The Medicare Advantage program has enjoyed very steady growth for the last decade and seems to provide more generous benefits and as good or better quality for beneficiaries than does the traditional, fee-for-service Medicare program. A CMS announcement about plans and premiums for 2019 seems to herald another good Medicare Advantage year. (CMS Announcement) According to the agency, about 2.4 million more people will enroll in MA in 2019, bringing it to almost 37% of all beneficiaries. Premiums for MA plans, that is, the part of the cost paid by the beneficiary, is projected to be an average of $28.00 per month, or a decline of $1.81 from 2018’s premiums. Drug plan premiums are also expected to have a slight decrease. Premiums for MA plans have been decreasing for several years. Almost 83% of enrollees will have the same or a lower premium in 2019 if they remain in the same plan they had for 2018. 46% of beneficiaries are projected to be in zero premium plans, which is truly astounding and accounts for the growing popularity of MA. 99% of beneficiaries will have access to at least one MA plan and they all will have access to a Part D plan. There will be around 600 more plan choices in 2019, up to 3700 in total, and 91% of beneficiaries will have a choice among at least ten plans. 270 MA plans are taking advantage of new rules to offer the new types of supplemental benefits, such as adult day care and reduced cost-sharing for certain conditions.
MA is an important and meaningful option for most Medicare recipients. It should be encouraged even more and at the same time CMS should look harder at whether it is paying plans more than it needs to to ensure adequate choice and quality. And the proponents of Medicare for all, who routinely lie or dissimulate about its features, like paying doctors and other providers substantially less than they currently make (and I am sure we all want our over-worked and over-pressured physicians getting paid less), should be thinking about Medicare Advantage for all, including all Medicare beneficiaries. The advantages of a health plan, which should be focussing on care coordination and better health outcomes, are by now readily apparent and well-demonstrated by research. Better for everyone to be in a good quality health plan and less expensive too.