Situation Report | June 28, 2021
The Kaiser Family Foundation has released three reports on Medicare Advantage Managed Care plans.
Among other key findings:
- In 2021, more than 26 million people are enrolled in a Medicare Advantage (MA) plan, accounting for 42 percent of the total Medicare population; in New York State, 45.5 percent of Medicare beneficiaries are enrolled in MA plans. The average Medicare beneficiary in 2021 has access to 33 Medicare Advantage plans, the largest number of options available in the last decade.
- Most enrollees in individual MA plans have access to some benefits not covered by traditional Medicare, including eye exams and/or glasses (99 percent), telehealth services (94 percent), dental care (94 percent), a fitness benefit (93 percent) and hearing aids (93 percent). Other benefits are offered far less frequently, such as a meal benefit (55 percent), transportation (37 percent), and in-home support services (7 percent); and when they are offered, they tend to be offered more frequently in special needs plans.
- More than 80 percent of MA enrollees in 2021 are in plans that receive bonus payments from Medicare based on quality star ratings — substantially higher than the share in 2015 (55 percent).
- Spending on bonus payments to MA plans totals $11.6 billion in 2021, almost four times the amount in 2015.
- Nine in ten MA enrollees are in plans that include prescription drug coverage and nearly two-thirds of these enrollees (65 percent) pay no premium other than the monthly Medicare Part B premium ($148.50 in 2021).
- In 2021, the weighted average out-of-pocket limit for Medicare Advantage enrollees is $5,091 for in-network services and $9,208 for in-network and out-of-network services combined. For enrollees in HMOs, the average out-of-pocket (in-network) limit is $4,566.
The reports include: