum Out-of-Pocket limits for Medicare Advantage plans and how MOOP limits have changed since 2019.
(8) More 2023 Medicare Advantage Special Needs Plans (SNPs).
Although about
14% of the 2022 Medicare Advantage
Special
Needs Plans (SNPs) will be discontinued
in 2023, The number of 2022 SNPs leaving the market will be offset by the
introduction of new 2023 SNPs, resulting in a
11% actual increase in the
total number of 2023 SNPs. Both chronic illness SNPs (C-SNPs) and Dual-Eligible
Medicare/Medicaid plans (D-SNPs) will see a 13% increase. The vast majority (61%) of SNPs remain
Dual-Eligible Medicare/Medicaid plans (D-SNPs).
Learn more about
2023 Medicare Advantage Special Needs Plans and how the SNP landscape has changed since 2019.
(9) 2023 Medicare Medical Savings Accounts (MSAs)
will continue to be widely available.
In 2023,
Medicare Medical Savings Accounts
(
MSAs) will be available in 37 states (2,313 counties)
across the country (down slightly from 2022). 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.