7 Trends Changing Medicare Advantage Plans In 2022

CMS projects that nearly 30 million people are signing up for MA in 2022 Highlights In 2022, 295 plans (compared to 256 in 2021), will cover all Medicare services, plus Medicaid-covered behavioral health treatment or long-term services and supports, through a single organization,” CMS said. Medicare Advantage plans are increasing multiple strategies to address social determinants of health by offering expanded benefits. Medicare Advantage Plans are increasing supplemental benefits. Medicare Advantage Plans are expanding dual-eligible special needs plans. Trends Trend #1. Number of Plans Increasing More than 26 million Medicare beneficiaries – 42 percent of all beneficiaries – are currently in Medicare Advantage plans, which are mostly HMOs and PPOs offered by private insurers that are paid to provide Medicare benefits to enrollees. In 2022, the average Medicare beneficiary will have 39 plans to choose from in their local market. But the number of Medicare Advantage plans available varies greatly across the country, with an average of 42 plans in metropolitan areas and 25 plans in non-metropolitan areas. In 2022, 25 percent of beneficiaries live in a county where they can choose among 50 Medicare Advantage plans (Figure 1). Trend #2. Availability of Insulin Demonstration Plans One in every three Medicare beneficiaries has diabetes, and over 3.3 million Medicare beneficiaries use one or more of the common forms of insulin. In 2022, beneficiaries in each state will have the option to enroll in a Part D Senior Savings Model. CMS’s Innovation Center model is testing the impact of offering beneficiaries an increased choice of enhanced alternative Part D plan options that offer lower out-of-pocket costs for insulin. The voluntary Model began on January 1, 2021, and will continue for five years, through December 31, 2025. The Model’s test contributes to the modernization of the Part D benefit and enhanced access to prescription drugs for Medicare beneficiaries. Trend #3. Special Needs Plans (SNPs) More SNPs are available for 2022 than in any year since they were authorized, increasing from 975 plans in 2021 to 1,156 plans in 2022, a 19 percent increase (Figure 2). The number of SNPs offered for people with chronic conditions (C-SNPs) is also increasing in 2022 (272 plans), more than doubling from 2017 (122 plans), most of which focus on people with diabetes, heart disease, or lung conditions, as has been the case since the inception of C-SNPs. In 2022, 25 percent of beneficiaries live in a county where they can choose among 50 Medicare Advantage plans. For 2022, three firms are offering C-SNPs for people with dementia (the same as 2021), four firms are offering C-SNPs for people with mental health conditions (up two from 2021), four firms are offering C-SNPs for people with end-stage renal disease (up one from 2021) and two firms are offering C-SNPs for people with HIV/AIDS (same as 2021). Trend #4. New Market Entrants and Exits 20 new firms are entering the market for the first time in 2022. Three of the new firm entrants are offering plans in Massachusetts, two are offering plans in California, Florida, North Carolina, South Carolina, and Utah, and the remainder are offering plans in at least one of thirteen other states (Arizona, Indiana, Louisiana, Maryland, Michigan, Minnesota, Montana, New Hampshire, North Dakota, South Dakota, Oklahoma, Rhode Island, and Texas). Seven firms that previously participated in the Medicare Advantage market are not offering plans in 2022. Trend #5. Availability of Extra Benefits in Plans for General Enrollment Historically, the extra benefits offered most often were fitness, dental, vision, and hearing. More than 90% of individual plans offer access to vision, fitness, telehealth, hearing or dental benefits in 2022. Though these benefits are widely available, the scope of specific services varies. For example, a dental benefit may include cleanings only or more comprehensive coverage, often subject to an annual cap on the amount covered by the plan. (Figure 3). As of 2020, Medicare Advantage plans have been allowed to include telehealth benefits as part of the basic benefit package – beyond what was allowed under traditional Medicare prior to the COVID-19 public health emergency. Trend #6. Availability of Special Supplemental Benefits for the Chronically Ill (SSBCI) Beginning in 2020, Medicare Advantage plans have also been able to offer extra benefits that are not primarily health related for chronically ill beneficiaries, known as Special Supplemental Benefits for the Chronically Ill (SSBCI). Information on the availability of SSBCI for 2022 has not yet been published by CMS (Figure 4). Trend #7. Supplemental Benefits Are Increasing To Address Social Determinants Of Health (SDOH) In 2022, 58 percent of Medicare Advantage plans are providing meals, transportation, nutrition and in-home support – all four with a $0 premium compared to 53 percent in 2021 plans according to analysis provided by Avalere. Related Stories Medicare Advantage: Five Care-At-Home Supplemental Benefits Skyrocket in 2022 GAO Report: Medicare Advantage Beneficiaries Switching to Medicare Fee-For-Service During Last Year of Life

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173.236.20.0/24	173.236.20.2	173.236.20.254
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7 Trends Changing Medicare Advantage Plans In 2022

CMS projects that nearly 30 million people are signing up for MA in 2022

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