CHA News Article

Report Examines State, National Medicare Advantage Enrollment Trends

According to a new report from the Kaiser Family Foundation, the number and share of Medicare beneficiaries enrolled in Medicare Advantage has steadily climbed over the past decade — a trend that continues in 2016. The enrollment growth has occurred despite reductions in payments to plans enacted by the Affordable Care Act. As of 2016, payment reductions have been fully phased-in for 78 percent of counties, accounting for 70 percent of beneficiaries and 68 percent of Medicare Advantage enrollees. The report reviews national and state-level Medicare Advantage trends as of March 2016, and examines variations in enrollment by plan and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost sharing and plans’ quality ratings. Key findings include:

  • Total U.S. enrollment in Medicare Advantage is 16,761,673 people and has increased in virtually all states over the past year. Almost one in three people on Medicare (31 percent or 17.6 million beneficiaries) are enrolled in a Medicare Advantage plan in 2016. The penetration rate exceeds 40 percent in five states. In California, 2,244,709 individuals are enrolled in Medicare Advantage, representing a 6 percent increase from 2015 enrollment.​
  • Within states, Medicare Advantage penetration varies across counties. For example, 44 percent of beneficiaries in Los Angeles County are enrolled in Medicare Advantage plans compared to only 11 percent of beneficiaries in Santa Cruz County.
  • Over 3 million enrollees (18 percent) are in a group plan in 2016.
  • On average, premiums paid by enrollees were relatively constant between 2015 and 2016 ($37 per month in 2016 versus $38 per month in 2015), although premiums vary widely across states, counties and plan types. Premiums also vary greatly within a state since plans and federal payments to plans vary by county. For example, in California Medicare Advantage prescription drug enrollees pay an average of $3 per month in Los Angeles County, but $64 per month in San Francisco County.
  • Medicare Advantage plans, unlike traditional Medicare, are required to provide an out-of-pocket limit (not to exceed $6,700) for services covered under Parts A and B. In 2016, the average enrollee had an out-of-pocket limit of $5,223 – nearly $1,000 higher than it was in 2011 ($4,313). More than one-third of all enrollees in Medicare Advantage prescription drug plans in 2016 (37 percent) are in plans with limits at the maximum.