From 1999 to 2019, Medicare Advantage (Part C) enrollment almost doubled, as reported by Henry J. Kaiser Family Foundation (KFF), rising from 18% of Medicare beneficiaries to over 34% across this time period. The Congressional Budget Office (CBO) expects sign-ups to increase to about 47% by 2029, noting that Medicare beneficiaries with Part C reached 41% and higher in 2019 within Hawaii, Oregon, Minnesota, Wisconsin, Pennsylvania, Florida and Puerto Rico.
Benefits of MA Plans
Original Medicare, the healthcare program administered by the federal government for individuals 65 years of age or older or those under 65 with certain disabilities, leaves Medicare recipients with a level of exposure. Although it helps cover many medical expenses through Part A and Part B, there are potential gaps in coverage. It does not include any out-of-pocket maximums, prescription drug coverage, vision benefits or dental care.
Some people opt to purchase supplemental insurance, called Medicare Supplement or Medigap plans, combined with Part D for prescriptions drugs to help cover some of those out-of-pocket costs. There are vision and dental programs that can be purchased separately. However, the Part B premium is due to Medicare regardless, and supplement plans require a premium on top of that.
Though some Medicare Advantage (MA) plans require a premium as well, many MA plans across the United States charge no premium. Most MA Plans have out-of-pocket limits and Part D built into the package that encompasses your Part A and Part B coverage. An exception is hospice care, which is still covered by Original Medicare. Some MA Plans offer accessory coverage for vision, dental, hearing and even wellness programs like gym memberships.
Additional benefits in 2020
Look for plans with additional benefits not offered in the past:
- Transportation to doctor visits.
- Over-the-counter drugs.
- Adult day-care services.
- Health-related services that promote wellness.
In addition, chronically ill members may be eligible for plans with specific benefits tailored to treat certain conditions. Inquire further if you think you may qualify.
Types of 2020 MA Plans
When weighing the pros and cons of different plans, consider whether or not you are comfortable with abiding by a provider network. While some plans allow beneficiaries to stray from the network, benefits are usually reduced. In making a selection, also check if prior approval is required for specialists. All MA Plans are required to cover emergency and urgent care.
Following is a list of 2020 plan types. Not all plans are available in all states.
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS)
- Special Needs Plans (SNPs)
- HMO Point-of-Service (HMOPOS)
- Medical Savings Account (MSA)
Companies that offer MA Plans
The private insurance brokers that offer MA Plans are required to adhere to rules fixed by Medicare. The insurance carriers with the largest combined market share for Part C include United Healthcare, Humana and BlueCross BlueShield (BCBS), according to KFF’s 2019 research results. Other insurance companies offering this product are Cigna, Wellcare, Kaiser Permanente and Aetna. Aetna was purchased by CVS in 2018.