Medicare Market Insights and Plan Competition for 2023
October 24, 2022
Medicare Advantage (MA) plans have been preparing their Medicare products in anticipation of the 2023 Annual Election Period (AEP), which is now upon us. The MA market is comprised of national health plans, Blue Cross Blue Shield organizations, prominent regional health plans and specialized Medicare companies. MA plans currently provide medical coverage for nearly 30.2 million beneficiaries, as of October 2022. While MA market penetration is strong, there is still ample opportunity for growth in this segment, with approximately 47% of the 64.7 million people eligible for Medicare enrolled in MA plans. This brief presents a snapshot of the 2023 Medicare Advantage market with insights from the Centers for Medicare and Medicaid Services (CMS) Medicare Landscape reports.
Medicare Advantage plans have collectively increased enrollment by approximately 6.9 million members, in the past three years. The 2023 Annual Election Period (AEP) for MA plans and prescription drug plans (PDPs) is currently underway as of October 15th. Medicare Benefits Analyzer™, a Mark Farrah Associates’ database, helps simplify analysis of the Medicare.gov data for companies competing in this segment.
Medicare Landscape at a Glance
Based on an aggregate analysis of CMS Landscape reports, a total of 5,764 distinct MA plan offerings are in the market lineup for the 2023 AEP. This includes Medicare Advantage plans without Part D coverage (MA w/no PD), Medicare Advantage with prescription drug plans (MAPDs), Medicare/Medicaid plans (MMPs – Demonstration plans), and Special Needs Plans (SNPs). During the AEP, Medicare beneficiaries can choose to change MA plans or switch from Original Medicare to MA, for plan benefits effective on January 1, 2023. As indicated in the charts below:
- A total of 4,431 MA w/no PD and MAPD plans are being offered for 2023, which is a slight increase from the 4,232 plans offered for 2022.
- Health Maintenance Organizations (HMOs) continue to be the dominant MA plan type with 2,543 offerings, or 57% of MA plans for the coming year.
- A total of 3,941, or 89% of MA plans, include Part D benefits.
- 1,333 Special Needs Plans (SNPs) are available for 2023, up from 1,198 in 2022.
- Stand-alone PDPs, nationwide, marginally increased from 776 plans in 2022 to 811 plan offerings for 2023.
Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Medicare 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.
2023 MA Premium Spread
Per the chart below, 66% of 2023 MA plans (excluding SNPs) are available at the $0 plan premium level, and 19% of plans will be charging monthly premiums ranging from $2 to $50. Only 57 plans (1%) 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.
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.
2023 MA Plan Competition
- According to the 2023 CMS Medicare Landscape Source Files, Humana continues to broaden its offerings and expand coverage for 2023, with 654 distinct plans.
- UnitedHealth and CVS also continue to increase MA plan offerings and expand $0 premium plan options for the 2023 calendar year, identifying 555 and 548 distinct plans, respectively.
- Elevance Health, previously Anthem Inc., is offering 240 plans, and Centene has 378 MA plans for 2023.
- BCBS companies (excluding Elevance Health) are offering 490 MA plans, nationwide.
It is interesting to note that Devoted Health, a Massachusetts-based health insurance company that exclusively offers MA plans, outpaced other significant insurers in terms of number of plans for 2023. The insurance company more than doubled the number of plans to 102 and is expanding services to eight new states: Alabama, Colorado, Hawaii, North Carolina, Oregon, Pennsylvania, South Carolina, and Tennessee for 2023.
Source: Mark Farrah Associates' Medicare Benefits Analyzer TM presenting data from CMS Medicare.gov 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 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.gov data more efficiently, Mark Farrah Associates (MFA) maintains this data in its Medicare Benefits AnalyzerTM product. Benefits detail for 2023 is online now, along with Star Quality Ratings. 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™, 5500 Employer Health PLUS, 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.
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