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 2020 is greater than ever, according to a recent analysis by the nonprofit Kaiser Family Foundation (KFF). Nationwide, there are 3,148 Medicare Advantage plans for 2020 — a 15% increase from just one plan year prior.
That doesn’t mean seniors will have that many Medicare Advantage plans to choose from, though. These alternatives to the traditional Medicare program are offered by private insurers that contract with the federal government’s Medicare program, so plan availability can vary widely from county to county.
On average, seniors will have 28 Medicare Advantage plans to choose from for 2020, according to the KFF analysis. That is up from 24 plans for 2019 and the highest average number of available plans since 2010.
Besides the plan availability in their area, another factor that will help seniors narrow down their Medicare Advantage options is the presence of any “extras” that come with a plan.
Medicare Advantage plans must provide all the same benefits as Original Medicare, which is the other of two main types of Medicare. But Medicare Advantage plans can offer additional benefits that aren’t covered by Original Medicare — and many do.
For example, the following five “extra” benefits are offered by a majority of 2020 Medicare Advantage plans, according to the KFF analysis:
- Fitness benefit: Provided by 93% of Medicare Advantage plans for 2020
- Prescription drug coverage: 90%
- Dental benefit: 88%
- Eye exams and glasses: 87%
- Hearing aids: 83%
Extras covered by only a minority of 2020 Medicare Advantage plans include:
- Meal benefit (such as a cooking class, nutrition education or meal delivery): 46%
- Transportation: 33%
- Bathroom safety devices: 6%
- In-home support: 4%
- Telemonitoring: 4%
- Support for caregivers of Medicare enrollees: 2%
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 alternative to the traditional program offered by private insurance companies.
Choosing between these two options is perhaps the biggest decision Medicare recipients 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. Last year, about 36% of all Medicare enrollees chose a Medicare Advantage plan, according to the latest annual report from the Medicare boards of trustees.
Medicare Advantage plans are growing in popularity, though. By 2029, an estimated 47% of Medicare enrollees will have one of these plans.
Be cautious when switching from Original Medicare to Medicare Advantage
While Medicare Advantage plans are often considered a more affordable or at least a more inclusive 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 may limit you to a certain network of doctors. So, you might not be able to continue seeing the same doctor and still have the visits covered if you switch from Original Medicare to Medicare Advantage.
Medicare Advantage 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 and 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 Dangers for First-Time Medicare Enrollees.”