More 2020 Medicare Advantage plan choices, with increases in HMO and local PPO options

• A brief review of Medicare Advantage plans
  
  Medicare Advantage plans come in two general forms, MAs (Medicare Advantage plans that do not include prescription drug coverage) and MAPDs or Medicare Advantage plan that includes prescription drug coverage (MAPD).  A Medicare Advantage plan (MA or MAPD) includes your Medicare Part A (in-patient and hospitalization coverage), Medicare Part B (out-patient and physician coverage), may include additional healthcare benefits (basic dental, optical, hearing, and/or fitness coverage) - and non health-related benefits (food delivery and general transportation).  A MAPD also includes your Medicare Part D drug coverage.  If you enroll in some types of Medicare Advantage (MAs) that do not include drug coverage, you may not be permitted to also join a stand-alone Medicare Part D plan (PDP) (so be sure to check before you join).
  
  
• More 2020 Medicare Advantage plans than ever before
  
  Overall, there will be 15% more Medicare Advantage plans available in 2020.  Across the country, the number of 2020 Medicare Advantage plans (combined MAs and MAPDs) will increase to 4,047**, as compared to 3,508 Medicare Advantage plans offered nationwide in 2019.
  
  
• Like 2019, Most 2020 Medicare Advantage plans provide Part D drug coverage (MAPDs)
  
  92% of 2020 Medicare Advantage plans include prescription drug coverage (MAPDs) -- the same percentage as in 2019.   
  
  
• A few more 2020 Medicare Advantage plan options that do not include drug coverage (MAs)
  
  There is a slight increase in the number of 2020 Medicare Advantage plans without prescription coverage (MA) as compared to 2019.
  
  
• More Medicare Advantage HMOs options offered in 2020
  
  The majority (around 68.6%) of 2020 Medicare Advantage plans will be HMOs (Health Maintenance Organizations) with a 15% increase in the number of 2020 HMO plans over 2019.
  
  Members of a Medicare Advantage HMOs (MA-only) are not permitted to enroll in a stand-alone Medicare Part
  D plan (PDP) and will need another source for their drug coverage.
  
  
• More Local PPOs
  
  There will be a 18.6% increase in 2020 Medicare Advantage Local PPOs (Preferred Provider Organizations) plans as compared to 2019.
  
  Members of a Medicare Advantage PPOs (MA-only) are not permitted to enroll in a stand-alone Medicare Part D plan (PDP) and will need another source for their drug coverage.
  
  
• The declining Medicare Advantage PFFS plan offering
  
  The number of Medicare Advantage Private Fee for Service (PFFS) plans continues to decline in 2020 (a 7% decrease in PFFS plans).  As a note, PFFS plans have continued to decrease since 2015 when the number of Medicare Advantage PFFS (MA and MAPD) plans decreased by 43%.  In particular, 2015 Medicare Advantage PFFS plans offering prescription drug coverage (MAPDs) decreasing by 66% or losing 33 PFFS plans.
  
  Members of a Medicare Advantage PFFS (MA-only) can enroll in any available stand-alone Medicare Part D plan (PDP) for their drug coverage.
  
  
• Only a few 2020 MSAs offered, but Medical Savings Accounts (MSAs) are now available to more beneficiaries in 2020.
  
  In the chart below, we see that there are only six Medicare Medical Savings Accounts (MSAs) being offered in 2020.  However, these MSAs will be available in 29 states (1,883 counties) across the country and available to millions of Medicare beneficiaries.  In comparison, 2019 MSAs were offered in 19 states (1,262 counties) - and in 2018, MSAs were available to Medicare beneficiaries in only 111 counties across two states.
  
  Unlike other Medicare Advantage (MA) 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.
  

Jump to 2017 - 2020 MAPD Plan chart
Jump to 2017 - 2020 MA Plan chart
Jump to Health Plan Type definitions

• HMO - Health Maintenance Organization plans
  
  HMOs are wellness-based Medicare Advantage plans and usually have the most-restrictive healthcare provider network, meaning that your healthcare costs may be considerably higher if you go outside of your plan’s established network.  Also, depending on your HMO plan, you may only have access health services outside of your plan network with a referral from your doctor.  Local HMOs are often very affordable compared to other Medicare Advantage plans because the restrictive network and focus on wellness helps to control healthcare costs.  The majority of 2020 Medicare Advantage plans will be HMOs (Health Maintenance Organizations).
   
• HMO POS - Health Maintenance Organization with Point-of-Service option plans
  
  These Medicare Advantage HMO’s have a more flexible healthcare network allowing you to seek care outside of your plan’s network by paying a higher cost-sharing rate.  An HMO-POS is often chosen by people who travel part of the year, but still return home for the majority of their healthcare needs.  Again, expect out-of-network healthcare costs to be more than in-network.  For instance, you may have a $30 co-payment when you visit a healthcare provider in-network (at home) and pay $60 when you visit a provider outside of the plan’s network (while traveling).
  
  Important: In past years, some Members of a HMO-POS plans were "crosswalked" or moved into HMOs (without the POS option).  Be sure to read your Annual Notice of Change (ANOC) carefully to be sure that you still have your POS option.
  
  Please also note, depending on your HMO-POS plan, you may find that out-of-network costs do not count toward your Maximum Out of Pocket (MOOP) limit or you may have a much higher out-of-network MOOP — check with your plan's Member Services department for more details.
   
• PPO - Preferred Provider Organization plans
  
  Medicare Advantage PPOs have a less-restrictive provider network, but again, you probably will pay a higher cost-sharing rate when you visit a healthcare provider outside of your plan’s network.
   
• PFFS - Private Fee for Service plans
  
  Although very popular (and affordable) several years ago, fewer Medicare Advantage PFFS plans are now available (only 41 PFFS plans are available in 2020).  PFFS plans have the most flexible network, meaning that you can go to any health care provider as long as the provider accepts Medicare and the terms and conditions of your PFFS plan.  As noted, although PFFS plans will continue to be rare in 2020, some people still find PFFS plans as a flexible and economical alternative to other Medicare Advantage plans.  If you choose a PFFS plan that does not include prescription drug coverage, you have the option to join a separate stand-alone Medicare Part D plan (PDP).
  
  
• SNP - Special Needs plans
  
  SNPs are Medicare Advantage plans designed for a people with specific conditions or financial needs.  Certain SNPs are available only to diabetics, people with chronic cardiac conditions, nursing home residents, or people dual eligible for both Medicare and Medicaid (D-SNPs).  If you do not meet the plan’s “special need”, you will not be permitted to join the Special Needs plan.  In a separate article, "Significant changes in the 2020 Medicare Advantage Special Needs Plan (SNP) landscape", we look closer at the 2020 SNPs ( on this site).
   
• MSA - Medical Savings Account plans
  
  MSAs are like Health Savings Accounts (HSAs) — a high-deductible health plan combined with a medical spending account that you can use to pay for your health care costs.  MSAs do not provide prescription drug coverage and you would need to join a separate stand-alone Medicare Part D plan (PDP) for your prescription needs.  More people will have access to MSA plans in 2020.  Although there are only six (6) MSA plans in 2020, MSAs are available in 1,883 counties across 29 states.
   
• MMP - Medicare-Medicaid Plans
  
  MMP plans were introduced in 2014 and are only offered in 155 counties across nine (9) states.  As noted by CMS: "A Medicare-Medicaid Plan (MMP) [like a D-SNP] is a private health plan that has been competitively selected and approved to provide integrated care to eligible full-benefit Medicare-Medicaid enrollees under the CMS Financial Alignment Demonstration." (CMS, “Financial Alignment Initiative,”
  (https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/FinancialModelstoSupportStatesEffortsinCareCoordination.html.)
   
  MMPs only serve full-benefit dual-eligible (Medicare/Medicaid) beneficiaries and some additional limitations may apply.