A preliminary analysis of the 2016 Medicare Advantage plan (MA
) landscape data recently released by the Centers for Medicare and Medicaid Services (CMS) shows changes in Medicare Advantage plan availability, with stable plans premiums, and lower maximum out-of-pocket limits.
You can receive Medicare prescription drug coverage from either a stand-alone Medicare
Part D plan
(PDP) or a Medicare
that includes prescription drug coverage (MAPD). A Medicare Part D plan only
prescription drug coverage. A Medicare Advantage plan includes your Medicare Part A (in-patient and
hospitalization), Medicare Part B (out-patient and physician), and may include additional healthcare benefits. Some
Medicare Advantage plans do not include prescription drug coverage (MAs). If you enroll in a Medicare Advantage (MA) that
does not include drug coverage, you
may not be permitted
to join a stand-alone Medicare Part D plan (PDP). Please telephone a Medicare representative at 1-800-633-4227 for more details.
Here are a few highlights of the 2016 Medicare Advantage plans:
- As noted
by CMS, Medicare Advantage plan premiums have remained stable over the past few years. Overall, almost 70% of the
2016 Medicare Advantage plans will have premiums
under $50, with 35% of the 2016 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. Please
note: The overall stability of Medicare Advantage plan premiums does
not indicate that your 2015 Medicare Advantage plan premium will remain the
same 2016. Please review your Annual
Notice of Change letter to see how your 2015 Medicare Advantage plan is
changing in 2016 or use our Medicare
Advantage plan 2015/2016 comparison tool (MA-Compare.com/2016).
- The total number of 2016 Medicare Advantage
plans will increase slightly across the country with 4% more Medicare Advantage
plans offered in 2016. Overall, there
will be 2,618 Medicare Advantage plans (MAs and MAPDs) available in 2016, as
compared to 2,526 Medicare Advantage plans offered in 2015. You
can click here to read more about annual changes
in Medicare Advantage plan availability by health plan type.
- However, when viewed in detail, many 2015
Medicare Advantage plans will be terminated in 2016 or merged into other 2016
plans and many counties will see significant changes in their Medicare
Advantage plan landscape. The counties seeing
the largest decrease of 2016 Medicare Advantage plans are found in: Florida,
York, and Puerto
Rico. For example, Twenty (20) of
the 81 Medicare Advantage plans currently available Richmond
County, New York are no longer offered in 2016. You
can click here to read more about county-level
changes in the available Medicare Advantage plans. You can also see more 2016 Medicare Advantage
plan changes using our MA-Compare tool found here: MA-Compare.com/2016.
- The majority (around 71%) of 2016 Medicare
Advantage plans will be HMOs (Health Maintenance Organizations), 20% of 2016
Medicare Advantage plans will be Local PPOs (Preferred Provider Organizations).
You can click here to read more about the
different types of Medicare Advantage plans and plan availability changes.
- Over 24% of the 2015 Medicare Advantage Special
Needs Plans (SNPs)
will be discontinued in 2016 as compared to 16% of the 2014 Special Needs Plans
that were discontinued in 2015. The good
news is that such a large number of new SNPs are being introduced in 2016, that
overall, there is actually an increase of one (1) SNP for 2016. You can click here to learn more about the 2016
Medicare Advantage Special Needs Plans and how the SNP landscape has changed
- Most (90%) of 2016 Medicare Advantage plans will
include prescription drug coverage (MAPDs), with 2,286 MAPD plans available in
2016 as compared to the 2,216 MAPDs available in 2015. However, slightly fewer Medicare Advantage
plans without prescription coverage (MA) will be offered in 2016, with 266
plans available as compared to 278 MAs available in 2015. You
can click here to read more about the
changes in Medicare Advantage plans that offer prescription drug coverage over
the past few years.
- A large number of 2016 Medicare Advantage plans
will include prescription drug coverage and have a $0 premium and $0 drug deductible. You can click here to read more about the 2016
Medicare Advantage plans that have a $0 premium and a $0 initial deductible for
prescription drug coverage.
- Some 2016 Medicare Advantage plans will offer a
variation in the standard drug plan Initial Coverage Limit of $3,310. You can click here to read more about
2016 Medicare Advantage plans that have an increased or decreased Initial
more 2016 Medicare Advantage plans (MAPDs) will offer Donut Hole coverage
for prescriptions purchased while in the Coverage Gap. The 2016 Donut Hole discount will continue to
provide a 55% discount for brand-name drugs and the generic drug discount will
increase to 42%.
- More 2016 Medicare Advantage plans will lower
their Medicare Part A and Part B Maximum Out-of-Pocket (MOOP) Limit from the
$6,700 maximum. The number of 2016 Medicare
Advantage plans having the statutory maximum MOOP will decrease to 33% -- down
from 48% in 2015. You can click here to learn more about the
Maximum Out-of-Pocket Limits for 2016 Medicare Advantage plans and how MOOPs
have changed since 2014.
- As in prior years, no Medicare Advantage plans are offered in Alaska.
Need an example?
To get you started with an overview of the 2016 Medicare
Advantage plans in your area, just click on your state and then click on your
county name: AL
You can also use our 2016 Medicare Advantage plan finder (or
that can be found directly at: MA-Finder.com/2016
. The MA-Finder displays the plan premium,
prescription deductible, Gap or Donut Hole coverage availability, and Medicare
Part A and Part B Maximum Out-of-Pocket limit (or MOOP), drug tier
You can also use our 2015/2016 MA-Compare tool to see how
your 2015 Medicare Advantage plan is changing in 2016. Our Medicare Advantage comparison tool can be
found directly at: MA-Compare.com/2016