Part C or Medicare Advantage plans are offered by private companies that have been granted permission by Medicare. The latter reimburses these private insurance providers for covering Medicare costs.
When you enroll in a Medicare Advantage Plan, you will no longer need to worry about Medicare Parts A and B separately. New data shows that more than 28.5 million people are enrolled in Medicare Advantage plans. When compared to the same period last year, that’s an increase of around 9%.
There are currently over 63 million people registered in Medicare, and more than 40 percent of them are enrolled in an MA plan.
A Growing Trend
The number of enrollments in MA has been steadily rising. Between 2011 and 2020, that number more than doubled. More than half of all Medicare recipients are projected to be participants by 2026.
That said, Medicare Advantage is becoming increasingly popular among seniors because it offers higher-quality benefits at reduced costs.
Private insurance companies run Medicare Advantage programs under contract with the federal government. Most packages include not just inpatient but also outpatient and pharmaceutical benefits.
Each Medicare Advantage enrollee in 2019 cost the government an extra $321. The government might have saved $7 billion, or less than 1% of total Medicare spending, if all Advantage enrollees had instead been enrolled in regular Medicare.
The additional expenditures, in other words, barely register on the government budget. Medicare paid out $25 billion in “improper payments” in the fiscal year 2019–2020, including amounts for fraudulent claims and those with insufficient supporting paperwork.
Medicare Advantage enrollees, meanwhile, reap enormous benefits for only a small additional expense.
When comparing Advantage plans, keep in mind that most of them include coverage for things like vision, hearing, and dental care that aren’t included in the basic Medicare plan. In reality, vision care is covered in some capacity by 99 percent of Medicare Advantage plans. Hearing tests and aids are paid for by 97% of employers, while dental care is provided by 94%.
A Small Peek into the Numbers
One in five people on standard Medicare must come up with the money to cover these costs. One-third of seniors with regular Medicare also purchase Medigap coverage, which can increase annual premium costs for these individuals by as much as $3,600.
That’s on top of the roughly $5,000 in annual premiums and out-of-pocket expenses that come with original Medicare.
Meanwhile, the annual premiums for Medicare Advantage plans for seniors are often under $3,400.
Patients enrolled in MA programs typically do better than their conventional Medicare-covered counterparts. The recipients are more likely to receive preventative care and have fewer hospitalizations and emergency department visits, according to a Health Affairs meta-analysis of nearly 50 studies.
They are also more likely to be vaccinated against pneumonia and undergo testing for depression. And the Better Medicare Alliance found that among seniors with “complex chronic conditions,” MA enrollees were 57% less likely to incur an unnecessary, short-term hospitalization.
One possible explanation is that Medicare Advantage insurance is a for-profit industry. Since they are mandated to compete with one another and keep their pricing below a federal standard, insurers have the incentive to deliver the best coverage to their beneficiaries at the lowest cost. In the long run, it prevents health issues that are much more serious in nature.
As a result of these market forces, Advantage plans have steadily improved over time. One to five “stars” are assigned to each plan based on how satisfied participants and beneficiaries are with that particular plan. More than 70 received a “five-star” rating this year, nearly four times as many as in 2021.
Conclusion
Medicare Advantage plans have become increasingly popular among seniors due to their higher-quality benefits at reduced costs. Private insurance companies run Medicare Advantage programs under contract with the federal government, and most packages include not just inpatient but also outpatient and pharmaceutical benefits. Enrollees in Medicare Advantage plans are more likely to receive preventative care, have fewer hospitalizations and emergency department visits, be vaccinated against pneumonia, and undergo testing for depression.
Overall, Medicare Advantage reduces healthcare expenditures without compromising quality, and it is no wonder that ninety-eight percent of Medicare recipients are content with their plans.
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