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Q1Group 2017 MA Analysis: A preliminary summary of the 2017 Medicare Advantage plan landscape

Category: Annual Medicare plan changes
Published: Sep, 25 2016 03:09:24


Our short analysis of the 2017 Medicare Advantage plan landscape is based on the 2017 Medicare plan information (MA, MAPD, and SNP) released by the Centers for Medicare and Medicaid Services (CMS).  (The CMS 2017 data was compiled earlier in September 2016 and subject to change as the Medicare plan contracts are finalized.)
  • The total number of Medicare Advantage plans increased in 2017. The total number of 2017 Medicare Advantage plans will increase slightly across the country with approximately 2% more Medicare Advantage plans available.

  • However, some service areas (counties) will experience Medicare Advantage plan terminations or consolidations.  In some areas, many 2017 Medicare Advantage plans will be terminated or merged into other plans and many counties will see significant changes in their Medicare Advantage plan landscape. The counties losing the most Medicare Advantage plans are in the states of: New YorkOhio, and Florida.

    As an example, Queens County, New York and Bronx County, New York will lose thirty-three (33) Medicare Advantage plan options in 2017 (and have the introduction of nine (9) new 2017 Medicare Advantage plans). It is not yet known if current 2016 Medicare plan members will be automatically “crosswalked” to another plan or whether they will need to choose a 2017 Medicare plan.

  • Many 2017  Medicare Advantage plans are available with a low monthly premium.  Overall, 70% of the 2017 Medicare Advantage plans will have premiums under $50, with 34% of the 2017 Medicare Advantage plan have a $0 premium, 10% in the $0.01 to $25 premium bracket and 27% in the $25.01 to $50 premium bracket.

  • Most 2017 Medicare Advantage plans will be HMOs. The majority (around 71%) of 2017 Medicare Advantage plans will be HMOs (Health Maintenance Organizations), 22% of 2017 Medicare Advantage plans will be Local PPOs (Preferred Provider Organizations).

  • Most (90%) of 2017 Medicare Advantage plans will include prescription drug coverage (MAPDs).

  • Slightly fewer 2017 Medicare Advantage plans with drug coverage will offer Donut Hole coverage for prescriptions purchased while in the Coverage Gap.   However, the 2017 Donut Hole discount will increase to a 60% discount for brand-name drugs and a 49% discount on generic drug purchases.
As a reminder, Medicare Advantage plan cost and coverage can change every year and if you would like an overview of how individual Medicare Advantage plans are changing in 2017, see our MA-Compare.com/2017 – begin by entering your ZIP code.  To get you started with our MA-Compare, you can click here for an example of how all Medicare Advantage plans available in Allegheny County, Pennsylvania are changing in 2017. Again, just enter your own ZIP code and click on “Click to Compare Annual Plan Changes” to see plans in your county.

To review all 2017 Medicare Advantage plans, you can to go directly to our 2017 MA-Finder and begin by entering your ZIP code to see all plans available in your county or you may wish to narrow your search by selecting specific plan features in the search box.  Our MA-Finder can also be found directly at: MA-Finder.com/2017.

At this time, our MA-Finder provides basic information on all Medicare Advantage plans, including monthly premiums, prescription deductible, Gap or Donut Hole coverage availability, and Medicare Part A and Part B Maximum Out-of-Pocket limit (or MOOP). We will be updating the MA-Finder with plan cost-sharing and coverage information as it becomes available.  To get you started, you can click on the following link for an example of all Medicare Advantage plans available in Queens County, New York or you can click here for an example of all the Medicare Advantage plans in Cook County, Illinois. Just change the ZIP code to match your area to see the plans available to you.

If you are interested in seeing an overview of Medicare prescription drug plans, our stand-alone 2017 Medicare Part D prescription drug plan (PDP) finder (or PDP-Finder) is also online and provides basic information on all 2017 Medicare Part D plans available in your state. PDP-Finder can be found directly at: PDP-Finder.com/2017.

If you would like to see how stand-alone 2016 Medicare prescription drug plans are changing in 2017, you can use our PDP-Compare.com/2017 (here is an example for California).

If you are looking for an analysis of the 2017 Medicare Part D plan landscape on a national and state-by-state basis our PDP-Facts.com/2017 is now online.

Remember that the 2017 annual Open Enrollment Period for Medicare Part D plans and Medicare Advantage plans begins on October 15th and continues through December 7th – with your new Medicare plan coverage beginning on January 1, 2017.






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Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.