The Medicare Advantage Program in 2014. Since the Affordable Care Act: Medicare Advantage Plan Availability Remains High

04/07/2014

Table 2 shows that MA plan availability has been stable since the enactment of the Affordable Care Act, with most Medicare beneficiaries having access to at least one MA plan. Plan participation continues to be robust, with nearly all (99.1 percent)27 of beneficiaries having access to an MA plan in their area in 2014. Additionally, the number of plan choices has remained stable since the transition to FFS-based rates began in 2012. The average beneficiary can choose from among 10 plans (based on unweighted data, or 17 plans if the data are weighted by the number of Medicare eligible in a given county), including plans from a wide number of MA organizations – a number which has generally held steady for the past 4 years, during the transition to FFS payment levels. Additionally, over 80 percent of Medicare beneficiaries have access to a $0 premium MA plan.

Table 2

Percent of Beneficiaries with Access to Medicare Advantage Plans By Type, 2011-2014 (1)

Type of Plan 2011 2012 2013 2014
All Plan Types 99.7% 99.7% 99.6% 99.1%
 
Local Coordinated Care Plan (CCP) 92.3% 92.9% 95.0% 95.0%
Regional Preferred Provider Organization (PPO) 86.0% 75.8% 70.5%

70.5%

Private Fee-For-Service (PFFS) 63.3% 61.2% 59.1% 51.5%
 
Zero-Premium Plans With Drugs 89.8% 87.6% 85.9% 84.2%
Average Number of Plan Choices (unweighted) (2) 12 12 12 10
Average Number of Plan Choices (weighted) (3) 20 19 19 17

(1) These figures exclude special needs plans and employer-only plans. A zero premium plan with drugs includes Part D coverage and has no premium beyond the Part B premium. Regional PPOs were created in 2006. Part D began in 2006.

(2) The unweighted averages are consistent with the MedPAC 2014 Report to the Congress.

(3) For the weighted averages, the data on the number of plan choices have been weighted based on the number of Medicare eligibles in a given county.

Sources: Centers for Medicare & Medicaid Services; Medicare Payment Advisory Commission (MedPAC), March 2014 Report to the Congress; Centers for Medicare & Medicaid Services


Some Medicare Advantage plans participate in more geographic areas than others. Plans from the top 2 insurers are available to 83 percent and 73 percent of beneficiaries.28

27 Centers for Medicare & Medicaid Services, “More, higher quality options for seniors in Medicare Advantage,” Press Release, September 19, 2013, accessed at http://www.hhs.gov/news/press/2013pres/09/20130919b.html.

28 Mathematica Policy Research and Kaiser Family Foundation, “Medicare Advantage 2014 Spotlight: Benefits and Premiums,” December 2014.

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