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. | ||||||||||||||||