A report 3,834 Medicare Benefit plans can be out there throughout the nation as alternate options to conventional Medicare for 2022, a brand new KFF evaluation finds. That’s a rise of 8 p.c from 2021, and the biggest variety of plans out there in additional than a decade.
On the similar time, the variety of Medicare Half D stand-alone prescription drug plans that can be supplied in 2022 is reducing by 23 p.c to 766 plans, primarily the results of agency consolidations resulting in fewer plan choices sponsored by Cigna and Centene, in accordance with one other new KFF evaluation.
These findings are featured in two briefs launched by KFF right now that present an summary of the Medicare Benefit and Medicare Half D market for 2022, together with the most recent knowledge and key tendencies over time. Medicare’s open enrollment interval started Oct. 15 and runs via Dec. 7.
Medicare Benefit
Greater than 26 million Medicare beneficiaries – 42 p.c of all beneficiaries – are at present in Medicare Benefit plans, that are principally HMOs and PPOs supplied by personal insurers which are paid to offer Medicare advantages to enrollees.
In 2022, a typical beneficiary can have 39 plans to select from of their native market. However the variety of Medicare Benefit plans out there varies drastically throughout the nation, with a median of 42 plans in metropolitan areas and 25 plans in non-metropolitan areas. In 2022, 25 p.c of beneficiaries stay in a county the place they will select amongst 50 Medicare Benefit plans.
Most Medicare Benefit plans (89%) embody prescription drug protection. Fifty-nine p.c of those plans don’t cost any further premium past Medicare’s commonplace Half B premium. Greater than 90 p.c of non-group Medicare Benefit plans supply some imaginative and prescient, telehealth, listening to, or dental advantages.
Regardless of the common beneficiary getting access to plans supplied by 9 totally different companies, Medicare Benefit enrollment is concentrated in plans operated by UnitedHealthcare, Humana, and Blue Cross Blue Defend associates. Collectively, UnitedHealth and Humana account for 45 p.c of Medicare Benefit enrollment in 2021.
Half D
On account of consolidations within the stand-alone drug plan market, the standard Medicare beneficiary can have a selection of 23 stand-alone drug plans subsequent 12 months, seven fewer than in 2021. Beneficiaries receiving low-income subsidies (LIS) may even have fewer premium-free plan decisions in 2022, which might make it harder for some enrollees to discover a premium-free plan that covers all their prescription medicines. Within the stand-alone drug plan market, 8 out of 10 enrollees subsequent 12 months are projected to be in stand-alone plans operated by simply 4 companies: CVS Well being, Centene, UnitedHealth, and Humana.
The estimated common month-to-month premium for Medicare Half D stand-alone drug plans is projected to be $43 in 2022, primarily based on present enrollment, whereas common month-to-month premiums for the 16 nationwide stand-alone drug plans out there in 2022 are projected to vary from $7 to $99.
Almost three-fourths, or 10 million, of the 13.3 million stand-alone drug plan enrollees who don’t qualify for low-income subsidies should pay increased premiums subsequent 12 months in the event that they keep on with their present plan, and lots of may even face increased deductibles and price sharing for lined medication. Whereas the common weighted month-to-month PDP premium is rising by $5 between 2021 and 2022 (from $38 to $43), almost 4 million non-LIS enrollees (28%) will see a premium improve of $10 or extra per thirty days. Considerably fewer non-LIS enrollees (0.2 million, or 2%) will see a premium discount of the identical magnitude.
Along with these two new analyses, KFF has up to date its assortment of incessantly requested questions on Medicare Open Enrollment to assist beneficiaries perceive their choices in the course of the annual open enrollment interval. A latest KFF evaluation discovered that 7 in 10 Medicare beneficiaries say they didn’t examine their choices throughout a latest open enrollment interval. Evaluating and selecting among the many big selection of Half D plans could be troublesome, on condition that plans differ from one another in a number of methods, past premiums, together with value sharing, deductibles, lined medication, and pharmacy networks. Evaluating Medicare Benefit drug plans could also be made harder by the truth that not solely drug protection varies but additionally different options, together with value sharing for medical advantages, supplier networks, and protection and prices for supplemental advantages.