Medicare Blog | Medicare News | Medicare Information

A Turkey Trot Down Memory Lane

Posted by Caroline Callahan on Tue, Nov 24, 2015 @ 02:27 PM

A Turkey Trot Down Memory Lane with PSM

It is a much talked about fact within the PSM office that we work with the nation’s greatest senior market insurance agents. The successes of our agents are our number one focus and everything we do is conceived and designed to best serve them.

With that being said, we could not express our gratitude enough for our agents this Thanksgiving holiday. Just eight short years ago, working with 1,000 agents was a glimmer in our mind’s eye. Today, we're proud to have reached a milestone of working with 15,000 agents and are incredibly thankful for each and every one of them.

This Thanksgiving holiday, we want to take a moment to express our extreme gratitude and heartfelt thanks in a big way.

PSM was started with one simple goal: to meet the distribution, marketing and administrative needs of independent senior market insurance agents on a national scale so that their businesses could continue to flourish. Through our upcoming expansion with the addition of five new Marketing Directors and two Administrative Assistants, that goal has not changed. With every product improvement, new product release and every offering in between, we have been and continue to be laser-focused on making sure that the tools we provide our agents with will ultimately help them grow their businesses.

We're ecstatic for the upcoming 2016 year, with the growth of our business, and know that we could not have done it without our ever-growing PSM community. We are truly grateful for all our incredible agents, marketing agency partners, employees and fans.

We wish that this Thanksgiving holiday finds you with plenty of reasons to give thanks. As we celebrate our gratitude, we look forward to adding 15,000 more agents to the PSM community and leave you with one final, heartfelt thought: THANK YOU FOR BEING YOU AND FOR CHOOSING PSM!

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Tags: Senior Market Success, Insurance Agents

[INFOGRAPHIC] Medicare Advantage vs. Medigap

Posted by Caroline Callahan on Fri, Nov 20, 2015 @ 09:17 AM


Over the past few years, the markets for both Medicare Advantage and Medigap have continued to skyrocket in growth with respect to enrollment rates, plan options and beneficiary satisfaction. Thus, it is imperative, more now than ever, for senior market insurance agents to have a diversified portfolio to accommodate the demands of both respective client bases. As we prepare to break into a new year, Precision Senior Marketing has crafted this handy infographic to demonstrate trends and changes within those markets so that senior market insurance agents may create an efficient game plan for 2016.


Below are key takeaways from this infographic:

Growth in Enrollment Rates

  • Medicare Advantage ↑ 9% in 2014
  • Medigap ↑ 5.7% in 2014

Popular Medicare Advantage and Medigap Plans

  • Medicare Advantage
    • HMO plans ↑ 6% in 2015
    • Local PPO plans ↑ 8% in 2015
    • Regional PPO plans are fairly flat in enrollment
  • Medigap

Overall Beneficiary Satisfaction

  • Nearly half of all Medicare Advantage plans received a 4-star or better rating out of five stars
    • 70% of Medicare Advantage beneficiaries are enrolled in a plan that has a 4-star rating or better
  • 9 out of 10 beneficiaries would recommend Medigap to a friend or relative to fill the gaps left by traditional Medicare
  • 94% of Medigap beneficiaries are satisfied with their coverage

Take a peep below for some further insight!


To get more information on KFF.org's "Medicare Advantage 2015 Spotlight: Enrollment Market Update", visit: http://kff.org/medicare/issue-brief/medicare-advantage-2015-spotlight-enrollment-market-update/

For more information on AHIP.org's "Trends in Medigap Enrollment and Coverage Options", visit: http://www.ahip.org/epub/medigap-trends-report/

Sources: www.kff.org, www.ahip.org

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Tags: Medicare Advantage, Medicare Supplement, Medigap

[INFOGRAPHIC] 2016 Medicare Parts A & B Premiums and Deductibles Announced

Posted by Caroline Callahan on Thu, Nov 12, 2015 @ 12:35 PM


On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced the 2016 premiums and deductibles for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.

Lucky for you, Precision Senior Marketing has taken the time to put together the following infographic summarizing what your senior clients can expect in result from the adjustments made via the Bipartisan Budget Act singed into law by President Obama last week.

P.S. Don't be too shy to share this infographic with your clients by positing it to your Facebook page :)

Medicare Part B Premium and Deductible

  • Most Medicare Part B beneficiaries are immune from any increase in premiums in 2016 and will pay $104.90, which is the same monthly premium they paid last year
  • 30% of beneficiaries not subject to the “hold harmless” provision will pay an increased Medicare Part B monthly premium of $121.80
  • The annual deductible for all Medicare Part B beneficiaries will be a flat rate of $166.00

Medicare Part A Deductible

  • Beneficiaries will face a 2% increase in Medicare Part A deductible and coinsurance amounts for inpatient hospital, skilled nursing facility, and some home health care services in 2016

Premiums for Medicare Advantage and MAPD plans already finalized are unaffected by this announcement.

Find the original press release from CMS here!

To get more information about state-by-state savings, visit the CMS website at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html .

For more information on the 2016 Medicare Parts A and B premiums and deductibles (CMS-8059-N, CMS-8060-N, and CMS-8061-N), visit: https://www.federalregister.gov/public-inspection

Sources: www.cms.gov

Additional Updates:

Tags: Medicare Part A, Medicare Part B, Medicare Premiums

Everything Your Senior Clients Need to Know About the Budget Deal

Posted by Caroline Callahan on Thu, Nov 05, 2015 @ 02:52 PM


On Monday, November 2, 2015, President Obama signed into law a two-year budget deal that diverts a spike in Medicare Part B premiums, but conversely wipes out billions in potential future Social Security Disability Insurance (SSDI) program benefits for Baby Boomers.

While the Bipartisan Budget Act of 2015 has certainly granted much needed relief to nearly 15 million Medicare beneficiaries by lessening premium and deductible Part B increases, its approval has triggered an undesirable response to upcoming SSDI program changes.

Whether or not your clients will be negatively affected by the budget deal all comes down to one very important criterion: While the reforms within the budget deal are projected to save the SSDI program $168 billion over 75 years, seniors who rely upon implementing certain strategies to increase the amount they’ll get from SSDI will ultimately lose if they fail to rethink their retirement plans.

So, what are those strategies to disappear in just six short months and how can your clients get through this?

Saying “goodbye” to the “file and suspend” strategy

One strategy, commonly referred to as “file and suspend”, has meant an extra $10,000 to $60,000 in SSDI benefits for some married couples age 66 to 70. Under current law this strategy allows you to sign up for benefits at age 66, but not claim them. For four years those unclaimed benefits will grow at the rate of 8% per year through delayed retirement credits. In the meantime your spouse may immediately begin collecting half of your check starting at age 66. (Divorced persons may utilize the strategy if they were once married for 10 years and are currently single.)

Restricting a restricted claim of spousal benefits

Author of A Social Security Owner’s Manual, Jim Blankenship, believes divorced people “will be the big losers” due to the dismissal of the “restricted application” strategy. Under current law this strategy allows you or your spouse to file just for spousal benefits at Full Retirement Age and then let his or her own retirement benefits continue to grow.

The end to the lump sum

Senior policy analyst Web Phillips of the National Committee to Preserve Social Security and Medicare (NCPSSM) says the end of the lump sum SSDI benefits is another “good deal that goes away” in 2016.

Under current law if you are diagnosed with a terminal illness at age 68 you may collect a lump sum SSDI check for the benefits you had suspended over the past two years. Under the new law this would not be the case – you could certainly begin getting retirement checks immediately, but you sure wouldn’t get a check for those back payments.

What should senior couples do regarding the change?

  1. Take a close look at your potential benefits.
  2. Decide whether it makes sense to implement a file and suspend approach.

David Leland, a managing director of Merrill Lynch in Beverly, Massachusetts advises seniors to refrain from panicking. In the future spouses will have a choice of the larger of either their own benefit or the spousal benefit when applying for SSDI benefits. Any benefit they choose they “are stuck with”, said Leland.


While your clients may have already seen headlines disclosing relief to their Medicare Part B premium and deductible (to rise by 15% opposed to the projected 52%), it is important to inform them of the above information regarding the vanishing of strategies to SSDI benefits to come. Checking up on and reaching out to your current clients to share news of this political and economic reform could be a wonderful platform for you to display your appreciation for their business. By doing so you’re essentially dropping by to say, “Hey, Mrs. Smith! I thought of you when you read this and how it could affect your and Mr. Smith’s financials.”

A.K.A. “Hey, I really care about you!”


Want to keep up-to-date with more stories like these? Give Precision Senior Marketing's Facebook page a “Like”, follow us on Twitter and request to join our LinkedIn group, titled "Senior Insurance Agents", providing a central exchange for information among insurance agents. to stay informed! :)




Sources: www.californiahealthline.com, www.forbes.com

Additional Updates:

Tags: Medicare Part B, Social Security, Retirement Planning

Medicare Scare De-Fanged

Posted by Caroline Callahan on Fri, Oct 30, 2015 @ 10:55 AM


The Senate voted early Friday morning to approve a two-year budget deal intended to spook years of gridlock and frequent scares of government shutdowns.

President Barack Obama is expected to sign the agreement [pumpkin] patched by the White House and congressional leaders.

The Bipartisan Budget Act of 2015 extends the nation's debt limit through 2017 and mummifies spending levels through September of that year to keep things under wraps. It also lifts the spirits of ghostly spending caps set in place in 2011, providing for $80 billion in sequester relief.

The agreement includes long-term entitlement comebacks to the Social Security Disability Insurance (SSDI) program — the first major boo-merang to Social Security since 1983 — and frightens a spike in Medicare B premiums for millions of seniors.

Once signed, 15 million older Americans will face a Part B premium increase of roughly 17 percent opposed to the projected 52 percent, easing pain in the neck for beneficiaries.

It's all grave-y for “held harmless” Medicare beneficiaries, as they will not see an increase in their Medicare Part B premiums due to a provision of federal law that draws blood for premiums from Social Security benefits.

The Part B deductible, which covers costs if Medicare beneficiaries are coffin and need to see a doctor, will rise to $167 rather than the $223 proposed.

To cover the cost of moderating the Medicare Part B premium increase, the U.S. Treasury will lend money to the Medicare blood bank.

To repay the loan, beneficiaries will pay a premium surcharge of three bones each month over about five years until 2021.


On behalf of the PSM staff, we wish everyone a safe and happy Halloween filled with unlimited amounts of candy corn and other delicious treats. In the case that you over-indulge on sweets, have no fear: We've got the perfect dental and vision product for you with no waiting periods on all services!


Original sources:




Sources: www.nbcnews.com, www.washingtonpost.com

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Tags: Congress, Medicare Part B, Premium Increases

Federal Health Officials Bob-and-Weave to Prevent a Low Blow from Medicare Part B Premium Increases

Posted by Caroline Callahan on Thu, Oct 29, 2015 @ 03:22 PM


In hopes of a TKO in projected Medicare Part B premium increases for the coming year, congressional leaders and the White House have wrapped up their hands, thrown on their gloves, and forged a tentative budget agreement to go toe-to-toe with the pressing issue.

Under current law nearly 15 million Medicare beneficiaries, who do not collect Social Security and will be enrolling in Medicare’s Part B next year for the first time, either have incomes great enough that they are charged higher premiums, or are poor enough that they also qualify for Medicaid, are about to be sucker punched with an increase of more than 50 percent in their standard monthly Medicare Part B premiums.

If Congress throws in the towel at the main event and agrees on the tentative budget agreement, those 15 million older Americans will face a Part B premium increase of roughly 17 percent opposed to the projected 52 percent.

“Held harmless” Medicare beneficiaries will not see an increase in their Medicare Part B premiums due to a provision of federal law that links premiums to Social Security benefits.

Also, the Part B deductible, which affects all Medicare beneficiaries, will rise to $167 rather than the $223 proposed.

To cover the cost of moderating the Medicare Part B premium increase, the U.S. Treasury will lend money to the Medicare trust fund.

To repay the loan beneficiaries will pay a $3 premium surcharge each month over about five years until 2021.

On Tuesday AARP praised the agreement and urged Congress to adopt it rather than face the brawl.

We'll keep you up-to-date with coverage on Congress’s response to the open invitation.



Original source: https://www.washingtonpost.com/news/federal-eye/wp/2015/10/27/budget-deal-blunts-but-doesnt-erase-increase-in-medicare-premiums/


Source: www.washingtonpost.com

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Tags: Congress, Medicare Part B, Premium Increases

3 Reasons Why Senior Market Insurance Agents Should Be Utilizing Facebook

Posted by Caroline Callahan on Thu, Oct 22, 2015 @ 03:44 PM


Just recently, a research study conducted by Limelight Network, Inc. has concluded that Baby Boomers are spending more than 15 hours online per week, making them the majority power users online. With 55% of seniors on Facebook in 2014, implementing a Facebook marketing strategy should no longer be an afterthought for senior market insurance agents. Companies of all sizes from every industry have made the leap into Facebook and are actively planning strategic campaigns around their social activity, but senior market insurance agents have seemingly lagged behind.

Why is this?

Is it a lack of understanding about social media as a whole and how it integrates with marketing efforts?

Or, could it be somewhat of a fear of compliance with regulations set standard by CMS?

These obstacles should not stand in the way of building up Facebook marketing strategies, as they are all easily overcome. See, there's a lovely void of which YOU can take advantage: There aren't very many agents in the game and the bar for Facebook marketing strategy is set pretty darn low. With that in mind, let’s get into the three reasons why senior market insurance agents should be utilizing Facebook.

1) It helps you to better service and retain your existing clients

The rapid pace of consumer and technological change is like nothing seen before. Access to digital technologies has equipped consumers with the ability to research, read reviews, share recommendations and get instant answers to their inquiries. In turn, it’s caused much disruption to traditional insurance business models and has created quite a significant change in consumer expectations and behaviors.

Facebook is a great way to spread the word about the social, political and economic industry trends and changes. For example, there's plenty of misleading or confusing information on the Internet about Medicare - think about ways in which you can use your Facebook page to positively impact clients and the public to combat this. Be conscious of articles that may come across your eyes, such as those elaborating upon the rising Medicare Part B Premiums or the pressures mounting for Medicare drug benefits, and be sure to share your ideas upon them with your audience. The idea here is to limit self-promotional posts and instead focus on ways that help clients make sense of the abundance of product information, as your Facebook marketing strategy should not revolve around selling a product or a service.

2) It improves the overall client experience

To keep up-to-date with your clients and gain insight, use your Facebook as a way to inform, assist, and entertain them.

Engage with them. Show off your personality. Humanize your business as a senior market insurance agent. Respond to reviews and inquiries.

3) It will attract new clients

Apparently, Baby Boomers are spending more time online per week than we do sleeping each night. With that being said, it’s a no-brainer that Facebook can serve as a great way to reach prospective clients. Plus, as mentioned above, not many other senior market insurance agents have implemented their own Facebook marketing strategy.

Use Facebook as a platform to raise awareness to your business as a senior market insurance agent, or (if you have a personal website) to drive prospects toward landing pages so that you can nurture those leads into becoming clients. Your Facebook posts should be relevant, well-written and accompanied by media to grab your audience's attention. The sky is the limit here - Explaining the enrollment process through infographics, guiding them to video resources that may explain Medicare a little more in depth, etc.


No matter which segment your specialty lies within, whether it's Medicare Supplements, Medicare Advantage, Annuities or Final Expense, your Facebook marketing efforts will relay social proof that emphasizes your role as a highly-trusted, impartial advisor. When it comes down to it, this is what will get you shares, likes, retweets and favorites - in turn, landing you more referrals!

As the number of seniors on Facebook continues to evolve, more reasons for you to get started on your Facebook marketing strategy will come about. If it helps, you can always search around for other insurance agents on Facebook and get a sense for what they’re posting. Jot down some notes of what resonates with you versus what feels a bit off. After you get comfortable, you’re ready to create your Facebook page and start engaging with your clients on Facebook.

For ideas on what to post, or to stay up-to-date with industry trends and changes, be sure to like Precision Senior Marketing on Facebook! :)

Your senior market insurance business will flourish for years to come.



Source: www.linkedin.com

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Tags: Medicare, Insurance Marketing, Social Media Marketing

The Ultimate Annual Enrollment Period Check List

Posted by Caroline Callahan on Fri, Oct 16, 2015 @ 10:15 AM

The Ultimate AEP Checklist

With thousands of seniors RSVP’ing for AEP each day and nearly three months of non-stop shows this fall tour, Precision Senior Marketing wants to help get you ready to rock!

So, have you created the perfect set list to shake up your Medicare sales this AEP?

Take a peep at this ROCKIN' SlideShare, sharing all items ‪senior market‬ ‪insurance agents‬ need to take care of prior to their big show.

Best of luck this enrollment window and we look forward to offering you the products, training and resources to make your business a success. - The PSM Team



Source: www.slideshare.net

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Tags: Medicare Advantage, MAPD, PDP

Medicare Part B premiums to rise 52% for 7 million enrollees

Posted by www.psmbrokerage.com Admin on Fri, Oct 09, 2015 @ 08:22 AM

For seven in 10 Medicare beneficiaries 2016 will be much like 2015.

For seven in 10 Medicare beneficiaries 2016 will be much like 2015. They will pay $104.90 per month for their Medicare Part B premium just as they did in 2015.

But 2016 might not be anything like 2015 for some 30% of Medicare beneficiaries — roughly 7 million or so Americans. That’s because premiums for individuals could increase a jaw-dropping 52% to $159.30 per month ($318.60 for married couples). And for individuals whose incomes exceed certain thresholds, premiums could rise to anywhere from $223.00 per month up to $509.80 (or $446 to $1,019.60 for married couples), depending on their incomes.

What gives? Blame the “hold harmless” provision in the law that addresses cost-of-living adjustments (COLA) for Social Security benefits.

That law limits the dollar increase in the premium to the dollar increase in an individual’s Social Security benefit, according to a report by Alicia Munnell of the Center for Retirement Research at Boston College.

At the moment, the consumer price index (CPI) is not expected to increase in the period used to determine the COLA for 2016.

And that means it’s very likely that Social Security recipients — for just the third time since automatic adjustments were adopted in 1975 — will not receive an increase in their benefit next year, according to Munnell’s report.

No COLA means no increase in Medicare Part B premiums. Or at least that's the case for 70% of Medicare beneficiaries who are collecting Social Security and don’t pay an income-related higher Medicare Part B premium, says Mark Lumia, founder and CEO of True Wealth Group in Lady Lake, Fla., and author of Thinking Outside the Money Box.

As for the remaining 30% of beneficiaries, they have to cover the difference. “Under current law, Part B premiums for other beneficiaries must be raised enough to offset premiums forgone due to the hold harmless provision,” says Lumia.

Medicare Part B covers services such as lab tests, surgeries and doctor visits, and supplies such as wheelchairs and walkers that are considered medically necessary.

Who must pay the higher Medicare Part B premium? This group includes individuals who enroll in Part B for the first time in 2016; enrollees who do not receive a Social Security benefit; beneficiaries who are directly billed for their Part B premium; current enrollees who pay an income-related higher premium; and dual Medicare-Medicaid beneficiaries, whose full premiums are paid by state Medicaid programs, according to this year’s Medicare Trustee’s report.

What might you do or consider if you’re among those who have to pay the higher “not held harmless” Medicare Part B premium?

Individuals who enroll in Part B for the first time in 2016. “Enroll earlier if you’re already 65 and otherwise eligible,” says Michael Kitces, publisher of The Kitces Report and author of the Nerd's Eye View blog. “If you’re not eligible now, I’m afraid you’re stuck.”

Enrollees who do not receive a Social Security benefit. Those who are already on Medicare now, or could apply immediately, and who were going to start Social Security benefits in the next year or so might consider applying right now instead,  Kitces says.

“Those who file in the coming weeks should be able to get both Social Security benefits and Medicare in November and December, which are the two months used for measuring, and therefore make themselves eligible,” he says.

If you are among those who are currently considering different Social Security claiming strategies — such as file-and-suspend, restricted application and delay to age 70 — there’s no getting around it. You’ll have to do cost-benefit analysis to determine if the benefit of the strategy is greater than the cost of the increased Medicare Part B premium.

In the long run, though, Kitces says those who anticipate living a long time and who will benefit from delaying Social Security by several years should still delay. “The value of delaying Social Security is far more beneficial than the squeeze from hold harmless,” he says. Read Social Security And Medicare Claiming Strategies To Navigate The Looming 52% Medicare Part B Premium Spike and How The Medicare “Hold Harmless” Rules May Spike Part B Premiums By 52% In 2016.

Beneficiaries who are directly billed for their Part B premium. If you’re already getting Social Security benefits, request to have your Part B premium deducted from your Social Security check ASAP, and you should still have time to be eligible for hold harmless, says Kitces.

Current enrollees who pay an income-related higher premium. “It is critically important for folks to review the Social Security notice of 2016 Medicare B premiums that will be in mailboxes later this fall,” says Katy Votava, president of Goodcare.com in Rochester, N.Y. “It's not uncommon for people to qualify for a decrease because their income drops to a lower bracket as a result of specific life changing events.” The problem, says Votava, is that Social Security doesn't know about those life changing events unless the person notifies the agency.

For those whose incomes are still above the thresholds: “Unfortunately you’re stuck here,” says Kitces. The Income-Related Medicare Adjustment Amount (IRMAA) was already locked in based on 2014 income. “If possible, get your 2015 income below the line, so that at least if hold harmless kicks in again ... you can benefit slightly from the second time it flows through,” says Kitces.

Dual Medicare-Medicaid beneficiaries, whose full premiums are paid by state Medicaid programs. “Since your Medicare premiums are being paid by the state at this point, it doesn’t effectively matter whether hold harmless applies for you or not, as to the extent higher premiums occur, they will be paid by the state anyway,” says Kitces. “Not surprisingly, I believe there are some states who are not so happy about this.”

Back to normal. It’s also worth noting that in a few years, says Kitces, that when CPI presumably does increase again and Social Security benefits rise, the excess premiums on the 30% essentially unwind themselves.

“That’s why Medicare premiums dropped in 2013, after being up in 2011 and 2012 the last time this hold harmless scenario played out,” he says. “Which means, again, if you weren’t going to start Social Security and/or Medicare for several years anyway, this is a non-issue. It’s just those who would have started both, and soon, who may wish to accelerate claiming to try to get in under the wire.”

Robert Powell is editor of Retirement Weekly, contributes regularly to USA TODAY, The Wall Street Journal and MarketWatch. Got questions about money? Email Bob at rpowell@allthingsretirement.com.


Source: www.usatoday.com

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Tags: Medicare Part B, Medicare, Premium Increases

Pressures Mounting for Medicare Drug Benefit, Market for Medicare Advantage Plans Appears Stable in 2016

Posted by www.psmbrokerage.com Admin on Fri, Oct 02, 2015 @ 08:17 AM

Many beneficiaries are likely to see their Part D premiums increase significantly, with enrollment-weighted premiums projected to increase by an average of 8 percent among the top 10 PDPs that account for more than 80 percent of PDP enrollment. Indeed, within the top 10 plans, five will have double digit premium increases in 2016, as shown in Figure 1. Overall, assuming Part D enrollees elect to remain in their current plan, the average monthly premium for all PDPs will increase by as much as 6 percent, from $38.83 projected in 2015 to $41.34 projected in 2016. 

Since 2010, the final average Part D premium has remained remarkably consistent, with limited fluctuations from year to year. The projected premium increase would return premium growth to levels not seen since before the “patent cliff” began in 2011, when several high-cost drugs lost their patents. The 2016 Part D premiums also mark the first time average premiums exceed $40.

Premium Increases by PDP

The number of PDPs available in 2016 will shrink for the second straight year. In 2016, 886 PDPs will be offered in the U.S., an 11.5 percent drop from 2015. Despite these decreases, beneficiaries in most states will still have 25 or more PDPs to choose from in 2016. Of particular concern to policymakers, the number of $0 premium plans available to poor beneficiaries that receive the low-income subsidy (LIS) will decline. Specifically, the number of LIS $0 premium plans has declined by 32 percent since 2013. 

“Medicare beneficiaries should carefully review their prescription drug plan options in 2016 to make sure they choose a plan that is right for them,” said Colin Shannon, senior manager at Avalere Health. “With many plans taking large premium increases in 2016, those beneficiaries that choose not to change plans will likely pay more in premiums than if they look for lower cost options.”

Availability of $0 premium MA plans is increasing, though drug benefits may decrease among MA-Prescription Drug plans

A larger percentage of Medicare beneficiaries will have access to $0 premium MA prescription drug (MA-PD) plans in 2016.  Eighty-one percent of beneficiaries will have access to a $0 premium plan in 2016 compared to 78 percent in 2015, further demonstrating the competitiveness of the MA program compared to Medicare Fee-for-Service. As shown in Figure 2, the availably of $0 premium plans varies by geography.   

Figure 2. Availability of $0 Premium MA-PD Plans

CMS estimates that the average MA premium will decrease by 1 percent ($0.31) to $32.60. The total number of MA plan options, excluding special needs plans (SNPs), will increase by 3 percent to 1,894 in 2016.

Local health maintenance organization (HMO) plans continue to make up the majority of MA plans – 70 percent – in 2016, increasing 6 percent in 2016. Other plan types, including preferred provider organizations (PPOs), are largely stable from 2015 to 2016. Similarly, SNP offerings, which serve beneficiaries who have Medicaid, certain chronic conditions, or are institutionalized, are stable.

The drug benefits available to MA enrollees may be less generous in 2016 as plans increase deductibles and roll back coverage for drugs in the “donut hole.” Next year, the percent of plans that offer a $0 deductible will decline to 55 percent from 63 percent, and the percent of plans offering additional coverage in the “donut hole” will decrease to 51 percent.  Plans could be reducing the amount of these supplemental Part D benefits in order to maintain an overall zero premium.  

“These numbers suggest the Medicare Advantage market is strong, despite payment pressures,” said Tom Kornfield, vice president at Avalere Health. “Looking ahead, it will be important to watch if Medicare Advantage enrollment increases more rapidly going into 2016 given the continued availability of zero premium products and the increased number of plans in the marketplace.”  


On September 21, the Centers for Medicare & Medicaid Services (CMS) released the 2016 Medicare Advantage (MA) and Medicare Part D landscape files. Avalere analyzed the data to assess trends in plan participation, beneficiary premiums, and benefit designs for the 2016 MA and Part D markets. Avalere analyzes information for unique plan options offered within each market. Avalere excludes information on Cost plans, Medicare-Medicaid plans, and plans offered in the U.S. territories from its analysis. CMS does not include information on employer-group waiver plans, Program of All-Inclusive Care for the Elderly (PACE) plans, or Part B-only plans in the landscape files.


Source: www.avalere.com

Additional Updates:

Tags: Medicare Advantage, Medicare, Part D

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