Plan Design
Analysis
and Trends 2020
October 25, 2019 Report
Ocotber 25, 2019
Report
Overview
With a plethora of benefits & differing costs attached to each Medicare Advantage plan, it can be difficult to compare & evaluate plans from both consumer and industry perspectives. This report highlights 2020 benefit & cost structure trends for the Medicare Advantage market as well as incorporating 2019 benefit details to provide a year-over-year (YoY) analysis to identify how the market is evolving.
Plan Design Trends (Y-o-Y)
Plan Benefits (YoY)
- The total MA market recognized a 15% increase in the number of plans available from 2019 to 2020.
- Plans offering a Remote Access Technology benefit have decreased (10%) from 2019 while number of plans offering other benefits have increased.
- There is a significant increase (35%) in plans offering OTC benefits.
Plan Costs (Y-o-Y)*
- Greater increase in high deductible plans (Mid + High) than low deductible plans (Zero + Low).
*The premium buckets are applicable for both 2019 and 2020.
- High premium plans have shifted from High to Low MOOP
*The premium buckets are applicable for both 2019 and 2020.
Note:
- If Premium is $0 then “Zero Premium Plans”; is between $0 and $50 then “Low Premium Plans”; is between $50 and $100 then “Mid Premium Plans”; is greater than $100 then “High Premium Plans”
- If Deductible is $0 then “Zero Deductible Plans”; is between $0 and $150 then “Low Deductible Plans”; is between $150 and $300 then “Mid Deductible Plans”; is greater than $300 then “High Deductible Plans”
- If MOOP is $0 then “Zero MOOP Plans”; is between $0 and $150 then “Low MOOP Plans”; is between $150 and $300 then “Mid MOOP Plans”; is greater than $300 then “High MOOP Plans”2
Plan Design (by Carrier Size)
- Average Premiums, MOOP and Health Benefit OOPC levels have decreased across all carrier sizes from 2019 to 2020.
- Average Deductibles have increased across all carriers.
Note: Carrier size is based on total MA enrollment in Aug 2019. If the total number of enrollments in a Parent Organization is over 250K then the organization is considered as a Large Carrier. For Medium carriers, it is from 50k – 250k and Small carriers are less than 50k enrollments.
Plan Design (by Regions)
- Average Deductible for Top 10 plans in California ($43.5) and Illinois ($39.5) is lower than Average Deductible for the State (CA $187.2, IL $66.7) and the Average Deductible for the New Plans (CA $120.9, IL $91.4).
- Average Premium for the New Plans in Pennsylvania ($3.1) is much lower than the Average State Premium ($53.2) and the Average Top 10 ($41.7).
- Average MOOP for Top 10 plans in Florida ($3885) is much lower than the Average State MOOP ($4876.9) and Average New Plan MOOP ($4438.6).average ($4714.3).
State Level
- The number of plans in most states have increased while the Premiums, MOOP and Health Benefit OOPC have decreased.
- Average MOOP in Kansas has decreased by 38%.
- The average Deductible for Illinois, Kansas and Pennsylvania is significantly lower than the other states.
Top 10 Plans*
- Last year’s Top 10 plans in most States have had no significant changes.
- Tennessee’s Top 10 have reduced Deductibles by 19%.
New Plans
- Average Premiums below $10 can be found in the state of Florida, Pennsylvania and Texas.
- Low average Deductible (below $100) in new plans can be found in the states of Illinois, Ohio and Pennsylvania with Pennsylvania at the lowest ($37.50).
Key Takeaways
- Along with an increase in MA plans (15%), there has also been an increase in benefits covered.
- High Premium plans have started to shift towards Lower MOOP offerings (from 2 to 275 Low MOOP plans).
- Average Premiums for Top 10 plans in different states have remained similar to last year.
- There seems to be an overall trend in decreasing Average Premiums, MOOP and OOPC.
