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Medicare Market Competition for 2020

 

October 16, 2019

 

Medicare Advantage plans continue to command a sizable proportion of the healthcare industry, providing medical coverage to over 23.1 million beneficiaries.  In the last three years, these plans have collectively increased enrollment by approximately 4.5 million members and currently cover 35% of the nearly 67 million people eligible for Medicare benefits. The 2020 Annual Election Period (AEP) for Medicare Advantage (MA) plans and prescription drug plans (PDPs) is underway as of October 15th.  As Medicare companies finalize sales and marketing strategies, they analyze data from Medicare Plan Finder (MPF), an online tool that makes it easy for seniors to review options and shop for new Medicare plans.  Medicare Benefits Analyzer™, a Mark Farrah Associates’ database, helps simplify analysis of the Medicare Plan Finder data for companies competing in this segment. This brief presents a snapshot of the 2020 Medicare Advantage market with insights from the Centers for Medicare and Medicaid Services (CMS) Medicare Landscape reports. 

 

 

Overview of the Medicare Landscape

Based on an aggregate analysis of CMS Landscape reports, a total of 4,407 distinct Medicare Advantage (MA) plan offerings are in the market lineup for the 2020 AEP, from October 15th through December 7th.  This includes MA plans, Medicare Advantage with prescription drug plans (MAPDs), Medicare/Medicaid plans (MMPs), and Special Needs Plans (SNPs).  During the AEP, Medicare beneficiaries can choose to change MA plans or switch from Original Medicare to MA, and plan benefits will become effective on January 1, 2020. 

A total of 3,534 MA and MMP plans are being offered for 2020, a sizeable increase from 3,084 in 2019.  Health Maintenance Organizations (HMOs) continue to be the dominant MA plan type with 2,252 offerings, or 64% of all MA plans for the coming year.  Additionally, 873 Special Needs Plans (SNPs) are available in 2020, up from 773 in 2019.   Stand-alone PDPs nationwide increased from 912 plans in 2019 to 959 plan offerings for 2020.

Medicare Advantage Plan Counts (MA & MAPD)

 Year 

 Cost

 Local HMO

 Local PPO

 MMP

 MSA

 PFFS

 Regional   PPO

 Total 

 2019

72 

1,949 

   905 

50 

52 

50 

3,084 

 2020

80 

2,252 

1,055 

44

45 

52 

3,534

 

 

Special Needs Plan Counts (SNPs)

 Year  Local HMO  Local PPO  Regional PPO  Total 
  2019

659 

61  13  733 
  2020 784  77  12  873 

 

Stand-alone Prescription Drug Plan Counts (PDPs)

 Year  PDP
 2019 912 
 2020 959 
Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Medicare Plan Finder and Landscape Source Files; excludes employer-sponsored plans. For this assessment, plans were counted as distinct company records by Contract-Plan-Segment ID without geographic distribution.

 

2020 Medicare Advantage Part D Coverage

  Count Percent
 Total Number of Plans 3,534  100% 
 Plans without Part D 339  10% 
 Plans with Part D 3,195  90% 
Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Medicare Plan Finder and Landscape Source Files; excludes employer-sponsored plans. For this assessment, plans were counted as distinct company records by Contract-Plan-Segment ID without geographic distribution.

 

A total of 3,195, or 90% of MA plans, include Part D benefits, and total monthly premiums range from $0 to $350.  Forty-nine percent of 2020 MA plans (excluding SNPs), are available at the $0 plan premium level.  In addition, 26% of all plans will be charging monthly premiums ranging from $2 to $50 while 15% of plan premiums are in the $51 to $100 range.  Only 2% or 59 plans are charging monthly premiums greater than $200.  These benefits-rich plans typically have low copays and as a result estimated out-of-pocket expenses are often minimal. 

2020 Medicare Advantage Premium Spread

  Count Percent
 Total Number of Plans 3,534  100%
 $0 Premium 1,724  49% 
 $2 - $50 Premium 910  26% 
 $51 - $100 Premium 520  15% 
 $101 - $200 Premium 315  9% 
 Greater than $200 Premium 59  2% 
 Null Premium Value 0% 
Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Medicare Plan Finder and Landscape Source Files; excludes employer-sponsored plans. For this assessment, plans were counted as distinct company records by Contract-Plan-Segment ID without geographic distribution.

 

Plan Competition for 2020

Many MA plans and stand-alone PDPs have expanded their current supplemental offerings or their coverage area for 2020. Anthem, Centene, and Humana have announced larger coverage areas for this year and Cigna recently increased its product offerings in Nashville. UnitedHealth not only gained coverage in new counties, but also recently acquired a Virginia MA plan.

According to the 2020 CMS Landscape reports, Humana will market 567 distinct plans, more MA plans than any other company nationwide.  UnitedHealth continued to increase its MA plan offerings for the 2020 calendar year with 478 distinct plans identified and CVS is offering 417 plans for 2020.  BCBS, Wellcare, Anthem, and Cigna also continue to have a notable plan offerings presence, respectively. 

 

Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Plan Finder and Landscape Source Files; excludes employer-sponsored plans. For this assessment, plans were counted as distinct company records by Contract-Plan-Segment ID without geographic distribution.

 

Medicare Benefits AnalyzerTM for Comparing Medicare Benefits

Analysts often use Plan Finder benefits data from the Medicare.gov website to compare plan premiums, copays and star rating awards, market by market.  Identifying plan-by-plan benefits details such as annual Out-of-Pocket Limits and Deductibles; Primary Care Doctor Visit Copays; Specialist Doctor Visit Copays; Inpatient Hospital Copays; Ambulance and Emergency Room Copays; and Drug Tier Copays helps companies to assess competitive advantages across markets.  This type of comparative analysis provides invaluable intelligence that prepares Medicare plans to promote and sell their products. 

In order to help Medicare plans access and use Medicare Plan Finder (MPF) data more efficiently, Mark Farrah Associates (MFA) maintains this data in its Medicare Benefits AnalyzerTM product.  2020 Plan Finder data is online now along with Star Quality Ratings to complement the benefits detail.  Subscribers may query tables presenting plan benefit comparisons by state and county or download large datasets using the file export interface.  Subscribers also have access to Medicare Business Online™ for tracking month-to-month Medicare Advantage and Prescription Drug Plan enrollment changes.  Visit our website at www.markfarrah.com or call 724-338-4100 for more information.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry.  Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™.  For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

Healthcare Business Strategy is a free monthly brief that presents analysis of important issues and developments affecting healthcare business today.  If you would like to be added to our email distribution list, please submit your email to the "Subscribe to MFA Briefs" section in the grey area at the bottom of the page.

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