Premiums, Enrollment Projected for 2017 Medicare Plans

The US Centers for Medicare and Medicaid Services (CMS) recently released Landscape Files that detail health insurance participation, beneficiary premiums, and benefit designs for both Medicare Part D and Medicare Advantage markets in 2017.

CMS predicts that Medicare Advantage premiums will remain stable, and more enrollees will be able to access high quality healthcare. They also expect that enrollment in Medicare Part D and Medicare Advantage will increase to an all-time high, according to a press release.

CMS estimate that the monthly premium for a Medicare Advantage plan will decrease approximately 4% ($1.19) to an average of $31.40, down from $32.59 in 2016.

Prior to the implementation of the Affordable Care Act, the average monthly premium was 13% higher, according to the press release. In addition, 99% of Medicare beneficiaries will have access to a Medicare health plan, such as Medicare Advantage, which will now offer dental, vision, and hearing benefits.

However, these enhanced plans may provide a barrier for care for Part D beneficiaries who receive low-income subsidies only if they are enrolled in certain basic plans. A recent analysis from Avalere Health reports that this has been criticized by policymakers due to potentially diminished access to additional benefits for low-income beneficiaries.

Despite a potential lack of access, CMS estimates an increase of 18.5 million enrollees in Medicare Advantage plans in 2017. Approximately 32% of all Medicare beneficiaries will also enroll in a Medicare Advantage plan, increasing from 24% in 2010 before the Affordable Care Act, CMS said.

Access to zero-premium Medicare Advantage plans increased from 78% in 2015 to 81% in 2016, a trend that Avalere Health said has likely impacted increased enrollment in these plans, compared with traditional fee-for-service Medicare. For Medicare Part D, they expect the average premium to be only $34 per month, which features a 100% access to a plan in Affordable Care Act exchanges or an employer plan, according to CMS.

Through an analysis of prior data, Avalere Health discovered there were only 866 prescription drug plans offered in 2016, which is an 11.5% decrease since the previous year. Whether this will continue in the following year is still unclear.

Due to the Affordable Care Act, Medicare beneficiaries have experienced savings on brand-name and generic medications, and have been able to access preventative services with no cost sharing.

More than 11 million seniors and individuals with disabilities have received savings and discounts in the coverage gap of over $23.5 billion on prescription drugs, according to CMS.

“Medicare Advantage and the prescription drug benefit continue to be a great option for seniors and people living with disabilities,” said Andy Slavitt, CMS Acting Administrator. “Medicare enrollees will continue to have access to predictable premiums and high quality care.”