Medicare Advantage enrollees expected to top 22M in 2019 as premiums drop once again

Medicare enrollment form
Along with reductions in premiums, the Centers for Medicare and Medicaid Services projects Medicare Advantage enrollment to reach 36% of Medicare beneficiaries by 2019. (Getty/zimmytws)

Medicare Advantage premiums will continue to decrease into 2019, according to the Centers for Medicare & Medicaid Services, in stark contrast to the commercial insurance market.

CMS expects average monthly premiums to decrease 6% to $28 per month, down from an average of $29.81 in 2018. The agency anticipates lower premiums will drive enrollment to an all-time high, with 36% of Medicare beneficiaries purchasing Medicare Advantage coverage in 2019, a total of 22.6 million people. 

Medicare Part D premiums are also expected to drop, from $33.59 in 2018 to $32.50 next year. It's the second straight year that Part D premiums have declined.

RELATED: CMS allows Medicare Advantage plans to negotiate Part B drug prices, implement step therapy

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13th Partnering with ACOS & IDNS Summit

This two-day summit taking place on June 10–11, 2019, offers a unique opportunity to have invaluable face-to-face time with key executives from various ACOs and IDNs from the entire nation – totaling over 3.5 million patients served in 2018. Exclusively at this summit, attendees are provided with inside information and data from case studies on how to structure an ACO/IDN pitch, allowing them to gain the tools to position their organization as a “strategic partner” to ACOs and IDNs, rather than a merely a “vendor.”

“Medicare Part D and Medicare Advantage demonstrate the successes possible when we harness consumer choice and private-sector innovation to improve care and lower cost,” said Department of Health and Human Services Secretary Alex Azar in a statement.

The projection would mean a four-year streak of Medicare Advantage premium decreases since hitting $32.91 in 2015. Premiums in MA plans are tied to income, so about 46% of enrollees will have a zero premium next year. 

The agency said 83% of current enrollees will see their premium stay the same or decrease from 2018.

The popularity of MA plans has enabled CMS to expand its range of programs. Next year, the program will offer about 600 more plans than in 2018 to a total of approximately 3,700 plans across the country. The agency said 91% of beneficiaries will have access to 10 or more plans next year.

RELATED: CMS announces big expansion to Medicare Advantage value-based insurance design model

“The popularity of programs, such as Medicare Advantage, and with the various new supplemental benefits and policy changes that have been adopted, we expect plan choices to be even more robust moving forward," said CMS Administrator Seema Verma.

In addition, MA plans will be able to offer supplemental benefits such as adult day care services, in-home support services, caregiver support services, home-based palliative care and therapeutic massages. They will also be able to offer reduced cost sharing for beneficiaries with chronic conditions like diabetes, CMS said.

A spending bill passed earlier this year also including legislation that will allow MA plans to incorporate telehealth benefits beginning in 2020

MA plans aren't without fault. A recent report issued by the HHS Office of Inspector General indicated MA insurers overturn 75% of denials on appeal, raising concerns that plan sponsors are limiting access to care in the name of higher profits.

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