A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s an increase of 8 percent from 2021, and the largest number of plans available in more than a decade.
At the same time, the number of Medicare Part D stand-alone prescription drug plans that will be offered in 2022 is decreasing by 23 percent to 766 plans, primarily the result of firm consolidations leading to fewer plan offerings sponsored by Cigna and Centene, according to another new KFF analysis.
These findings are featured in two briefs released by KFF today that provide an overview of the Medicare Advantage and Medicare Part D marketplace for 2022, including the latest data and key trends over time. Medicare’s open enrollment period began Oct. 15 and runs through Dec. 7.
More than 26 million Medicare beneficiaries – 42 percent of all beneficiaries – are currently in Medicare Advantage plans, which are mostly HMOs and PPOs offered by private insurers that are paid to provide Medicare benefits to enrollees.
In 2022, a typical beneficiary will have 39 plans to choose from in their local market. But the number of Medicare Advantage plans available varies greatly across the country, with an average of 42 plans in metropolitan areas and 25 plans in non-metropolitan areas. In 2022, 25 percent of beneficiaries live in a county where they can choose among 50 Medicare Advantage plans.
Most Medicare Advantage plans (89%) include prescription drug coverage. Fifty-nine percent of these plans do not charge any additional premium beyond Medicare’s standard Part B premium. More than 90 percent of non-group Medicare Advantage plans offer some vision, telehealth, hearing, or dental benefits.
Despite the average beneficiary having access to plans offered by nine different firms, Medicare Advantage enrollment is concentrated in plans operated by UnitedHealthcare, Humana, and Blue Cross Blue Shield affiliates. Together, UnitedHealth and Humana account for 45 percent of Medicare Advantage enrollment in 2021.
As a result of consolidations in the stand-alone drug plan market, the typical Medicare beneficiary will have a choice of 23 stand-alone drug plans next year, seven fewer than in 2021. Beneficiaries receiving low-income subsidies (LIS) will also have fewer premium-free plan choices in 2022, which could make it more difficult for some enrollees to find a premium-free plan that covers all their prescription medications. In the stand-alone drug plan market, 8 out of 10 enrollees next year are projected to be in stand-alone plans operated by just four firms: CVS Health, Centene, UnitedHealth, and Humana.
The estimated average monthly premium for Medicare Part D stand-alone drug plans is projected to be $43 in 2022, based on current enrollment, while average monthly premiums for the 16 national stand-alone drug plans available in 2022 are projected to range from $7 to $99.
Nearly three-fourths, or 10 million, of the 13.3 million stand-alone drug plan enrollees who don’t qualify for low-income subsidies will have to pay higher premiums next year if they stick with their current plan, and many will also face higher deductibles and cost sharing for covered drugs. While the average weighted monthly PDP premium is increasing by $5 between 2021 and 2022 (from $38 to $43), nearly 4 million non-LIS enrollees (28%) will see a premium increase of $10 or more per month. Substantially fewer non-LIS enrollees (0.2 million, or 2%) will see a premium reduction of the same magnitude.
In addition to these two new analyses, KFF has updated its collection of frequently asked questions about Medicare Open Enrollment to help beneficiaries understand their options during the annual open enrollment period. A recent KFF analysis found that 7 in 10 Medicare beneficiaries say they did not compare their options during a recent open enrollment period. Comparing and choosing among the wide array of Part D plans can be difficult, given that plans differ from each other in multiple ways, beyond premiums, including cost sharing, deductibles, covered drugs, and pharmacy networks. Comparing Medicare Advantage drug plans may be made more difficult by the fact that not only drug coverage varies but also other features, including cost sharing for medical benefits, provider networks, and coverage and costs for supplemental benefits.
The middle of October starts a very important timeline to compare your current Part D or Part C plan to plans offered by other companies for 2022 coverage!
The new year can bring costly surprises. Every year, most companies change their monthly premium, coverage options, copays, and provider networks for services and RXs.
Participating in Medicare’s annual Open Enrollment is not required to keep your current Medicare Part D or Part C insurance.
- However, it’s the only time (for most people) to find out if your current plan will continue to work for you next year and to shop for a new plan, if desired.
Note: Medigap (also called “supplemental”) plans are not subject to the annual Medicare Open Enrollment timeline. See here for more information about Medigaps in Washington.
For people currently enrolled in a Medicare Advantage plan, below is information about the last opportunity to compare other plan options and change plans for the remainder of 2021.
If you are not enrolled in a Medicare Advantage plan, this enrollment period does not apply to you.
If currently enrolled in a Medicare Advantage Plan (non-employer based):
- You can switch to a different Medicare Advantage plan or switch to Original Medicare (and to a separate Medicare drug plan) once from January 1, 2021 – March 31, 2021
- The new plan is effective the month after the company receives the request for enrollment
See Page 67 of the 2021 Medicare & You Handbook (click link) for more information.
Finding a Part D (drug plan) or Advantage plan that covers your specific prescriptions, pharmacy, and medical providers is crucial.
- See Contact Information section below for free help to review your options.
Considerations & Reminders
- People, with or without Medicare, and enrolled in insurance through a current or previous employer or union need to check with their plan or benefit administrator about allowed timelines and circumstances for changing plans.
- People enrolled in Medicare, who qualify for Extra Help from Social Security, can change plans more often, within specific times of year.
- Click here and scroll down the page to find, “Other Special Situations” section and the “I qualify for Extra Help Paying for Medicare Prescription Drug Coverage” topic
More information about Extra Help and other savings programs is also in Section 7 of the 2021 Medicare & You Handbook.
- Medicare Parts A & B have their own deductibles and out-of-pocket cost sharing requirements, which are different than Advantage plans. Parts A & B also do not provide prescription coverage or some of the additional benefits in Advantage plans.
- Click here to learn what is covered and costs for Medicare Parts A & B
- People may apply for a Medigap (supplemental) insurance to help offset some of the out-of-pocket expenses under original Medicare. You may not be guaranteed approval for a Medigap plan.
Click here for information about Medigap plans
With Medicare open enrollment underway, KFF has released new analyses that examine beneficiaries’ Medicare Advantage and Part D drug plan options for 2021.
The average person on Medicare will be able to choose among 33 Medicare Advantage plans during the open enrollment period that runs through Dec. 7, finds Medicare Advantage 2021 Spotlight: First Look. It also finds that:
- The average beneficiary can choose from plans offered by eight firms in 2021, although enrollment typically has been concentrated in plans operated by a handful of insurers.
- Among the majority of Medicare Advantage plans that cover prescription drugs, 54 percent will charge no premium (although beneficiaries will have to pay the Medicare Part B premium), similar to 2020. Ninety-six percent of beneficiaries have access to a Medicare Advantage drug plan with no monthly premium in 2021.
- Medicare Advantage plans may offer supplemental benefits not available in traditional Medicare. Most plans have historically offered fitness, dental, vision, and hearing. For 2021 the vast majority are also offering telehealth (98%).