This new requirement builds on the Part D Senior Savings Model established by the Center for Medicare and Medicaid Innovations (CMMI) in 2021 in which participating enhanced Part D drug plans cover insulin products at a monthly copayment of $35 in the deductible, initial coverage, and coverage gap phases of the Part D benefit. In 2023, under a provision in the Inflation Reduction Act, Part D enrollees will pay no more than $35 per month for covered insulin products in all Part D plans. Seven firms are offering C-SNPs for people with end-stage renal disease (up three from 2022).Īvailability of Insulin Demonstration Plans. Prior to this change, people with ESRD were not able to enroll in most Medicare Advantage plans, subject to limited exceptions, such as C-SNPs for people with ESRD. In 2021, people with end-stage renal disease (ESRD) became eligible to enroll in Medicare Advantage plans. For 2023, two firms are offering C-SNPs for people with dementia (compared to three firms in 2022), two firms are offering C-SNPs for people with mental health conditions (compared to four firms in 2022), and one firm is offering a C-SNP for people with HIV/AIDS (compared to three firms in 2022). The number of SNPs offered for people with chronic conditions (C-SNPs) is also increasing in 2023 (306 plans), more than doubling from 2018 (132 plans), most of which focus on people with diabetes, heart disease, or lung conditions, as has been the case since the inception of C-SNPs. The number of D-SNPs has increased sharply over the past five years, nearly doubling from 401 dual SNPs in 2018 to 789 dual SNPs in 2023, suggesting insurers continue to be drawn to this high-need population. The majority of SNPs (61%) are plans designed for people dually eligible for Medicare and Medicaid (D-SNPs). I-SNPs may be attractive to insurers because they tend to have much lower marketing costs than other plan types since they are often the only available option for people who require an institutional level-of-care, such as those who have been in nursing homes for an extended period of time. The rise in SNPs for people who require an institutional-level of care (I-SNPs) has been particularly notable, nearly doubling from 97 plans in 2018 to 189 plans in 2023 (an increase of 5 plans since 2022). In 2023, 1,284 SNPs will be offered nationwide, an 11 percent increase between 20 (Figure 3). While many employers and unions also offer Medicare Advantage plans to their retirees, no information about these 2023 plan offerings is made available by CMS to the public during the Medicare open enrollment period because these plans are not available to the general Medicare population. In the remaining states, the number of plans either stayed the same or the growth in plans was 13 or less. In contrast, Washington has 7 fewer plans available for 2023 than in 2022, while Kansas and Maine have 3 fewer plans Montana, New Hampshire, Oregon, South Carolina, Utah, Vermont, and the District of Columbia have one fewer plan available in 2023 than in 2022. The growth in number of plans varies across states and counties, with the preponderance of the growth occurring in Texas (42 more plans), Florida (26 more plans), and Pennsylvania (21 more plans) (data not shown). The number of regional PPOs and private fee-for-service plans (PFFS) have respectively slowly declined from around 2% of plans offered in 2019 to 1% in 2023. In 2023, 40% of all Medicare Advantage plans offered are local PPOs, compared to 30% in 2019. The availability of local PPOs has increased rapidly over recent years. HMOs account for about six in ten plans (58%) offered in 2023, a slight decline from 20 where they accounted for about two-thirds of all plans offered. These numbers exclude employer or union-sponsored group plans, Special Needs Plans (SNPs), PACE plans, cost plans, and Medicare-Medicaid plans (MMPs) that are only available to select populations. For 2023, the average Medicare beneficiary can choose from 43 Medicare Advantage plans, more than double the average number available in 2018, and the largest number of options available over the period we examined, which goes back to 2010 (Figure 1). Number of Plans Available to Beneficiaries. ( A separate overview of the 202 3 Medicare Part D marketplace is also available.

This brief provides an overview of the Medicare Advantage plans that are available for 2023 and key trends over time. In 2022, more than 28 million Medicare beneficiaries are enrolled in a Medicare Advantage plan, nearly half of the total Medicare population. Over the last decade, Medicare Advantage, the private plan alternative to traditional Medicare, has taken on a more prominent role in the Medicare program.

Medicare copay 2023