En español | Monthly premiums for Medicare Advantage (MA) plans continue to decline, with charges expected to go from an average of $23.63 this year to $21 in 2021, the Centers for Medicare and Medicaid Services (CMS) announced on Thursday. Federal officials also expect enrollment in these private insurance plans to grow by 2.5 million beneficiaries to a record-high 27 million.
Medicare beneficiaries will be able to review their coverage during the open enrollment period that runs from Oct. 15 to Dec. 7. Any changes enrollees make in their plans will take effect in January.
Premiums and deductibles for original Medicare's Part A (which covers hospital care) and Part B (which helps pay for doctor visits and other outpatient services) are expected to be released next month. Monthly premiums for the Part D prescription drug plans are expected to increase, on average, by 68 cents (2.3 percent).
Medicare Advantage, also known as Medicare Part C, is a private insurance alternative to original Medicare. Part D plans are also commercial plans. MA plans cover all the medical services that parts A and B do, and most also cover prescription drugs. The federal government also allows MA plans to offer dental, vision, hearing and other services that original Medicare does not.
More Medicare beneficiaries turn to Advantage plans
"We're seeing that more of our beneficiaries are coming to Medicare Advantage,” CMS Administrator Seema Verma said in a call with reporters previewing the MA rates for 2021. Verma said changes to Medicare regulations that give MA plans greater flexibility to structure coverage have “created more competition, and with more competition we have greater choice and lower costs."
The premiums announced Thursday, as well as the Part D expected monthly charges, represent national averages. The actual premiums beneficiaries will pay depend on the plans they select and where they live. When an enrollee chooses an MA plan, he or she will still be responsible for the government-set Part B monthly premium — $144.60 in 2020.
One issue that often keeps original Medicare enrollees from joining MA plans is that these plans are structured around networks of physicians and hospitals. That limits the providers beneficiaries can see without incurring higher out-of-pocket costs. In addition, those beneficiaries who don't live in one place throughout the year or travel often find themselves having to use out-of-network doctors, which either aren't covered by MA plans or charge patients more.
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Verma suggested that the increased availability of telehealth services for Medicare recipients may alleviate some of the concerns for beneficiaries who travel. “One of the things we've done is allow for greater flexibility around telehealth benefits, and I think that's very critical as patients are moving around,” Verma said.
The number of MA plans available to beneficiaries continues to increase. The average number of MA plans per county will increase from about 39 plans in 2020 to 47 in 2021, CMS says. There will also be an 18 percent increase in plans available in rural counties. CMS expects 42 percent of all Medicare beneficiaries to choose MA plans for 2021.