Q1Group 2020 MA/MAPD Analysis: Medicare beneficiaries can expect more Medicare plan options, continued low monthly premiums, more D-SNPs, and slightly more Medicare Advantage plans offering some Donut Hole coverage
A preliminary analysis of the 2020 Medicare Advantage plan (MA and
MAPD) landscape data recently released by the Centers for Medicare and Medicaid
Services (CMS) shows that Medicare beneficiaries can expect a few more Medicare
plans in most areas; continued low monthly premiums; slightly more Medicare Advantage plans offering
some Donut Hole coverage; and stable out-of-pocket spending limits (
MOOP).
First, here are four 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 and non-health related transportation.
(3)
You
cannot add a stand-alone
Medicare
Part D plan (
PDP)
if you are enrolled in a Medicare Advantage (MA) plan -- 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.
Highlights of the 2020 Medicare
Advantage plan landscape
- The
total number of 2020 Medicare Advantage plans will increase.
Across the country, there will be 15% more Medicare Advantage plans
offered in 2020 – with 4,047 Medicare Advantage plans (MAs and MAPDs)
available, as compared to 3,431 Medicare Advantage plans offered in 2019. You can click
here to read more about the number (and type) of 2020
Medicare Advantage plans.
- Most
2020 Medicare Advantage plans will offer prescription drug coverage (MAPDs).
As in past years, around 92% of 2020 Medicare Advantage plans will include
prescription drug coverage. 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 69%) of 2020 Medicare Advantage plans will be Local HMOs
(Health Maintenance Organizations). However, there will be a 19% increase in 2020 Local PPO
(Preferred Provider Organization) Medicare Advantage plans. You can click
here to read more about the different types of 2020
Medicare Advantage plans.
- Even
with more Medicare Advantage plans offered in 2020, many counties will see
significant changes in their Medicare Advantage plan landscape.
When viewed in detail, many 2019 Medicare Advantage plans will be
terminated in 2020 or merged into other 2020 plans. As an example, Miami-Dade
County, FL will lose 17 of the 82 Medicare Advantage plans that
are currently offered in 2019, however 14 new 2020 Medicare Advantage
plans will be introduced. You can
see more 2020 Medicare plan changes using our 2019/2020 Medicare Advantage
plan compare tool: MA-Compare.com/2020. You can click
here to read more about changes in Medicare Advantage plan
availability across the country.
- 2020 Medicare Medical Savings Accounts (MSAs)
will be more widely available.
In 2020, Medicare Medical
Savings Accounts (MSAs) will be available in 29 states (1,883
counties) across the country. In
2019, MSAs were available to Medicare beneficiaries in only 1,262 counties
across 19 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
2020 Medicare Advantage plan premiums will remain low.
As in past years, close to 79% of all 2020 Medicare Advantage plans will
have a monthly premium
under $50, with around 43% of the 2020 Medicare Advantage plans
having a $0 premium. You can click
here to read more about changes in Medicare Advantage plan
premiums and see a chart of how plan premiums have changed since 2014.
- More
2020 Medicare Advantage Special Needs Plans (SNPs).
Although about 13% of the 2019 Medicare Advantage Special
Needs Plans (SNPs) will be discontinued in 2020, plan losses will
be offset by the introduction of new SNPs, resulting in a 19% increase in
the total number of 2020 SNPs. The
vast majority of SNPs remains Dual-Eligible (D-SNPs) (63%). You can click
here to learn more about 2020 Medicare Advantage Special
Needs Plans and how the SNP landscape has changed since 2014.
- More
2020 MAPDs have a
$0 premium and $0 drug deductible ($0/$0).
Twenty-six percent (26%) of all 2020 Medicare Advantage plans will include
prescription drug coverage with a $0 premium and $0 drug coverage
deductible (up from 21% in 2019). You can click
here to read more about the 2020 $0/$0 Medicare Advantage
plans with prescription drug coverage (MAPDs).
- The Donut Hole will close in
2020.
All MAPD plans will honor the 2020 Donut
Hole discount that will increase to 75% for all formulary
medications purchased while in the Donut Hole. You pay 25% of your plan’s retail drug
price for both brand-name and generic formulary medications.
- Slightly more 2020 MAPDs will offer additional Donut
Hole coverage.
Forty percent (40%) of MAPD
plans will offer some level of additional
drug coverage should you reach the 2020 Donut Hole -- as
compared to 38% of MAPDs in 2019. For brand-name drug purchases, this gap
coverage is in addition to the brand-name drug manufacturers Donut
Hole discount.
- Slightly
more 2020 Medicare Advantage plans will offer a lower 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 decrease to 31% of all 2020 Medicare Advantage plans (down
from 34% in 2019). The number of
MAs with a MOOP under $3,400 will increase to 24% of all 2020 Medicare
Advantage plans as compared to 23% in 2019. You can click
here to learn more about the Maximum Out-of-Pocket Limits
for 2020 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 2020 Medicare Advantage plans available in
your area, just click on your state and then click on your county name:
MA-Finder)
to review plans in your area -- found directly at:
MA-Finder.com/2020
. 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). The 2020 Medicare plan drug tier
cost-sharing, health coverage information, formulary information, and star
ratings are
coming
soon.
You can use our 2019/2020 MA-Compare tool to see how your 2019 Medicare
Advantage plan is changing in 2020. Our
Medicare Advantage comparison tool can be found directly at:
MA-Compare.com/2020.
. . . and a few reminders . . .
Reminder #1: No need to rush.
The annual Open Enrollment Period (AEP) for 2020 Medicare Part D plans and
Medicare Advantage plans begins on October 15th and continues through December
7th, with 2020 Medicare plan coverage beginning on January 1, 2020. For more information, Medicare beneficiaries
can telephone Medicare at 1-800-633-4227 to speak with a Medicare
representative.
Reminder #2: Some Extra Help
recipients may need to act to keep their 2020 Extra Help status.
The
CMS, SSA, and Medicare plan mailings schedule is online and includes notices for people who need to
submit information to keep their 2020 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 2020. 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.