For seniors considering switching to a Medicare Advantage plan during the current Medicare open enrollment period — which runs through Dec. 7 — choosing a plan might be tougher than ever.
The number of Medicare Advantage plans for 2023 is greater than ever, according to a new analysis by the nonprofit Kaiser Family Foundation (KFF). Nationwide, there are 3,998 such plans, a 6% increase from 2022.
That doesn’t mean seniors will have that many plans to choose from, though. Medicare Advantage plans are offered by private health insurance companies, so plan availability can vary widely from county to county.
On average, seniors in any given location will have access to 43 Medicare Advantage plans for 2023, according to the KFF analysis. That is more than double the average for 2018.
Besides the plan availability in their area, another factor that will help seniors narrow their Medicare Advantage options are any “extra” benefits that come with a plan.
Medicare Advantage plans must provide all the same benefits as traditional Medicare. But Medicare Advantage plans can offer additional benefits that aren’t covered by traditional Medicare — and many do.
For example, the following “extra” benefits are offered by individual Medicare Advantage plans for 2023, according to KFF:
- Vision benefits: Offered by 99% of plans for 2023
- Fitness benefits: 99%
- Telehealth benefits: 97%
- Hearing benefits: 97%
- Dental benefits: 97%
- Prescription drug coverage: 89%
- Over-the-counter items (such as adhesive or elastic bandages): 87%
- Supplemental telehealth benefits via remote access technologies: 75%
- Meal benefits (such as meal delivery): 71%
- Transportation benefits: 43%
- Acupuncture: 36%
- In-home support services: 14%
- Bathroom safety devices: 10%
- Support for caregivers of enrollees: 4%
- Telemonitoring services: 3%
What’s the difference between Original Medicare and Medicare Advantage?
Original Medicare and Medicare Advantage are the two main types of Medicare.
Original Medicare is the traditional Medicare program offered directly by the federal government. Medicare Advantage plans are an all-in-one alternative offered by private insurance companies.
Choosing between these two options is perhaps the biggest decision Medicare enrollees face. They must make it when they first enroll in Medicare, and they have an opportunity to switch from one type of Medicare to the other during open enrollment periods.
Original Medicare is currently the more popular of the two main options. As of 2021, 43% of all Medicare enrollees chose a Medicare Advantage plan, according to the latest annual report from the Medicare boards of trustees.
Medicare Advantage plans have been growing in popularity, though. In 2004, only 12.8% of all Medicare enrollees chose a Medicare Advantage plan.
Be cautious when switching from Original Medicare to Medicare Advantage
While Medicare Advantage plans are often considered a more affordable alternative to Original Medicare, deciding whether to switch from Original Medicare to Medicare Advantage should not be done lightly.
Medicare Advantage is not for everyone, and switching to it can carry risk.
For example, one downside to Medicare Advantage plans is that they generally limit you to a specific network of health care providers. So if you switch from Original Medicare to Medicare Advantage, you might not be able to continue seeing the same doctor and still have the visits covered.
Government analyses also suggest that seniors who are in poorer health have more issues with access to medical care or quality of care under Medicare Advantage plans.
These plans also require prior authorization more often than Original Medicare does, according to a 2018 analysis by the Kaiser Family Foundation. As we explain in “8 Services Medicare Advantage Won’t Cover Without Preapproval“:
“Prior authorization requires enrollees to get approval from the plan before accessing a particular health care service. If the plan does not approve the service beforehand, the plan might not pay for the service — leaving the patient on the hook for the cost.”
Switching to Medicare Advantage is also risky for seniors with Original Medicare who also pay for a supplemental Medicare policy, also known as a Medigap policy.
If such seniors later decide to switch back to Original Medicare, they won’t necessarily be able to get the same Medigap policy back — or get a new Medigap policy at all. We explain this further in “4 Pitfalls for First-Time Medicare Enrollees.”