Q1Medicare Top 10 highlights of the 2023 Medicare Advantage plan landscape
Annual Medicare plan changes · published Oct 8, 2022
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. (10) All 2023 Medicare drug plans will offer insulin at a $35 or less co-pay and Part D vaccines at a $0 co-pay.
Based on the newly-passed Inflation Reduction Act, all 2023 Medicare Advantage plans with drug coverage (MAPDs) will offer all insulin found on the plan’s formulary for a co-pay of $35 (or less) through all phases of Part D coverage (with insulin costs possibility reduced further in the Catastrophic Coverage phase).
Also based on the Inflation Reduction Act, all Medicare Advantage plans with drug coverage (MAPDs) will offer $0 cost sharing for vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP), such as Shingles and Pneumonia vaccines.
Need an overview of Medicare Advantage plan options in your area?
To get you started with your review of 2023 Medicare Advantage plans available in your area, just click on your state and then click on your county name:
AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IS IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY You can also use our 2023 Medicare Advantage plan finder (MA-Finder) to review plans in your area – found directly at: MA-Finder.com/2023.
You can use our 2022/2023 MA-Compare tool to see how your 2022 Medicare Advantage plan is changing in 2023. Our Medicare Advantage comparison tool can be found directly at: MA-Compare.com/2023.
Reminder #1: No need to rush.
The annual Open Enrollment Period (AEP) for 2023 Medicare Part D plans and Medicare Advantage plans begins on October 15th and continues through December 7th, with 2023 Medicare plan coverage beginning on January 1, 2023.
Reminder #2: Some Extra Help recipients may need to act to keep their 2023 Extra Help status.
The 2022 / 2023 CMS, SSA, and Medicare plan mailings schedule is online and includes notices for people who need to submit information to keep their 2023 Extra Help status. Read more about the LIS mailings. When in doubt, contact your local Medicaid office for more information or call Medicare at 1-800-633-4227.
Review Your Medicare plan’s Annual Notice of Change letter.
If you are currently enrolled in a 2022 Medicare Part D or Medicare Advantage plan, you should have received your 2023 Annual Notice of Change (ANOC) letter from your Medicare plan provider. The ANOC contains details of how your 2022 Medicare plan coverage will change in 2023. If the ANOC does not contain your 2023 Evidence of Coverage (EOC) document, your Medicare plan will provide a link where you can download the EOC.