Medicare Advantage 2013 Spotlight: Enrollment Market Update

This data spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013 and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.

This analysis finds that 14.4 million Medicare beneficiaries are enrolled in private Medicare Advantage plans in 2013, up nearly 10 percent from 2012. Since 2010, enrollment in Medicare Advantage plans has grown by 30 percent in spite of concerns that the payment changes enacted in the 2010 Affordable Care Act would lead to significant reductions in enrollment. While about 28 percent of Medicare beneficiaries nationally are now enrolled in Medicare Advantage plans, the share varies greatly by state — ranging from 49 percent in Minnesota to less than 1 percent and 3 percent in Alaska and Wyoming, respectively. Medicare Advantage enrollment continues to be concentrated among a small number of organizations. Beneficiaries in Medicare Advantage Prescription Drug plans (MA-PDs) pay about the same premium ($35 per month) in 2013, on average, as plan enrollees in 2012, with somewhat lower premiums in health maintenance organizations (HMOs) and higher premiums in other plan types. While the vast majority of beneficiaries (98%) have access to a MA-PD with no premium, slightly more than half (55%) of beneficiaries are enrolled in a zero-premium plan in 2013, varying by plan type and locale. All Medicare Advantage plans have a limit on out-of-pocket spending, and nearly half of all Medicare Advantage enrollees are in a plan with a limit at or below $3,400 per year.

The analysis is authored by researchers at Mathematica Policy Research Inc. and the Kaiser Family Foundation.