Medicare Advantage enrollment by the numbers
If you’re overwhelmed by the number of Advantage Plans available it may be helpful to take a look at what have been the most popular Medicare Advantage Plans. Although a plan’s popularity is no guarantee that it will necessarily be your best option, there may be good reasons for its popularity and it may deserve your consideration.
Because plans are available County by County, it’s not practical to list the most popular plan specifically, but rather a discussion of which firms or affiliates have the greatest share of the market may be a starting place for plan comparisons.
It’s also interesting to look at which types of plans are most popular and explore possible reasons for their popularity. For instance, what could be some of the reasons that people choose a Medicare HMO over a PPO or Regional PPO? And why do so many people enroll a Medicare Advantage Plan with a premium, when $0 premium plans are available?
Medicare Advantage plan data
The only realistic way to assess a plan’s popularity is to look at historical data. The following information was obtained from a report by the Kaiser Family Foundation, entitled; Medicare Advantage 2013 Spotlight: Medicare Market Update. The report is quite lengthy and I’ve focused on plan popularity by firm or affiliate, type of plan(HMO, PPO, Regional PPO and PFFS) and what may be responsible for some specific data.
The first thing to take away from the report is that Medicare Advantage Plans are gaining in popularity. Over 14 million people (about 28% of beneficiaries) were enrolled in a Medicare Advantage Plan for 2013. This figure represents an increase of over 1 million people over 2012. Enrollment continues to grow even though enrollees have a fewer number of plans to choose from than from just a few years ago. On average a Medicare beneficiary has about 20 plans to choose from versus nearly 48 in 2009.
Some types of plans are more popular than others. In some cases this could be a function of the way benefits are received with each type of plan, but popularity may actually have more to due with what plans are offered by particular providers and which are more readily available in specific service areas. Here is the enrollment by plan type:
- 65% are enrolled in an HMO
- 22% are enrolled in a local PPO
- 7% are enrolled in a Regional PPO
- 4% are enrolled in PFFS
HMO enrollment is growing at about the same rate as overall Medicare Advantage enrollments. One reason for an HMOs popularity may be that they are the predominant plan in metropolitan areas where the population is much higher. It’s much easier for a insurance company to put together a credible network in an area where their are more providers than more rural areas.
PPOs on the other hand have grown in popularity as a percentage of Medicare beneficiaries. In 2007, only 6% of Medicare Advantage enrollees had a PPO compared to 29% today. This growth rate is phenomenal considering that there are more HMOs available than local PPOs and Regional PPOs combined.
Why the increase in PPO enrollment? One reason could be how you are able to use your plan compared to an HMO. When you are enrolled in an HMO you must get a referral from your primary care provider and receive all your services in network. With the exception of an HMO-POS, where you can get certain services at specif out-of-network locations, seeking care out-of-network will not be covered by the plan.
A PPO, on the other hand, does not require a referral to seek services out-of-network and those services will be covered, albeit with a little more out-of-pocket on your part. The freedom to go out-of-network may be driving more people to consider a PPO even if their is a higher premium required.
PFFS (Private Fee-for-Service) plans have declined in popularity due to the way they work and so many less of them available since 2011. In 2011, legislation was enacted that required these types of plans to make a network available to members. Because these plans were popular in rural area, many companies discontinued them when they couldn’t develop a credible provider network.
The most popular Medicare Advantage companies
Five insurance companies or their affiliates (BCBS affiliates) accounted for 63% of all Medicare Advantage Plan enrollments.
- United Healthcare – 21%
- BlueCross BlueShield – 17% including 4% in Wellpoint BCBS affiliates
- Humana 17%
- Kaiser Permanente 8%
- Aetna 4%
By far, the single most popular plan is AARP MedicareComplete Insured Through United Healthcare. Factors that may be driving enrollment include; the wide area where the plan is offered, name recognition, $0 premium plans and the level of benefits included.
Identifying one BlueCross BlueShield plan is difficult due to the number of affiliates and differences between service areas. Some popular plans include; Freedom Blue, Blue Medicare HMO and countless others.
Humana has a number of plans available including; Humana Choice, Humana Gold Choice and Humana Gold Plus.
Another 7 national companies account for 11% of all Medicare Advantage Plan enrollment. topping the list is CIGNA with 3%, followed by Coventry, WellCare, NetHealth and Universal American.
Medicare Advantage Plan Premiums
In 2013 approximately 98% of people on Medicare had at least one Medicare advantage plan without a premium (you must pay your Part B premium) available. 55% of beneficiaries are enrolled in a plan without a monthly premium. With the average premium being $35 per month, this shows that people are willing to pay a little more to get the benefits and plan type they want. In fact, choosing a plan based soley on premium is not recommended.
If you are interested in enrolling in a Medicare Advantage Plan for 2014, you should not limit your search to the most popular plans. When comparing plans you should consider all your options. The Medicare Advantage landscape is always changing and a plan that is currently popular may not be in the future.
Interesting article… My Medicare Advantage carrier is
TODAY’S OPTION which is probably the lowest rating among all
Medicare Advantage Company. I do like them because I think
they really care about your health by doing prevention check-
ups and lab testing at home. I see this as a good company
practices due to most of us “Old Folks”, do not even try in
going for physical check-ups until it is too late. I have
enrolled in many different Medicare Advantage Company’s and
none of them does this.
Jaime, It sounds as though you have found a plan that meets your needs. That’s more important than a plans popularity or rating. Just so you know, United Healthcare also offers in-home visits.