A preliminary analysis of the 2019 Medicare Advantage plan (MA and
MAPD) landscape data recently released by the Centers for Medicare and Medicaid
Services (CMS) shows that Medicare beneficiaries may notice changes in Medicare
plan availability (
more plans in some areas); continued low monthly
premiums;
more Medicare Advantage plans offering some Donut Hole
coverage; however,
higher out-of-pocket spending limits (
MOOP).
First, a brief review of 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 additional healthcare benefits (such as vision,
dental, or fitness coverage). (2) A
Medicare Advantage plan may include Medicare prescription drug coverage (
MAPD) or can
be offered without drug coverage (
MA). (3)
You cannot
add a stand-alone
Medicare Part D plan (
PDP) plan,
if you are enrolled in a Medicare Advantage (MA) plan, -- unless your Medicare
Advantage plan is a
MSA or
PFFS
plan. (4) A Medicare Advantage plan
is not a
Medicare Supplement (Medigap plan) and cannot be used with a Medicare
Supplement.
Highlights of the 2019 Medicare plan
landscape with links to additional information:
- The
total number of 2019 Medicare Advantage plans will increase.
Across the country, there will be 14%
more Medicare Advantage plans offered in 2019. Overall, there will be 3,431 Medicare
Advantage plans (MAs and MAPDs) available in 2019, as compared to 3,001
Medicare Advantage plans offered in 2018. You can click
here
to read more about the number (and type) of Medicare Advantage plans
available in 2019.
- Most
2019 Medicare Advantage plans will offer prescription drug coverage (MAPDs).
As in past years, around 92% of 2019
Medicare Advantage plans will include prescription drug coverage
(MAPDs). You can click
here
to read more about the annual changes in the number of Medicare Advantage
plans offering prescription drug coverage.
- Most
Medicare Advantage plans are HMOs.
The majority (around 77%) of 2019
Medicare Advantage plans will be Local HMOs
(Health Maintenance Organizations). However, there will be a 21% increase in 2019 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 2019.
- Even
with more Medicare Advantage plans offered in 2019, many counties will see
significant changes in their Medicare Advantage plan landscape.
When viewed in detail, many 2018
Medicare Advantage plans will be terminated in 2019 or merged into other
2019 plans. The counties with the
largest number of 2018 Medicare Advantage plans that will no longer be
available in 2019 are found in Minnesota. You can see more 2019 Medicare plan
changes using our 2018/2019 Medicare Advantage plan compare tool: MA-Compare.com/2019. You can click
here
to read more about changes in Medicare Advantage plan availability across
the country.
- 2019 Medicare Medical Savings Accounts (MSAs)
will be more widely available.
In 2019, Medicare Medical Savings Accounts (MSAs)
will be available in 19 states (1,262 counties) across the country. In 2018, MSAs were available to Medicare
beneficiaries in only 111 counties across two states. 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.
- Monthly
2019 Medicare Advantage plan premiums will remain low.
As in past years, close to 77% of all
2019 Medicare Advantage plans will have monthly premiums
under $50, with around 39% of the 2019 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
2019 Medicare Advantage Special Needs Plans (SNPs) - with large changes in the SNP landscape.
Although about 28% of the 2018 Medicare
Advantage Special
Needs Plans (SNPs) will be discontinued in 2019. There will be an introduction of so many
new 2019 SNPs, that there is a resulting 9.5% increase in the total number
of SNPs. Overall, there are fewer
2019 Chronic Illness SNPs, with more Dual-Eligible (Medicare-Medicaid)
SNPs and Institutional SNPs. You
can click
here
to learn more about the 2019 Medicare Advantage Special Needs Plans and
how the SNP landscape has changed since 2014.
- A few
more 2019 MAPDs have a
$0 Rx deductible and $0 premium.
21% of all 2019 Medicare Advantage plans
will include prescription drug coverage with a $0 premium and $0 drug
coverage deductible. You can click
here
to read more about the 2019 $0/$0 Medicare Advantage with Prescription
Drug Coverage plans (MAPDs).
- A few
2019 Medicare Advantage plans will offer some variation of the standard Initial
Coverage Limit (ICL) of $3,820.
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.
- Slightly
more 2019 MAPDs will offer Donut Hole coverage.
37% of MAPD plans
will offer some level of additional
drug coverage should you reach the 2019 Donut Hole -- as
compared to 34% of MAPDs in 2018.
All MAPD plans will honor the 2019 Donut
Hole discount that will increase to 75% for brand-name drugs (you
pay 25%) and 63% for generic medications (you pay 37%).
- More
2019 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 2019 Medicare Advantage (up from 28% in 2018). You can click
here
to learn more about the Maximum Out-of-Pocket Limits for 2019 Medicare
Advantage plans and how MOOPs have changed since 2014.
Need
an overview of Medicare Advantage plan options in your area?
To get you started with your review of 2019 Medicare Advantage plans available 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.
You can also use our 2019 Medicare Advantage plan finder (
MA-Finder)
to review plans in your area - found directly at:
MA-Finder.com/2019. 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, health coverage information, formulary information and star ratings.
You can also use our 2018 / 2019 MA-Compare tool to see how your 2018 Medicare
Advantage plan is changing in 2019. Our Medicare Advantage comparison tool can be found directly at:
MA-Compare.com/2019.
No need to rush.
The Annual Enrollment Period (AEP) for 2019 Medicare Part D plans and Medicare
Advantage plans begins on Monday, October 15th and continues through Friday,
December 7th, with 2019 Medicare plan coverage beginning on Tuesday, January 1,
2019. For more information, Medicare
beneficiaries can telephone Medicare at 1-800-633-4227 to speak with a Medicare
representative.
Some Extra Help recipients may need to act to keep their 2019 Extra Help status.
The
2018 / 2019 CMS, SSA, and Medicare
plan mailings schedule is online and includes
notices for people who need to submit information to keep their 2019 Extra Help
status. So be sure to review anything
you receive from Medicare or the Social Security Administration as some
Medicare Part D Extra Help recipients will need to act or risk losing their
Medicare Part D Extra Help or Low-income Subsidy (LIS) in 2019. Please
click here to
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.