2019 Medicare Advantage and Part D Prescription Drug Program Landscape
Both the Medicare Advantage and the Part D prescription drug programs continue to grow and provide high quality care and services to Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) is committed to strengthening and modernizing the Medicare Advantage and Part D prescription drug programs by providing additional flexibilities and efficiencies so that plan sponsors are encouraged to provide innovative benefits and plan offerings that provide Medicare enrollees with high quality healthcare services. By unleashing and strengthening the Medicare Advantage and Part D programs, CMS is giving Medicare beneficiaries the flexibility to make informed healthcare choices that best fit their health needs.
The data released with the 2019 Medicare Advantage and Part D landscape provides important premium and cost sharing information for Medicare health and drug plans offered in 2019:
- Enrollment in Medicare Advantage is projected to be at an all-time high in 2019 with 22.6 million Medicare beneficiaries. This represents a projected 2.4 million (11.5 percent) increase from 20.2 million in 2018. Based on projected enrollment, 36.7% of Medicare beneficiaries will be enrolled in Medicare Advantage in 2019.
- Medicare Advantage premiums, on average, have steadily declined since 2015 from the actual average premium of $32.91. For 2019, CMS estimates the Medicare Advantage average monthly premium will decline by $1.81 to $28.00 from 2018.
- Approximately 83 percent of Medicare Advantage enrollees will have the same or lower premium in 2019 if they continue in the same plan. About 26 percent of enrollees staying in current plans will see their premiums decline in 2019. Approximately 46 percent of enrollees in their current plan will have a zero premium in 2019.
- Access to Medicare Advantage and prescription drug plans will remain nearly universal, with about 99 percent of Medicare beneficiaries having access to at least one health plan in their area. All Medicare beneficiaries will have access to at least one stand-alone prescription drug plan.
- Nationally, the number of Medicare Advantage plan choices will increase from about 3,100 in 2018 to about 3,700 in 2019 – and more than 91 percent of people with Medicare with have access to 10 or more Medicare Advantage plans in 2019, compared to nearly 86 percent in 2018.
- The average number of Medicare plan choices per county will increase by 5 plans – up to approximately 34 plan choices per county.
- Due to new flexibilities available for the first time in 2019, nearly 270 Medicare Advantage plans will be providing an estimated 1.5 million enrollees new types of supplemental benefits:
- Expanded health-related supplemental benefits, such as adult day care services, and in-home and caregiver support services; and
- Reduced cost sharing and additional benefits for enrollees with certain conditions, such diabetes and congestive heart failure due to the agency’s reinterpretation of uniformity requirements.
- Access to important supplemental benefits, such as dental, vision, and hearing continues to grow.
- The average monthly premium for a basic Medicare prescription drug plan in 2019 is projected to decrease by $1.09 (3.2 percent decrease) to an estimated $32.50 per month. The basic premium for an average Medicare prescription drug plan is projected to decline for a second year in a row.
Promoting Innovation, Flexibility and Efficiency in Medicare Advantage and Part D
The policies CMS finalized in April 2018 for Medicare health and drug plans for 2019 advance broader efforts to promote innovation that empowers Medicare Advantage and Part D sponsors with new tools to improve quality of care and provide additional plan choices for Medicare Advantage and Part D enrollees. Through policies adopted through the 2019 Rate Announcement and Call Letter and the final rule, CMS is providing more choices for beneficiaries, a greater number of affordable options, and new benefits to meet their unique health needs.
To view the premiums and costs of Medicare health and drug plans in 2019, please visit: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/index.html.
For state-by-state information on Medicare Advantage and Part D in 2019, please visit: https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/MA-Part-D-Landscape-State-by-State.pdf