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Medicare Open Enrollment is Here:
Time for Members to Consider Their Options

It’s open enrollment season for Medicare plans—the one time of year when Medicare-eligible individuals can make changes to their coverage. Between now and December 7, 2019, seniors can make the switch from original Medicare to Medicare Advantage, or choose a new Medicare Advantage or Prescription Drug (Part D) Plan. In this blog, we’ve compiled some information that may be helpful for Medicare members to understand as they evaluate their choices.

A five-star quality rating system ensures members know which plans offer the best experience.

Medicare Advantage (MA) Plans continue to be popular. In fact, the Centers for Medicare and Medicaid Services (CMS) projects MA enrollment will climb by 2.2 million to a record 24.4 million in 2020.1

With so many seniors taking advantage of these plans, CMS instituted a star rating system to ensure that each Medicare Advantage or Prescription Drug (Part D) Plan meets quality standards. The rating is on a scale of one to five, with five being the highest rating a plan can get. CMS updates the rating system each year to ensure that the most relevant criteria are assessed (see this link for recent changes).

Medicare Advantage Plans are rated on five areas:

  1. Staying healthy (screenings, tests, and vaccines)
  2. Managing chronic (long-term) conditions
  3. Plan responsiveness and care
  4. Member complaints, problems getting services, and choosing to leave the plan
  5. Health plan customer service

Prescription Drug (Part D) Plans are rated on four areas:

  1. Drug plan customer service
  2. Member complaints, problems getting services, and choosing to leave the plan
  3. Member experience with the drug plan
  4. Drug pricing and patient safety

2020 plans feature more choice, improved quality, and lower premiums.2

  • Choice: Compared to last year, Medicare Advantage beneficiaries will have about 1,200 more plans to choose from.
  • Quality:
    • The average star rating for MA Plans with prescription drug coverage has increased from 4.02 (2017) to 4.16 (2020). The average star rating for stand-alone prescription drug plans increased from 3.34 to 3.5.
    • There are now 15 combined Medicare Advantage and Part D plans with a five-star rating, and four Prescription Drug (Part D) Plans with a five-star rating.
    • In 2020, about 81% of MA enrollees with prescription drug coverage will be in four- and five-star plans.
  • Cost: According to CMS estimates, the average MA premium will decrease 14% to $23.00, while the average monthly premium for a basic Part D Prescription Drug Plan will decrease by $2.50 to $30.00.

Use the tools to help you choose the right plan.

Senior are encouraged to log on to www.medicare.gov and use the Find a 2020 Medicare plan tool. After entering some demographic information and data on prescription drugs they take, the tool will display the plans available in their geographic area.

They can also view monthly premiums, deductibles, and out-of-pocket maximums for each plan and use the compare feature to see how the plans stack up against one another. Of course, seniors who are more comfortable discussing their options over the phone can always call 1-800-MEDICARE.

With more choice and improved plan quality, today’s Medicare beneficiaries have good options for their health care in 2020. Health plans can help members with their choices by making them aware of their options, the tools that are available to them, and the enrollment deadlines.

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