Good News: 2021 Medicare Advantage Plans Have Higher Ratings and Lower PremiumsOctober 28, 2019
It’s time to start making decisions for your healthcare coverage in 2021. The Annual Enrollment Period for Medicare beneficiaries is going on NOW and only lasts through December 7.
As you’re looking through your Medicare Advantage and Part D plan options for next year, you may notice that monthly premiums are shrinking and benefits are expanding!
- Lower Medicare Advantage and PDP premiums
- Average star ratings increasing
- Remind me: What is Medicare Advantage?
- Expanded benefits for 2021
- $0 premiums and Special Needs Plans
- How to get a low-cost, five-star Medicare Advantage plan in 2021
Lower Medicare Advantage and PDP premiums
CMS (The Centers for Medicare & Medicaid Services) released a statement earlier this fall that said the average monthly premium for a Medicare Advantage plan in 2021 will be the lowest it’s been in 14 years (since 2007!)
In fact, the average Medicare Advantage (MA) premium will see a decrease of 34.2% from 2017, while plan choice and benefits continue to expand. In some states like Alabama, Nevada, and Kentucky, the average premium decrease since 2017 will be closer to 50%.
Medicare Part D prescription drug plans (PDPs) will also have low premiums in 2021, with standard plans averaging around $30.50 a month. This marks a 12% decrease in PDP premiums since 2017.
Average star ratings increasing
The average star ratings for Medicare Advantage and prescription drug plans in 2021 are set to increase significantly. About 77% of Medicare Advantage enrollees will have a plan with 4 or more stars, and 98% of those in a standalone PDP plan will have a rating of more than 3.5 stars.
There will also be more plans with a 5-star rating than were available in 2020, including UnitedHealthcare, Cigna, and Anthem BCBS. Even the lowest-rated plans have improved to at least 2.5 stars.
CMS uses this Medicare star rating system for Medicare Advantage and Part D plans to determine whether or not a plan is doing its job, and whether or not it can stay on the market. Plans that consistently receive poor ratings (one or two stars) will eventually be removed from the market.
Plans are given a star rating between one and five, with one being “poor” and five being “excellent.”
Medicare Advantage plans are rated on the following factors:
- Level of access to preventive services (including annual physical exams and screenings)
- Care coordination
- How often members receive treatment for long-term conditions
- Current member satisfaction
- Plan performance in comparison to the previous year
- Customer service quality
Part D plans are rated on the following:
- Number of member issues with the plan
- How many people left over one year
- Patient safety while using prescriptions in the plan
- Accuracy of pricing
- Quality of care
- Customer service quality
More and more Medicare Advantage and Part D plan carriers are entering the market every year, meaning there is more competition. More competition means that more plans are trying to be the most valuable to be able to compete. That’s why even though costs may be going down, plan ratings are still increasing.
If you plan on meeting with a licensed agent during this year’s Annual Enrollment Period, be sure to ask about four and five-star plans in your area!
Remind me: What is Medicare Advantage?
You can enroll in Medicare Advantage as an addition to your Original Medicare coverage. Since Medicare Advantage plans are owned and operated by private insurance companies and are not the same as the government Medicare program, the coverage is a bit different.
Medicare Advantage plans are able to cover things that Original Medicare is not, such as fitness programs, dental, vision, and prescription drugs.
Medicare Advantage plans might come with copayments, coinsurance, and deductibles, but the average premium for 2021 is expected to be $21/month.
If you can afford to add a Medicare Advantage premium, the benefits may save you from thousands of dollars in healthcare costs later on.
Expanded benefits for 2021
Earlier this year, CMS released the 2021 benefit and cost sharing information on Medicare.gov. In large part due to the coronavirus pandemic, they are offering expanded benefits in several key areas, and many health care providers are taking advantage of this flexibility.
There will be over 4,800 Medicare Advantage plans in 2021 for enrollees to choose from, a 76.6% increase since 2017. The number of MA plans per country is also growing in the new calendar year.
In response to the COVID-19 pandemic, 94% of all MA plans will provide added telehealth benefits. The current health crisis also drove CMS to develop the Part D Savings Model, which sets a $35 monthly copay rate for insulin. Over 1,750 MA and PDP plans are participating in this new model in 2021.Many health plans are also expanding their benefits for enrollees with chronic conditions. About 500 Medicare Advantage plans will feature either supplemental benefits or lower copays to those with specific chronic diseases or other conditions.
$0 Premiums and Special Needs Plans
Some people may even be eligible for a $0 premium Medicare Advantage plan. Others still may be eligible for low-cost Medicare Advantage Special Needs Plans.
There are three types of Special Needs Plans: DSNP, ISNP, and CSNP.
CSNPs are Chronic Special Needs Plans and are for people who have certain chronic conditions and need additional coverage. ISNPs are Institutional Special Needs Plans and are for people who have been living in an institution such as an inpatient medical facility for 90 days or more. DSNPs are Dual Eligible Special Needs Plans and are for people who are dual-eligible for both Medicare and Medicaid.
How to Get a Low-Cost, Five-Star Medicare Advantage Plan in 2020
Our licensed agents across the nation are contracted and certified to sell a number of Medicare Advantage plans. An agent can sit down with you and show you all of the top-rated plans available in your area and help you select which one is best for you.
To get in touch with a licensed agent, call 844-431-1832 or click here.