Saturday, October 31, 2020

Medicare Advantage Growth in the Mid-East States

The Medicare open enrollment period is now underway through December 7th. During this period, many Medicare beneficiaries will be considering changing their Medicare coverage to a Medicare Advantage (MA) plan. MA Plans are an increasingly popular type of health plan offered by private insurers as an alternative to original Medicare.  MA plans are offered through private insurance carriers that contract with the federal government to provide an alternative to Medicare Part A and Part B benefits coverage. With MA plans, the U.S. government basically contracts private insurers to offer Medicare eligible individuals health plans that, at a minimum, match Original Medicare Part A and Part B benefits.  What gives Medicare Advantage plans their growing appeal is that private insurers have been able to bundle Part A and Part B benefits, plus a variety of extra benefits, into their plans at little to no cost to enrollees.

With normally lower costs and more benefits, MA Plans can be a great value compared to Original Medicare.  This added value that comes with MA plans is usually made possible, in part, through the imposition of managed care protocols and restricted provider networks that are not found with Original Medicare coverage.  While MA Plans can come in a various insurance models, the most popular Medicare Advantage plans feature HMO and PPO structures.  Notwithstanding managed care protocols and fewer provider choices, more and more Medicare eligible seniors are switching to Medicare Advantage plans because of the value they offer.  As of October 2020, across all 50 states there were about 24 million Americans enrolled in MA plans, an increase of more than 40% in the past 4 years.  During this same timeframe total Medicare enrollment across all 50 states has grown only about 10%, so MA plan market share in the Medicare market has been growing robustly, from just a 30% share four years ago to 39% today.

The growing popularity of Medicare Advantage plans nationally is mirrored in the Mid-East states, where MA plan enrollment over the past four years has grown nearly 35%.  During the same period, Overall Medicare enrollment in the five-state region has grown less than 8%, so the region has seen MA market share jump from around 30% four years ago to nearly 38% today.  Here is a closer look at Medicare Advantage enrollment growth in the five-state Mid-East region over the last four years:

Medicare Advantage Growth in the Mid-East States
Medicare Advantage Growth in the Mid-East States

Medicare Eligible (in thousands) MA Enrollment (in thousands) % Growth
State 2020 2016 2020 2016 Eligible MedAdv
DE 215.6 186.8 40.7 17.0 15.4% 139.4%
MD 1060.3 964.8 136.6 53.3 9.9% 156.5%
NJ 1639.5 1532.2 531.6 254.3 7.0% 109.0%
NY 3684.6 3432.4 1613.8 1276.4 7.3% 26.4%
PA 2782.5 2598.2 1235.4 1031.3 7.1% 19.8%
ME Only 9,382 8,714 3,558 2,632 7.7% 35.2%
All States 61,584 55,972 24,050 16,909 10.0% 42.2%

For a summary look at MA plan enrollment growth in other states, check out our resource page Medicare Advantage Enrollment Growth.