2019 Medicare Advantage and Part D Prescription Drug Program updates

July 23, 2019

Leona Rajaee

Enrollment in Medicare Advantage plans is up and premiums are down, according to data released by the Centers for Medicare & Medicaid Services (CMS). Medicare Advantage plans cover what is sometimes referred to as Medicare Part C. Advantage plans are administered by private companies and require the patient to pay an additional premium for services covered by the plan. Medicare then pays those companies a fixed amount for the patient’s care.

CMS projects that there will be record enrollment in Medicare Advantage plans in 2019, estimating that 36.7% of Medicare beneficiaries will enroll in an Advantage plan this year. CMS also states that “Medicare Advantage premiums, on average, have steadily declined since 2015 from the actual average premium of $32.91. For 2019, CMS estimates the Medicare Advantage average monthly premium will decline by $1.81 to $28.00 from 2018.”

Approximately 99 percent of Medicare beneficiaries will have access to a Medicare Advantage plan as well as a prescription drug plan in 2019. Prescription drugs are covered under Medicare Part D, which is generally included in most Advantage plans. Additional benefits, such as vision, hearing, dental, and/or health and wellness programs, may also be included in Medicare Advantage plans.

CMS also states that “Due to new flexibilities available for the first time in 2019, nearly 270 Medicare Advantage plans will be providing an estimated 1.5 million enrollees new types of supplemental benefits, including:

Expanded health-related supplemental benefits, such as adult day care services, and in-home and caregiver support services; and
Reduced cost sharing and additional benefits for enrollees with certain conditions, such diabetes and congestive heart failure due to the agency’s reinterpretation of uniformity requirements.

Premiums for prescription drug plans are also declining, with the basic premium projected to decline for the second year in a row. The average monthly premium for a basic Medicare prescription drug plan is projected to decrease in 2019 by 3.2%, to an estimated $32.50 per month.

CMS is encouraging health plan providers to offer more choices in their Medicare Advantage plans, with policies for Medicare health and drug plans for 2019 that provide “new tools to improve quality of care.”