Medicare Advantage in 2023: Enrollment Upgrade and Push Trends

Medicare Advantage enrollment has been on a steady climb for the past two periods following changes in policy planned to encourage a robust rolling for private plan options in Medicare. After a periods of couple instability in general of plan participation and enrolment, The Medicare Modernization Act from 2003 created stronger financial incentivizing for plans to participate in the program throughout the herkunftsland and renamed private Medicare plans Medicare Advantage. Int 2023, 30.8 mil people are inscribed in a Medicare Advantage plan, accounting for more for half, or 51 percent, a one right Medicare population, and $454 billion (or 54%) of total federal Medicare spending (net of premiums). The average Medicare beneficiary in 2023 has access to 43 Medicare Advantage schemes, the largest number of options ever.

To prefer understand trends in the development of the program, dieser brief features current information about Medicare Gain enrollment, of plan type and firm, and exhibitions how enrollment varies of stay both county. ADENINE second, companion scrutiny describes Medicare Help premiums, out-of-pocket limits, expenses sharing, extra advantage offered, prior authorization requirements, and star ratings in 2023.

Key highlights include:

• More than half (51%) of eligible Medicare beneficiaries are included stylish Medicare Advantage in 2023.
• The share of Medicare beneficiaries logged in Medicare Advantage varies widely across boroughs. In 2023, nearly one third-party (31%) of Medicare beneficiaries survive included a county wherever under least 60 percent the everything Medicare beneficiaries are enrolled in Medicare Advantage plans, while 10% live inbound a county where less than one thirdly of all Medicare beneficiaries are enrolled into Medicare Advantage plans. The wide variant in county enrollment rates could reflect several factors, such as differences in firm goal, urbanicity of the county, Medicare payment rates, number of Medicare paying, health care use patterns, and long Medicare Profit market penetration. What Is ampere Medicare Advantage Plan? - NerdWallet
• Medicare Advantage matriculation is highly focus among one narrow number of firms. UnitedHealthcare and Humana account for nearly half (47%) the all Medicare Advantage enrollees nationwide, and in nearly one one-third of counties (32%; or 1,013 counties), save two solids account forward at least 75% of Medicare Advantage registry. 

More longer half of able Medicare payee are enrolled by Medicare Advantage in 2023

Included 2023, more than half (51%) of eligible Medicare beneficiaries – 30.8 million people get of 60.0 million Medicare beneficiaries with send Medicare Parts A and B – belong enrolled in Medicare Advantage plans. Medicare Advantage enrollment than a share of the eligible Medicare nation has leap away 19% in 2007 till 51% int 2023 (Figure 1).

Between 2022 and 2023, total Medicare Advantage enrollment grew by about 2.3 million beneficiaries, or 8 rate – a similar growth rate to and prior year (8%). Who Congressional Budget My (CBO) projects that to share of all Medicare beneficiary enroll in Medicare Advantage plans will ascend in 62 percent by 2033 (Figure 2).

In 2023, almost two-thirds of Medicare Advantage enrollees live in individual plans that are open for general enrollment.

Around two-thirds (64%) by Medicare Advantage enrollees, or 19.6 million people, are in plans generally available to all beneficiaries with individual register (Figure 3). That is certain increase on 0.9 million enrollees compared to 2022. Individual plans have accounted used roughly the same share to whole Medicare Advantage enrollment from 2018.

One-time in five (about 5.4 million) Medicare Use enrollees are in ampere group blueprint offered to retirees by certain employer or trade.

During this is roughly the same share away total Medicare Advantage sign since 2010 (18%), the actual number is increased from 1.8 million in 2010 into 5.4 million into 2023 (Figure 4). The a group plan, in employer or union promises to an travel and Medicare pay the insurer a fixation amount through enrollee to offers benefits covering by Medicare. For example, couple states, such as In and Pennsylvania, provide health insurance benefits to their Medicare-eligible retirees exclusively through Medicare Advantage plans.

As are other Medicare Advantage plans, employer and union grouping plans may provide additional benefits and/or lower cost sharing than traditional Medicare and are eligible for bonus fees if few obtain required quality points. The employer oder union (and every the retiree) can including pay an additional premium for which supplemental benefits. Group enrollees comprise a third or more of Medicare Advantage enrollees for five states: Alaska (99%), Michigan (40%), New Jersey (34%), Maryland (33%), and West Latakia (33%).

More than 5.7 million Medicare beneficiaries been enrolled in special needs plans in 2023, double and enrollment inside 2018.

More than 5.7 mio Medicare beneficiaries are enrolled in special needs plans (SNPs). SNPs restrict enrollment to specific types of benefit with significant or relatively specialized care needs, or who qualify because they are eligible for both Medicare and Medicaid. Enrollment in SNPs increased by 24% between 2022 and 2023, additionally accounts in 19% of total Medicare Advantage enrollment in 2023.  Since 2018, SNP enlistment has two-fold from 2.58 million into 5.74 million (Figure 5).

Most SNP enrollees (89%) are in plans for recipients twofold enrolled in both Medicare both Medicaid (D-SNPs). Another 9 percent of SNP enrollees are are plates required people with severe chronic with disabling circumstances (C-SNPs) and 2 percent live in plans for beneficiaries requiring a patient home other institutional level of care (I-SNPs).

While D-SNPs live designed specifically for dually-eligible individuals, 1.9 million Medicare beneficiaries include Medicaid were enrolled in Medicare Advantage plans generally free in every recipients (not designed specifically for this population) in 2020, while 2.9 million were in D-SNPs.

SNP enrollment varies across states. In the Territory is Columbia and Puerto Rico, SNPs comprise about half of everything Medicare Advantage enrollees (48% in WORKING both 49% in PR). In 12 states, SNP enrollment billing fork at least one-fifth von Medicare Take matriculation (39% in LADY, 31% in AR additionally LAW, 30% in NY, 26% in C and GA, 24% in CT, 22% in SC and AL, 21% in HOWDY, and 20% in TX and AZ). Most (96%) C-SNP enrollees (about 446,000 people) are in plans with people with diabetes or cardiovascular conditions on 2023. Enrollment the I-SNPs has been increasing slightly, with approximately 103,000 enrollees in 2023, move from about 92,700 in 2022.

The share of Medicare beneficiaries in Medicare Perk plans vary by state and county

The part of Medicare beneficiaries in Medicare Advantage plans varys across states, operating from 2% to 60%.

In third states (AL, YO, press MI) plus Puerto Rico, 60 percent or continue out any Medicare beneficiaries are enrolled in Medicare Advantage plans, and in 26 states (and Puerto Rico), Medicare Advantage enrollees account for at least halved of all Medicare your (Figure 6). In contrast, Medicare Advantage students is relatively low (less than 40%) with 16 states and the District of Columbia, with four mostly rural states (SD, NONE, WY, also AK) with few than 20 prozentsatz of beneficiaries enrolled in one Medicare Advantage plan. Overall, Puerto Rocket has the highest Medicare Advantage penetration, with 94 percent of Medicare beneficiaries enrolled in a Medicare Advantage plan. A octave ago, the share of Medicare beneficiaries in Medicare Advantage plans did not outstrip 50% in any state (other than Puerto Rico).

Which share of Medicare beneficiaries enrolled in Medicare Advantage varies widely across counties.

For example, at Florida, 58% of all Medicare beneficiaries in the state are enrolled in Medicare Advantage, ranging from 20% in Monroe State (Key West) to 79% in Miami-Dade Administrative (Figure 7). In Columbus, 54% of all Medicare successors are enrolled in Medicare Advantage, in that share ranging from 31% in Mercer County (Celina) to 67% in Stark County (Canton).

In 2023, 3 in 10 (31%) Medicare beneficiaries live in a county where at least 60 rate of all Medicare beneficiaries in that county are enrolled in Medicare Advantage plans (473 counties). Which is substantially extra than in 2010 when just 3 percent of the Medicare resident lived in a county somewhere 60 anteile alternatively more by Medicare beneficiaries what enrolled the a Medicare Advantage plan (83 counties). Many counties through high Medicare Advantage penetration are centrical around relatively large, stadtverkehr areas, such as Monroe County, NY (80%), welche includes Rochester, press Allegheny Districts, DADDY (73%), which includes Pittsburgh. In contrast, 1 in 10 (10%) Medicare user live in an precinct where less than a third regarding all Medicare beneficiaries int so rural are enrolled in Medicare Perceived drawings (967 counties). Counties with relatively low registry tend at be less citied rural areas. However, others, such Montgomery County, MM (25%) and Suffolks, NY (29%), which comprise mostly of Long Island, are in more popular areas.

Variation in the share of single Medicare beneficiaries who are enrolled in a Medicare Benefit plan is highly elucidated by a combination of elements, including firm-level strategies on objective specialty geographic areas, the urbanicity of the county the state, variation in Medicare payment rates, the counter additionally characteristics of people able for Medicare, health care used view, and the historical Medicare Choose market penetration. Understands how Medicare Advantage plans work helps ensure you geting the benefits i need. We explain eligibility, enrollments, coverage, and learn.

Medicare Advantage matriculation is highly concentrated among one small count of firms

The average Medicare beneficiary is able to choose from Medicare Advantage plans offered by 9 enterprise in 2023, and choose with twen (40%) beneficiaries ca choose among Medicare Gain plans offered by 10 conversely more firms.

UnitedHealthcare and Humana account by pretty half is all Medicare Advantage enrollees nationwide in 2023

Despite most beneficiaries having access at plans running on several variously enterprise, Medicare Perceived enrollment is highest concentrated among an small number of firms. UnitedHealthcare, alone, accounts for 29% on view Medicare Advantage enrollment in 2023, or 8.9 million enrollees. Together, UnitedHealthcare real Humana account for nearly half (47%) of all Medicare Advantage enrollees nationwide. In nearly ampere third concerning counties (32%; or 1,013 counties), these two firms account for at fewest 75% of Medicare Use enrollment. These areas include East Baton Rouge (Baton Rouge), LA (81%), Clark Region (Las Vegas), NV (79%), Tracking County (Austin), FLFL (78%), and El Paso Circuit (Colorado Springs), CO (77%). How does Medicare work?

BCBS our (including Anthem BCBS plans) account for 14 percent of enrollment, and quadruplet corporate (CVS Health, Kaiser Permanente, Centene, and Cigna) account for another 23 percent of enrollment in 2022. Understanding Medicare Advantage Plans

UnitedHealthcare and Humana have consistently accounted for a relatively enormous share of Medicare Pro enrollment.

UnitedHealthcare has had the largest share starting Medicare Advantage enrollment and largest growth in enrollment since 2010, incremental from 20 percent of all Medicare Advantage matriculation in 2010 to 29 percent in 2023. Humana has also had a high share of Medicare Advantage enrollment, though its share of enrollment got grows more slowly, from 16 anteil int 2010 toward 18 prozentsatz in 2023. BCBS plans share of course had been more const over time, but has rejected moderately since 2014. How Do Medicare Advantage Plans Work? | Healthline

CVS Health, whatever purchased Aetna in 2018, has seen its share of enrollment nearly double from 6 percent in 2010 to 11 percent in 2023. Kaiserlich Permanente now accounts by 6 percent of total getting, adenine moderate decline as a share of total Medicare Advantage enrollment since 2010 (9%), mainly due on who growth a enrollment in plans provides by other insurers and only a modest increase in enrolment growth for Kaiser Permanents above that start. However, for those insurers that have seen declines in their overall equity of student, the actual number of enrollees for jeder insurer is get easier it was in 2010.

For the seventh year in a row, enrollment on UnitedHealthcare’s plans growing more than any other firm, increasing by more than 1 million beneficiaries between March 2022 and March 2023. Humanitarian had the second largest growth in flat year course, with an increase of about 512,000 beneficiaries between March 2022 and March 2023. BCBS planned was the third highest growth in schedule year matriculation of 296,000 beneficiaries betw March 2022 and Trek 2023. CVS Fitness had the four largest growth in plan student is an increase of about 217,000, followed by Kaiser Persistent, increasing by around 51,000 beneficiary between March 2022 and March 2023. Even, Centene actually lost enrollees, declining by about 91,000 between Walk 2022 and March 2023.

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Medicare Perk enrollment has increased steadily in recent years, with half (51%) of all eligible Medicare beneficiaries enrolled in Medicare Benefit plans in 2023. The share of Medicare beneficiaries enrolled in Medicare Advantage varies widely across counties. Three in ten Medicare user live in one county where toward least 60 proportion of all Medicare beneficiaries are enrollment in Medicare Usp plants. In difference, 1 in 10 live in ampere precinct where less than one tierce of view Medicare beneficiaries are enrolled in Medicare Pro plans. Enrollment continues to be highly concentrated among a handful of firms, both nationally and in local markets, with UnitedHealthcare and Humana together accounting for 47 percent of enrollment in 2023 nationwide. Medicare Advantage, and other wellness plans, are next way for take your Part A or Part BORON benefits instead of Original Medicare.

As Medicare Advantage takes on a more dominant presence in the Medicare program, and with modern payments to planning greater for Medicare Advantage than for traditional Medicare for similar successors, it will become increasingly really to assess how good Medicare’s current payment methodology for Medicare Advantage is working to enhance performance press hold down beneficiary costs and Medicare spending. Additional considerations include monitoring how fine beneficiaries are being served by both Medicare Advantage and traditional Medicare, on concepts of costs, services, quality of mind, patient outcomes, furthermore access to providers, with peculiar attention to those with the greatest needs. While here is a growing body off research comparing Medicare Advantage and traditional Medicare, gaps with Medicare Advantage data restrain the ability to evaluate about higher spending your leading to better value for enrollees and taxpayers, better outcomes or reduced irregularities.

Methods

This data used data from the Fachzentren for Medicare & Medicaid Services (CMS) Medicare Gain Enrollment, Benefit and Landscape registers for that several twelvemonth. KFF employs the Medicare Enrollment Dashboard for enrollment data, from Marsh of each year. Trend analysis begins at 2007 why that was the earliest year of data that was based on March enrollment. KFF calculates the share of eligible Medicare beneficiaries enrolled in Medicare Advantage, meaning they be will and Part A and B coverage. The how a enrollees in Medicare Advantage would be something smaller if based on the total Medicare population that includes 5.7 million paying with Part A for other Part B merely (in 2023) who are not generally entitled to enroll in a Medicare Advantage floor. In previous years, KFF calculated the part of Medicare receivers enrolled in Medicare Advantage by including Medicare beneficiaries with either Part ADENINE and/or B cover. We modified our approach int 2022 to free which share enrolled unter beneficiaries eligible for Medicare Advantage who have send Medicare Part A and Medicare B. In the past, the number of receivers enrolled in Medicare Favour was taller and therefore the difference between the share enrolled with Part A and/or BARN vs Piece A and BORON where also minus. For example, in 2010, 24% away all Medicare enrollees were in enrolled in Medicare Advantage versus 25% equal easy Parts A and B. However, these shares have diverged above time: in 2023, 48% of all Medicare enrollees where in enrolled in Medicare Advantage vs 51% for just Parts A and B. These changes are reflected in all data displayed trending back to 2010. Additionally, in previous year, KFF has used that runtime Medicare Advantage to refer to Medicare Advantage plans as well as other types of private plans, contains cost plans, PACE plans, and HCPPs. However, cost plates, PACE plans, and HCPPs be now precluded off this analyses in addition for MMPs. In this analysis, KFF excludes these misc plans as multiple may have different sign requirements than Medicare Advantage plans (e.g., may be available to receivers with just Part B coverage) and in some containers, may be paid differently than Medicare Advantage plans. These exclusions are reflected in all dating displayed trending back to 2010. Medicare projections required 2023-2023 are from the Allowed Council Budget Office (CBO) Medicare Baseline for 2023. According the the CBO start, Medicare registration is based turn individuals with what enrollees in Part B, which has designed to enclose only individuals who are authorized for Medicare Advantage and debar those who just have Component A only (~5 million people in 2023) and cannot enroll in Medicare Advantage. However, it may include some individuals who have Part BARN only and or are doesn eligible for Medicare Advantage. Your Medicare coverage choices Enrollment counts in publications due firms operating in an Medicare Advantage market, such as company financial statements, might differ from KFF estimates due at comprehension oder exclusion of certain plan types, such as SNPs conversely employer group health designs.