Medicare Advantage

Good news abounds for Medicare Part C and Part D

For more information on Medicare, please call the number below to speak with a healthcare specialist


The Centers for Medicare & Medicaid Services (CMS) has revealed a wealth of good news for Medicare Part C (also known as Medicare Advantage, or MA) and Medicare Part D (Prescription Drug Plans, or PDPs). First, the agency expects premiums for both MA Plans and PDPs to remain stable in 2016. A larger number of enrollees should also have access to a variety of higher-quality MA plans, as well. And finally, for the sixth year in a row, MA enrollment is projected to increase to a new and all-time high.

The ACA driving down plan costs

The 2016 Open Enrollment Period (OEP), now known as the Annual Election Period (AEP), is set to run from Oct. 15-Dec. 15, 2015. As such, the CMS has released its projected premiums and other costs for both MA and PDPs. As of now, the agency expects average MA premiums to decrease from $32.91 in 2015 to $32.60 in 2016 (see table below).

In total, 59 percent of MA enrollees should face no premium increases. “Seniors and people with disabilities continue to experience stable premiums in Medicare health and drug plans, while benefiting from a transparent and competitive marketplace,” stated Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. “Medicare Advantage and prescription drug plans remain affordable and provide high quality care.”  

The agency revealed that Medicare Part D premiums will be stable next year, as well. The average basic PDP premium should stay at $32.50 per month in 2016. This stability is due to the Affordable Care Act (ACA). Under this law, beneficiaries are saving money on lower-priced brand name and generic drugs. And, they’ve been given better access to certain preventive services, without cost sharing.

The Affordable Care Act has also enabled enrollees to save money by closing the prescription drug “donut hole.” From Jan. 2014, when the ACA was enacted, through July 2015, more than 9.8 million Medicare beneficiaries have saved over $17.6 billion on prescription drugs. These savings are attributed to the ACA’s discounts and 2010 rebates; beneficiaries have saved an average of $1,796.

Better access, better plan quality

According to the CMS, the Medicare Advantage program is succeeding in providing its members with access to high-quality plans. An estimated 65 percent of members are currently enrolled in MA plans with four-star ratings or higher. In 2009, only about 17 percent of members were enrolled in similar plans. The CMS also stated that in 2016, more MA plans will offer enrollees supplemental benefits, including dental, vision and hearing benefits.

As for Part D, plan quality remains consistent, with nearly 50 percent of PDPs receiving four or more stars. Studies show that four-star or higher-rated PDPs serve about one-third of enrollees. In 2009, only 27 percent of enrollees were enrolled in similar plans.

MA enrollment continues to rise

In terms of enrollment, the CMS expects Medicare Advantage numbers to increase in 2016, for the sixth year in a row. The agency projects about 17.7 million people to be enrolled in an MA plan, compared to nearly 16.5 million at the same time last year; this represents a 7.3 percent increase.

In total, this is about 32 percent of all Medicare beneficiaries. In fact, the number of enrollees choosing MA over Original Medicare (Parts A and B) has more than doubled over the past decade. And according to a survey from Health Affairs, more than half of those enrolled in Medicare in the past few years selected MA Plans.