The Rise of Enrollment in Medicare Advantage Plans

Medicare Advantage continues to grow in popularity with Medicare beneficiaries. Data released in January 2023 by the Centers for Medicare and Medicaid Services shows Medicare Advantage provides coverage for just over half of all Medicare-eligible beneficiaries.

So out of almost 60 million people enrolled in Medicare Part A and Medicare Part B, just over 30 million are enrolled in a private plan.

What is Medicare Advantage?

Medicare Advantage is the private plan alternative to traditional Medicare. Coverage includes Medicare Part A and B and Medicare Part D benefits relating to prescription drugs. You must stay enrolled in Parts A and B in order to enroll in a Medicare Advantage plan also known as Part C. Plans are approved by Medicare and offered by private insurance companies.

Typically, Medicare Advantage plans require enrollees to see in-network providers or choose to pay additional out-of-pocket for out-of-network care.

Why the Rise?

According to research from the Kaiser Family Foundation, enrollment in Medicare Advantage has increased dramatically in the last few years.

For example, in 2007, less than 20% of eligible Medicare beneficiaries were enrolled in a private plan, compared to 50% today. 

The foundation believes the rise is because of several factors, such as additional benefits not typically available in Medicare, like vision, hearing and dental services. Medicare Advantage plans also offer the potential for lower out-of-pocket costs in comparison to traditional Medicare, which is attractive to many beneficiaries.

Another appeal of a Medicare Advantage plan is not having to purchase separate plans to ensure coverage for prescription drugs, typically included with a Medicare Advantage plan. 

Medicare Advantage vs Medicare

Analysts at the Kaiser Family Foundation predict that as Medicare Advantage grows, so will interest in how well the plan continues to serve beneficiaries, particularly with an increasingly diverse group, including Black, Hispanic and Asian and Pacific Islander beneficiaries.

A recent review sought to identify the differences between Medicare Advantage and Original Medicare relating specifically to beneficiaries, such as affordability, satisfaction, preventative care and quality of providers. 

The study showed few differences, with both plan members reporting similar satisfaction with their care. Medicare Advantage typically outperforms on preventative services, while Medicare outperformed in areas such as receiving care in the highest-rated hospitals for cancer care.

The Bigger Picture

Although Medicare Advantage has grown substantially over the past few years, it looks like the growth is starting to slow down. 

Data published by Chartis in February shows that between 2020 and 2022, Medicare Advantage enrollment grew between 1.9 million and 2.3 million beneficiaries. However, this year, enrollment has increased by just 1.5 million. 

Enrollment in Original Medicare also appears to be declining, with around 330,000 fewer people enrolling this year.