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Q1Group 2018 MA/MAPD Analysis Summary: Stable Medicare Advantage plan premiums, but beneficiaries in many counties will find significant changes in plan coverage and availability

Annual Medicare plan changes · published Oct 9, 2017

A preliminary analysis of the 2018 Medicare Advantage plan (MA and MAPD) landscape data recently released by the Centers for Medicare and Medicaid Services (CMS) shows that, in general, Medicare beneficiaries may notice changes in Medicare plan availability (more plans in some areas), continued low monthly premiums, higher out-of-pocket spending limits (MOOP), and fewer Medicare Advantage plans offering some Donut Hole coverage.

First, a brief review of Medicare Advantage plans: 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 additional healthcare benefits (such as vision, dental, or fitness coverage). A Medicare Advantage plan may include Medicare prescription drug coverage (MAPD) or can be offered without drug coverage (MA ). Usually you cannot join a Medicare Advantage (MA) plan and then add a stand-alone Medicare Part D plan (PDP). A Medicare Advantage plan is not a Medicare Supplement (Medigap plan) and cannot be used with a Medicare Supplement.

Here are a few 2018 Medicare plan highlights with links to additional information:

  • The total number of 2018 Medicare Advantage plans will increase to new levels. Across the country, there will be 12% more Medicare Advantage plans offered in 2018. Overall, there will be 3,001 Medicare Advantage plans (MAs and MAPDs) available in 2018, as compared to 2,687 Medicare Advantage plans offered in 2017. You can click here to read more about the number (and type) of Medicare Advantage plans available in 2018.

  • Most 2018 Medicare Advantage plans offer prescription drug coverage (MAPDs). As in past years, around 91% of 2018 Medicare Advantage plans will include prescription drug coverage (MAPDs). You can click here to read more about the changes in Medicare Advantage plans that offer prescription drug coverage.

  • Most Medicare Advantage plans are HMOs. The majority (around 72%) of 2018 Medicare Advantage plans will be Local HMOs (Health Maintenance Organizations). However, we will see a 21% increase in 2018 Medicare Advantage plans that are Local PPOs (Preferred Provider Organizations).  You can click here to read more about the different types of Medicare Advantage plans offered in 2018.

  • Even with more Medicare Advantage plans offered in 2018, many counties will see significant changes in their Medicare Advantage plan landscape.  When viewed in detail, many 2017 Medicare Advantage plans will be terminated in 2018 or merged into other 2018 plans. The counties with the largest number of 2018 Medicare Advantage plans that will no longer be available are found in: Florida, New York, and Ohio. You can see more 2018 Medicare plan changes using our 2017/2018 Medicare Advantage plan compare tool: MA-Compare.com/2018. You can click here to read more about changes Medicare Advantage plan availability across the country.

  • Unfortunately, still no Medicare Advantage plans for Alaska.  As in prior years, no Medicare Advantage plans (MAs or MAPDs) are offered in the state of Alaska.

  • Monthly 2018 Medicare Advantage plan premiums will remain low.  As in past years, 73% of all 2018 Medicare Advantage plans will have premiums under $50, with around 36% of the 2018 Medicare Advantage plan having a $0 premium. You can click here to read more about changes in Medicare Advantage plan premiums and see a chart of how Medicare Advantage plan premiums have changed since 2014.

  • More 2018 Medicare Advantage Special Needs Plans (SNPs).  About 17% of the 2017 Medicare Advantage Special Needs Plans (SNPs) will be discontinued in 2018. The good news is, with the introduction of so many new 2018 SNPs, there is a resulting 9% overall increase in the 2018 SNP landscape. You can click here to learn more about the 2018 Medicare Advantage Special Needs Plans and how they SNP landscape has changed since 2014.

  • A few more 2018 MAPDs have a $0 Rx deductible and $0 premium. 19% of all 2018 Medicare Advantage plans will include prescription drug coverage with a $0 premium and $0 deductible. You can click here to read more about the 2018 $0/$0 Medicare Advantage plans (MAPDs).

  • A few 2018 Medicare Advantage plans will offer some variation of the standard Initial Coverage Limit (ICL) of $3,750. (A higher ICL means that you can buy more medications before reaching the Donut Hole.) You can click here to read more about Medicare Advantage plans offering a variation in the standard Initial Coverage Limit.

  • Fewer 2018 MAPDs will offer Donut Hole coverage.  34% of MAPD plans will offer some level of additional drug coverage should you reach the 2018 Donut Hole -- as compared to 46% of MAPDs in 2017. However, all MAPD plans will honor the 2018 Donut Hole discount that will increase to 65% for brand-name drugs (you pay 35%) and 56% for generic medications (you pay 44%).

  • More 2018 Medicare Advantage plans will have a higher Medicare Part A and Part B Maximum Out-of-Pocket (MOOP) Limit. The number of Medicare Advantage plans having the statutory maximum MOOP of $6,700 will increase to 30% of all 2018 Medicare Advantage (up from 28% in 2017).  You can click here to learn more about the Maximum Out-of-Pocket Limits for 2018 Medicare Advantage plans and how MOOPs have changed since 2014.

Need an example in your area?
To get you started with an overview of the 2018 Medicare Advantage plans in your area, just click on your state and then click on your county name: 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 .

We now have the 2018 Medicare Advantage plan information online in our 2018 Medicare Advantage plan finder (MA-Finder) that can be found directly at: MA-Finder.com/2018. The MA-Finder currently displays the plan premium, prescription deductible, Gap or Donut Hole coverage availability, and Medicare Part A and Part B Maximum Out-of-Pocket limit (MOOP), drug tier cost-sharing, heath coverage information. Formulary information is coming soon.

You can also use our 2017/2018 MA-Compare tool to see how your 2017 Medicare Advantage plan is changing in 2018. Our Medicare Advantage comparison tool can be found directly at: MA-Compare.com/2018.

No need to rush.
The annual Medicare Open Enrollment Period for 2018 Medicare Part D plans and Medicare Advantage plans begins on Sunday, October 15th and continues through Thursday, December 7th, with 2018 Medicare plan coverage beginning on Monday, January 1, 2018. For more information, Medicare beneficiaries can telephone Medicare at 1-800-633-4227 to speak with a Medicare representative.