Health Law Daily Medicare Advantage premiums drop, Part D caps insulin cost for seniors
Friday, September 25, 2020

Medicare Advantage premiums drop, Part D caps insulin cost for seniors

By Rebecca Mayo, J.D.

CMS announced that Medicare Advantage average premium prices have hit a 14 year low and unveiled new payment model that caps insulin pricing for seniors.

As beneficiaries prepare for the annual Medicare Open Enrollment, CMS has announced that the average premiums for Medicare Advantage plans are expected to decline to the lowest average premium in 14 years, while plan choice, benefits, and enrollment continue to increase. According to CMS calculations, since 2017, beneficiaries have saved approximately $3.4 billion in combined Medicare Advantage and Part D premium costs. CMS also announced that 1,600 Part D prescription drug plans will offer capped out-of-pocket costs for insulin as part of the Part D Senior Savings Model.

Medicare Advantage. The Medicare Advantage average monthly premium is expected to be $21. This is an 11 percent decrease from the average prince in 2020 and an estimated 34.2 percent decrease since 2017 and the lowest that the average monthly premium for a Medicare Advantage plan has been since 2007. Beneficiaries will be able to choose from more than 4,800 Medicare Advantage plans during 2021 open enrollment, which is about 2,100 more plans than in 2017. Enrollment is projected to increase to an all-time high of 26.9 million beneficiaries from a current enrollment of 24.4 million. This projected increase represents a 44 percent increase in Medicare Advantage enrollment since 2017.

Over 94 percent of Medicare Advantage plans will offer additional telehealth benefits in 2021, reaching 20.7 million beneficiaries, which is up from about 58 percent of plans offering telehealth benefits in 2020. For the first time in Medicare, 53 Medicare Advantage plans will offer increased access to palliative care and integrated hospice care through the Value-Based Insurance Design Model. About 730 plans will provide additional types of supplemental benefits, such as adult day health services, caregiver support services, in-home support services, therapeutic massage or home-based palliative care. About 500 plans will offer enrollees with particular conditions access to lower copayments or additional benefits such as meals and transportation. About 920 plans will offer non-primarily health related benefits tailored to people with chronic conditions that may help them better manage their disease. Some of these benefits include things like pest control, home cleaning services, meal home delivery, and transportation for noon-medical reasons such as trips to the grocery store.

Part D. The average basic Part D premium will be approximately $30.50 in 2021 which is a 12 percent decrease since 2017. This is a savings of nearly $1.9 billion in premium costs for beneficiaries over that time. Part D enrollment has also increased by 16. 7 percent since 2017. In 2021 Part D will have over 1,600 prescription drug plans across the nation that will offer insulin savings. For the first time, seniors who use insulin will be able to choose a plan in their area that offers insulin savings through the Part D Senior Savings Model and provides coverage of a broad set of insulins, each for no more than $35 per month. Beneficiaries will be able to find these plans on the Medicare Plan Finder on and will be able to use as "Insulin Savings" filter to easily display plans that will offer capped out-of-pocket costs for insulin.

MainStory: TopStory HealthCareReformNews CMSNews CoverageNews CopayNews DrugBiologicNews HealthReformNews HomeNews HospiceNews ManagedCareNews PartCNews PartDNews PrescriptionDrugNews

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