Medicare Advantage Plans in 2021

It’s likely that you have heard about Medicare Advantage Plans at this point. They are a type of private Medicare insurance that also represents the shift toward value-based care in the American healthcare system. Providers are given incentives to improve ‘quality outcomes’ rather than simply provide a high volume of services. This is good news for plan beneficiaries. Essentially, more benefits are offered at a more competitive price in an Advantage Plan than regular Medicare. 

Q1: How do Advantage plans offer such competitive benefits in the marketplace?

As stated earlier, Advantage plans have a lot of the attributes of value-based care built-in. Private insurance companies bid for government money, and, since they are usually able to stay under the Medicare cost benchmark, they are able to provide extra benefits with the extra money they receive. These benefits include hearing, vision, or dental benefits as well as non-medical supplemental benefits like transportation, telehealth, gym memberships, over-the-counter supplies, and meals after a hospital stay. Plans are able to receive more money if they are shown to provide excellent care through a high star rating.

Q2: This sounds too good to be true. Wouldn’t this put a monetary burden on the federal government and Medicare?

Medicare spends roughly the same amount per beneficiary for both Advantage and Traditional FFS (fee-for-service) plans. This is due to the competitiveness of the private market. One study even found that, with more enrolled in Advantage plans, hospital costs ‘declined for all Medicare beneficiaries and other commercially insured populations.’ 

Q3: What will the state of Advantage Plans be in 2021?

The overall number of Advantage plans available in the Treasure Valley has increased in 2021 to 43 plans. This means that the market has become even more competitive, and you can likely expect even better benefits. Access to these plans continues to improve throughout the state as well. There are great plan options in Idaho, and you can always count on Elise to assess which plan best suits your needs.

 

Sources: 2021 Medicare Part B Premiums Remain Steady, “State of Medicare Advantage Report” (July 2020) by the Better Medicare Alliance, “Medicare Advantage Program Payment System” (Revised October 2016) by Medpac, and HealthPayerIntelligence.com