Filling the need for trusted information on national health issues…

Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes

Table A1. Medicare Advantage Plan Market Entries and Exits, Average Monthly Premiums and Average Out-of-Pocket Spending Limits for Medicare Advantage Prescription
All Medicare Advantage Plans (MA-PD and MA-only plans) All plans HMO Local PPO PFFS Regional PPO Cost MSA
2014 Plan Total 2,014 1,242 511 120 48 87 6
Total number of staying plans 1,636 1,048 388 68 43 83 6
Number of staying plans with no service area reductions 1,377 906 312 33 41 79 6
Number of staying plans with reduced service areas 147 79 46 22
Number of consolidating plans, post consolidation 112 63 30 13 2 4
Total number of departing plans 378 194 123 52 5 4
Number of plans departing due to consolidation 163 90 47 20 2 4
Number of terminating plans 215 104 76 32 3
Number of new plans 309 227 77 1 3 1
2015 Plan Total 1,945 1,275 465 69 43 86 7
Total Medicare Advantage enrollees, as of September 2014 10,930,426 7,425,556 1,886,009 292,971 966,165 348,328 11,397
Number of staying plans’ enrollees 10,450,594 7,183,221 1,710,614 251,723 945,311 348,328 11,397
Number of enrollees losing access to their plan 479,832 242,335 175,395 41,248 20,854
Average premiums of MA-PDs, weighted by 2014 enrollment
Premiums for all plans, 2014 $35.23 $26.56 $57.57 $46.32 $28.62 $109.09 N/A
Terminating plans, 2014 $51.51 $40.84 $64.96 $44.93 $75.47 N/A N/A
Staying plans, 2014 $34.48 $26.08 $56.82 $46.54 $27.59 $109.09 N/A
2015 Premiums for remaining 2014 plans $41.49 $31.84 $70.06 $53.45 $34.47 $112.13 N/A
Change in premiums for plans available in both 2014 and 2015 $7.01 $5.76 $13.24 $6.91 $6.88 $3.04 N/A
Share of enrollees in MA-PDs with no premiums, among plans available in both 2014 and 2015
2014 56% 67% 27% 28% 59% 1% N/A
2015 44% 55% 14% 7% 42% 1% N/A
Change in share of plans with no premiums -13% -12% -14% -21% -17% 0% N/A
Average premiums paid per enrollee, among MA-PDs with premiums (excluding zero premium plans) and available in both 2014 and 2015
2014 $79.23 $78.33 $78.04 $64.32 $67.68 $110.66 N/A
2015 $74.04 $70.33 $81.02 $57.19 $59.66 $113.25 N/A
Average out-of-pocket spending limits per year among MA-PDs, weighted by 2014 enrollment, among plans available in both 2014 and 2015
2014 $4,898 $4,689 $5,012 N/A $6,389 N/A N/A
2015 $5,068 $4,852 $5,335 N/A $6,650 $3,359 N/A
Change in average out-of-pocket spending limits $170 $162 $323 N/A $261 N/A N/A
Total MA-PD enrollees, as of September 2014 10,331,741 7,246,187 1,848,656 202,268 870,350 164,280
Number of staying MA-PDs’ enrollees 9,879,504 7,007,807 1,675,876 180,097 851,444 164,280
Number of enrollees losing access to their MA-PD 452,237 238,380 172,780 22,171 18,906
NOTE: Excludes Special Needs Plans (SNPs), demonstrations, Health Care Prepayment Plans (HCPPs), Program of All Inclusive Care for the Elderly (PACE) plans, employer-sponsored (i.e., group) plans, plans for special populations and plans that do not offer Part D benefits.
SOURCE: MPR/KFF analysis of CMS’s Landscape Files for 2014 and 2015 and CMS’s 2014 and 2015 Part C and D Crosswalk file and September 2014 enrollment.
Table A2. Average Number of Plans Available to Beneficiaries by County of Residence, 2009-2015
2009 2010 2011 2012 2013 2014 2015
National Average 48 33 24 20 20 18 18
Metro counties 51 35 26 22 22 20 20
Non-metro counties 36 24 16 13 13 11 10
Fee-for-Service Costs, by Quartile
Lowest cost quartile 45 28 18 17 17 17 15
Second quartile 46 31 20 17 16 15 14
Third quartile 44 30 20 17 18 16 16
Highest cost counties 53 37 30 24 24 21 22
NOTE: Excludes SNPs, employer-sponsored (i.e., group) plans, demonstrations, HCPPs, PACE plans, and plans for special populations.
SOURCE: MPR/KFF analysis of CMS’s Landscape and Penetration Files for 2009 – 2015.
Table A3. Unweighted Average Monthly Premiums for Medicare Advantage Prescription Drug Plans, by Plan Type, 2009-2015
2009 2010 2011 2012 2013 2014 2015 Change, 2014-2015
All Plans $51.81 $55.86 $50.61 $49.80 $51.43 $51.47 $53.42 $1.95
HMOs $34.52 $40.11 $36.24 $33.20 $34.11 $35.37 $38.28 $2.91
Local PPOs $65.12 $70.17 $65.72 $69.14 $72.57 $74.92 $81.02 $6.10
PFFS plans $74.46 $75.09 $65.79 $70.96 $83.29 $90.93 $87.86 -$3.07
Regional PPOs $55.68 $59.29 $53.38 $55.64 $56.89 $59.30 $67.85 $8.55
NOTE: Excludes SNPs, demonstrations, HCPPs, PACE plans, employer-sponsored (i.e., group) plans, and plans for special populations. Premiums include plans with premiums as well as plans with no premiums. Cost plans are included in the total but are not shown separately.
SOURCE: MPR/KFF analysis of CMS’s Landscape Files for 2009-2015.
Table A4.   Number of Medicare Advantage Plans Available, by Plan Type and Firm, 2009-2015
click to view PDF of Table A4
Table A5.   Share of Medicare Beneficiaries with Access to Firms’ Medicare Advantage Plan Offerings, by Plan Type and Firm, 2009-2015
click to view PDF of Table A5
Table A6. Unweighted Average Monthly Premiums for Medicare Advantage Prescription Drug Plans, by Plan Type and Firm, 2014 and 2015
2014 2015
All HMOs Local PPOs PFFS Plans Regional PPOs Cost Plans All HMOs Local PPOs PFFS Plans Regional PPOs Cost Plans
All Plans Combined $51.47 $35.37 $74.92 $90.93 $59.30 $143.43 $53.42 $38.28 $81.02 $87.86 $67.85 $141.09
UnitedHealthCare $10.92 $13.09 $3.57 $14.00 $2.86 N/A $26.59 $26.23 $29.62 $43.00 $20.17 N/A
Humana $48.33 $13.92 $66.20 $84.00 $83.26 N/A $47.42 $18.73 $73.09 $93.90 $87.29 N/A
BCBS – Total $70.92 $51.63 $89.26 $32.92 $27.10 $129.75 $76.14 $50.34 $108.93 $41.95 $53.03 $108.40
Wellpoint BCBS $39.88 $12.32 $65.29 $35.00 N/A N/A $37.94 $12.14 $80.75 N/A $61.50 N/A
Other BCBS plans $81.17 $65.64 $96.95 $32.92 $21.83 $129.75 $85.57 $61.39 $114.35 $41.95 $36.10 $108.40
Kaiser Permanente $49.21 $49.06 N/A N/A N/A $50.05 $48.86 $47.50 N/A N/A N/A $72.00
Aetna $29.32 $22.36 $42.65 N/A N/A N/A $37.68 $31.34 $47.46 N/A N/A N/A
WellCare $37.34 $37.34 N/A N/A N/A N/A $7.10 $7.10 N/A N/A N/A N/A
CIGNA $22.72 $22.36 $35.00 N/A N/A N/A $23.89 $23.34 $33.75 N/A N/A N/A
Other $63.24 $44.94 $88.08 $92.09 N/A $160.44 $61.72 $49.11 $90.15 $64.40 N/A $148.04
NOTE: Excludes SNPs, demonstrations, HCPPs, PACE plans, employer-sponsored (i.e., group) plans, and plans for special populations. BCBS are BlueCross BlueShield affiliates, which includes Wellpoint BCBS plans.   In 2015, Aetna includes plans acquired through the merger with Coventry. Total for 2014 includes 6 MSAs, and total for 2015 includes 7 MSAs. Premiums include plans with premiums as well as plans with no premiums. N/A indicates plan not available.
SOURCE: MPR/KFF analysis of CMS’s Landscape Files for 2014 and 2015.
Table A7. Number and Type of Special Needs Plans, by State, 2014 and 2015
State 2014 2015
Overall Dual eligibles Institutional Chronic conditions Overall Dual eligibles Institutional Chronic conditions
Alabama 5 4 1 0 5 4 1 0
Alaska 0 0 0 0 0 0 0 0
Arizona 27 12 2 13 34 22 2 10
Arkansas 6 3 0 3 8 5 0 3
California 64 30 2 32 69 29 2 38
Colorado 8 4 3 1 8 4 3 1
Connecticut 2 1 1 0 3 2 1 0
Delaware 3 1 1 1 4 1 2 1
District of Columbia 5 3 1 1 7 3 2 2
Florida 130 71 11 48 92 49 4 39
Georgia 15 9 2 4 16 10 2 4
Hawaii 1 1 0 0 4 4 0 0
Idaho 1 1 0 0 1 1 0 0
Illinois 9 5 1 3 10 6 1 3
Indiana 7 2 1 4 8 3 1 4
Iowa 3 1 0 2 3 1 0 2
Kansas 2 1 0 1 2 0 1 1
Kentucky 5 3 0 2 10 6 0 4
Louisiana 12 9 0 3 14 10 0 4
Maine 0 0 0 0 3 3 0 0
Maryland 8 2 3 3 9 2 3 4
Massachusetts 10 6 3 1 10 6 3 1
Michigan 13 9 3 1 12 8 3 1
Minnesota 11 11 0 0 9 9 0 0
Mississippi 7 5 0 2 8 6 0 2
Missouri 11 6 1 4 10 4 2 4
Montana 0 0 0 0 0 0 0 0
Nebraska 1 0 0 1 1 0 0 1
Nevada 5 0 0 5 6 0 0 6
New Hampshire 0 0 0 0 0 0 0 0
New Jersey 9 3 4 2 8 3 4 1
New Mexico 10 6 2 2 7 4 2 1
New York 57 42 10 5 56 40 10 6
North Carolina 6 3 1 2 11 6 1 4
North Dakota 0 0 0 0 0 0 0 0
Ohio 18 11 3 4 18 11 3 4
Oklahoma 1 0 1 0 1 0 1 0
Oregon 10 6 3 1 12 7 4 1
Pennsylvania 21 10 6 5 21 10 6 5
Puerto Rico 17 12 1 4 16 12 0 4
Rhode Island 1 0 1 0 1 0 1 0
South Carolina 8 4 1 3 8 3 1 4
South Dakota 0 0 0 0 0 0 0 0
Tennessee 7 6 1 0 7 6 1 0
Texas 35 24 3 8 31 21 3 7
Utah 2 2 0 0 2 2 0 0
Vermont 0 0 0 0 0 0 0 0
Virginia 14 4 4 6 11 2 4 5
Washington 6 5 1 0 6 5 1 0
West Virginia 1 1 0 0 1 1 0 0
Wisconsin 17 14 2 1 19 15 3 1
Wyoming 0 0 0 0 0 0 0 0
Total, U.S. 560 347 61 152 548 339 57 152
NOTE: Columns do not sum to U.S. total because some SNPs overlap state boundaries.
SOURCE: MPR/KFF analysis of CMS’s Landscape Files for 2014-2015.
Issue Brief

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/KaiserFamFound

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.