Medicare Heads Up: December 6, 2019

Welcome to Medicare Heads Up, a regular feature intended to deliver state and national Medicare-related headlines that will keep consumers abreast of developments that affect their coverage and costs. This week:

Open enrollment is ending this week, but you still have options

Medicare open enrollment for 2020 ends on December 7, but that isn’t your last chance to get coverage for 2020. Here are upcoming opportunities to enroll or change coverage –  and deadlines to mark on your calendar:

• Five-star Medicare Advantage special enrollment period(December 8 –November 30, 2020) – If there is a 5-star Medicare Advantage or Part D plan available where you live, you can switch to it during this window. (Yes. It’s almost a full year.  But you can only make one such plan change per year.)
• Medicare Advantage open enrollment(January 1 – March 31) – Switch from an Advantage plan to traditional Medicare and a Part D – or – switch from one MA to a different MA plan.
• Medicare Part A/B general enrollment(January 1 – March 31) – If you didn’t sign up when you first became eligible, this is your chance to get traditional Medicare Part A and B (although there may be late enrollment penalty). If you already enrolled in Part A/B, you can now purchase Part D or switch to a Medicare Advantage plan.

Most beneficiaries don’t switch Medicare drug plans during open enrollment

The number of Medicare enrollees swapping Prescription Drug Plans (PDPs) during Medicare open enrollment decreased from 2014 to 2016 – in both Part D (between 10% and 13% switched) and Medicare Advantage plans (between 8% and 11%). The lack of movement could prove to be a landmine for consumers due to the frequency with which PDP coverage and pricing change from one year to the next. Although no single culprit is to blame, it seems that PDPs suffer from the same combination of consumer confusion, apathy, and cost factors that keep those in other types of health plans simply renewing – rather than researching options.

Consumers will see more Part D options and a wide range of costs in 2020

Consumers in search of a Medicare Prescription Drug Plan (PDP) will find more options than in 2019, but they will also see a wide range in premiums and higher costs. For 2020, more than 948 PDPs will be available nationally – 200 more plans than in 2017 – with an average of 28 different plans available to each beneficiary. Stand-alone PDPs premiums range in price from $13/month to $192/month, with an average premium increase of 7 percent ($42.05 a month). For the 86 percent of PDPs with a deductible, the maximum deductible will increase to $435, from $415 in 2019.

California tops states in Medicare Advantage enrollment

Medicare Advantage enrollment has climbed to 22 million beneficiaries in 2019 – or 35 percent of all potential Medicare eligible customers – and the rapid growth of Advantage plans has no end in sight. With the continued market penetration and a friendly regulatory climate, the growth of the plans could reach 70% of the entire Medicare marketplace by 2030 – 2040.

The top five states for Medicare Advantage enrollment:

• California (2,785,725)
• Florida (2,122,993)
• Texas (1,687,732)
• New York (1,538,736)
• Pennsylvania (1,174,686)

Revamped Medicare Plan Finder wildly criticized; CMS says it’s consumer-friendly

In an attempt to improve the consumer experience, CMS overhauled the Medicare Plan Finder tool, with the new version debuting just in time for the open enrollment period in the fall of 2019. Since the revamped Plan Finder launched, brokers, healthcare navigators, consumer advocates, and even the Delaware Department of Insurance have criticized the website as being difficult to use, not providing accurate cost estimates, and even of presenting incorrect information. CMS has denied technical issues with the new Plan Finder, but assures it is “doubling down” on staff to assist beneficiaries who may have enrolled in the wrong plan due to inaccurate or misleading information. CMS reports user traffic has increased 14 percent over last year.

Jesse Migneault is a journalist and editor who has written about business, government and healthcare – including public and private-payer health insurance. His articles have appeared in HealthPayerIntelligence, the Hartford Courant, Portsmouth Herald, Seacoastonline.com, Foster’s Daily Democrat, and York County Coast Star.

In addition, his work has been cited by health industry stakeholders such as the Eugene S. Farley Health Policy Center, Association of Healthcare Journalists, American Academy of Actuaries, Kaiser Permanente, blueEHR, San Diego Law Review, Medicare Agent News, healthjournalism.org, and Concierge Medicine among others.

Tags: Medicare Advantage, Medicare Heads Up, Medicare open enrollment, Medicare Part D, Medicare plan finder, Special Needs Plan