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In recent years, Medicare Advantage enrollment has been on the rise while the number of people covered under Original Medicare has declined. Many Medicare beneficiaries are opting to get their benefits from private insurers that contract with Medicare to provide all-in-one plans. But just how many seniors are switching over to Medicare Advantage compared to staying in traditional fee-for-service Medicare?
Medicare is the federal health insurance program for Americans aged 65 and older. Original Medicare includes Part A for hospital coverage and Part B for medical insurance. Medicare Advantage, also called Part C, provides an alternate way to receive your Medicare benefits through private plans.
In 2023, 29.5 million Americans are projected to be enrolled in Medicare Advantage Plans, while only around 18 million will have Original Medicare.
This represents a continuing trend of increasing Medicare Advantage enrollment. Since 2018, Medicare Advantage enrollment has increased by over 14 million people.
Over the past decade, the share of Medicare beneficiaries in Medicare Advantage Plans has grown from 30% in 2013 to an estimated 64% in 2023.
In 2022, over 27 million Medicare beneficiaries were enrolled in Medicare Advantage Plans, compared to around 19 million in Original Medicare.
What's behind this major shift from Original Medicare to Medicare Advantage?
Medicare Advantage Plans may often have lower out-of-pocket costs in the form of reduced or $0 premiums, copays, and deductibles.
Many plans offer additional benefits to Medicare beneficiaries enrolled not covered by Medicare like vision, dental, hearing and wellness programs.
The convenience of having medical, hospital, and prescription drug coverage combined in one plan appeals to beneficiaries.
Pros
Lower premiums and out-of-pocket costs
Extra benefits not offered by Medicare
One plan for all coverage
Cons
Limited provider network
Prior authorizations required
Changes each year to plan benefits
Medicare Advantage Plans are a great option for enrollees who:
Have chronic health conditions and take several medications
Qualify for plans that have $0 premiums
Don't mind network restrictions to access lower costs
Travel frequently within the United States
Certain enrollees may be better off staying in Original Medicare, such as:
Those who want the freedom to see any provider or specialist without referrals
People who travel internationally and want worldwide emergency coverage
Beneficiaries who qualify for Medigap policies that supplement Medicare
The number of Medicare beneficiaries who have switched from Original Medicare to Medicare Advantage Plans has skyrocketed over the past decade. Attractive benefits and lower out-of-pocket costs continue to motivate many seniors to make the switch during open enrollment periods. But Medicare Advantage isn't the right choice for everyone. Understanding the pros and cons can help you decide whether or not to join the millions making the change.
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Bourgeois Insurance a Call at (985) 803-8999. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
A: Around 27% of all Medicare beneficiaries (over 12 million people) are enrolled in Medicare Advantage Plans.
Traditional Medicare is administered directly by the government and includes Parts A, B & D. Medicare Advantage is provided by private insurers under contract with Medicare as an alternative "bundled" option.
Yes, beneficiaries can switch plans during the Annual Election Period each fall or qualify for special enrollment periods under certain circumstances.
Roughly 73% of all Medicare beneficiaries (over 32 million people) have Traditional Medicare rather than a Medicare Advantage Plan.
Plan costs, availability of providers, health status changes and satisfaction with services can all impact switching behavior between Traditional Medicare and Medicare Advantage.
The Centers for Medicare & Medicaid Services (CMS), under the Department of Health and Human Services (HHS), oversees both Medicare and Medicaid programs.
Yes - studies show switch rates from Medicare Advantage back to Traditional Medicare are higher than switching from Traditional to Medicare Advantage.
Medicare Advantage Plans must cover all benefits available under Medicare Part A and Part B. Many plans also include additional benefits and lower or no premiums.
Approximately 15-20% of all Medicare and Medicare Advantage beneficiaries are dually eligible for both Medicare and Medicaid benefits.
Medicare enrollment has grown substantially since the Medicare Modernization Act of 2003 and now represents a significantly larger share of total Medicare beneficiaries compared to past years.
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Plans are insured or covered by Medicare Advantage (HMO, PPO, and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan in your area. Please contact medicare.gov or 1-800-Medicare to get information on all your options.
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