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Medicare Advantage Enrollment

By April 1, 2020Commentary

So believe it or not, there actually was a Medicare Advantage open enrollment period this year and Mark Farrah Associates, as usual, gives us a good look at what the results were.   (MFA Report)   As of March 1, 2020, Medicare Advantage enrollment was 24,750,719 people, up 2,096,443 or around 9% from the prior year.  Stand-alone drug plans covered a little over 25 million Medicare beneficiaries and those plans had a small decline in total enrollment, but that could be because members went to full MA coverage, which almost always includes drugs.  Right now 36% of the total Medicare population of around 68.6 million people is enrolled in an MA plan.  The top ten plans have over 75% of all MA enrollment.  UnitedHealth is the leader, with 6.35 million members, 8.7% growth from the previous year and a 25% market share.  Humana is next with 4.46 million beneficiaries, a 12.6% growth rate and an 18% market share.  Third is Aetna/CVS at 2.26 million members, 15.8% growth and an 11% market share.  These companies are followed by Kaiser, Anthem and BCBS Michigan.  81% of Medicare Advantage enrollment is through individual plans, the remainder is from group, primarily employer, coverage.  HMO designs accounted for 14.7 million members and PPO designs for about 9 million.  Dual eligibles comprised around 378,000 members.  Enrollment gains occurred in all states.

Now, of course, we have to add a little coronavirus spin.  The elderly are a very clear risk group for coronavirus.  Although the effect is unclear, for the MA plans if there are a large number of deaths in the over-65 population, there will be a loss of membership and revenue.  The effect on medical costs is less clear.  Are patients putting off other forms of medical care?  Are coronavirus illnesses just substituting for flu or other diseases or are they additive?  How expensive is a coronavirus episode; if it includes a lengthy ICU stay, probably pretty expensive.  So likely loss of revenue, unclear effect on medical costs.  But other than that, a positive enrollment period for most MA plans.

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