If you are well versed in all things Medicare, this article will help you to determine what questions you might ask your Medicare Benefits Insurer for your 2022 coverage. Most Medicare Advantage companies have increased the number of counties in which they offer plans this upcoming year. Humana, UnitedHealthcare plans will be available in many more counties. This year Blue Cross Blue Shield Affiliates will sell insurance in 2,190 counties, also an increase. Since 2021 CVS Health has expanded to 1,840 counties, Centene has expanded to 1,525 counties, Cigna has expanded to 477 counties, and Kaiser Permanente with the slightest increase, with plans available in 116 counties.
Multiple Plan Offerings by Firms in the Same County:
In each county, several Medicare Part A & B companies provide more than one plan option. At least one firm is offering ten or more plans in 585 counties (representing 34% of beneficiaries). Two firms offer ten or more plans in 82 of those counties, and three firms offer ten or more plans in 12 counties. With 18 different plan options in six counties, Blue Cross Blue Shield Affiliates has the most plan alternatives in a county. Humana has the most plan alternatives, with 14 in five counties, followed by Centene and CVS, which each have 13 plan options in four counties respectively. In two counties, United Healthcare offers ten different plan options.
Premiums
Prescription drug coverage (MA-PDs) will be included in the vast majority of Medicare Advantage plans for individual enrollment. In 2022, more than 90% of beneficiaries will be eligible for an MA-PD with no monthly cost. Beneficiaries in Alaska and Wyoming, on the other hand, do not have access to an MA-PD with no premium.
In 2021, 65 percent of prescription drug enrollees will pay no premiums other than the $148.50 monthly Medicare Part B premium. The average monthly plan premium for all Medicare Advantage enrollees in 2022, including those who do not pay a premium for their Medicare Advantage plan, is predicted to drop from $20 in 2021 to $19 in 2022, according to the CMS.
Extra Medicare Benefits
Medicare Part A & B plans can provide additional benefits not available through traditional Medicare, as long as they are “mainly health-related,” and they can use rebate monies (including bonus payments) to help cover the cost of these additional benefits. CMS changed the definition of “primarily health-related” beginning in 2019 to allow Medicare Advantage plans to include more supplemental benefits. Some subgroups of beneficiaries, such as those with diabetes or congestive heart failure, may be excluded from receiving these additional benefits, resulting in different benefits being accessible to different members.
Extra Medicare Benefits in Plans for General Enrollment:
Fitness, dentistry, vision, and hearing were the most common supplementary benefits granted in the past. In 2022, more than 90% of individual policies will have vision, fitness, telehealth, hearing, or dental coverage. The extent of specific services varies, despite the fact that these advantages are universally available. A dental benefit, for example, may merely cover the cost of cleanings or provide more complete treatment, with a yearly cap on the amount reimbursed by the plan.
Beyond what was available under conventional Medicare prior to the COVID-19 public health emergency, Medicare Advantage insurers have been able to incorporate telehealth benefits as part of the basic insurance package beginning in 2020. Additionally, Medicare Advantage plans may provide supplemental telehealth benefits through remote access technologies and/or telemonitoring services.
Over-the-counter products, such as bandages, food benefits, such as cooking classes, nutrition instruction, meal delivery, and transportation benefits are also often offered for 2022. Less than 10% of plans offer toilet safety devices or telemonitoring services, as well as aid for subscribers’ caregivers. Plans may also cover additional services such as home-based palliative care, therapeutic massage, and adult day health programs, among other things.
Access to Extra Medicare Benefits:
Almost every Medicare beneficiary lives in a county where at least one Medicare Advantage plan available for general enrollment includes some extra benefits not covered by regular Medicare, with beneficiaries having access to some dental, fitness, vision, and hearing services in 2022. The vast majority of beneficiaries have access to telehealth services, over-the-counter medications, a meal benefit, and transportation assistance but fewer have access to in-home support services or bathroom safety devices.
Availability of Extra Medicare Benefits in Special Needs Plans:
Special Needs Plans are meant to serve a population with disproportionately high needs, and a somewhat higher number of SNPs than other Medicare Part A & B plans provide over-the-counter products, transportation benefits, and in-home support services to their participants. Similar to regular enrollment plans, only a tiny percentage of SNPs offer toilet safety devices or telemonitoring services.
Availability of Special Supplemental Benefits for the Chronically Ill (SSBCI).
Beginning in 2020, Medicare Advantage plans will be authorized to provide extra benefits to chronically ill beneficiaries that are not primarily health-related, known as Special Supplemental Benefits for the Chronically Ill. (SSBCI). Although CMS has not yet published information on the availability of SSBCI in 2022, you will want to be sure to ask about this supplemental plan if this benefits you.
Although the vast majority of plans do not yet provide these benefits, SNP plans are more likely to do so than individual enrollment plans. Food and produce, meals (beyond a limited basis), and pest treatment are among the most commonly offered SSBCI benefits.
Conclusion
In 2022, there are more Medicare Advantage plans available than in any previous year. Twenty insurers are entering the Medicare Advantage market for the first time, while seven insurers are quitting, indicating that the sector remains appealing and profitable for insurers.
In 2022, more than 99 percent of Medicare Advantage enrollees will have access to one or more plans, similar to previous years. With more companies offering SNPs and the number of SNPs rapidly increasing, there may be greater attention on how successfully Medicare Advantage plans, including SNPs and general enrollment plans, serve high-need, vulnerable members. As the number of people enrolled in Medicare Advantage continues to rise, insurers appear to be responding by giving additional plans and options to those on the program.