What shift has been observed in Medicare spending, particularly regarding Medicare Advantage plans?

Question

Christopher Boyd · Accepted Answer

Some plans which were in place in 2023 and 2024 have had their Maximum Out Of Pocket (MOOP) increase in 2025.

Larry Dalton · Answer

Many people with very limited incomes have enjoyed the opportunity to use OTC cards to help pay for over-the-counter drugs and utilities. There is considerable debate about whether this should continue in the future and whether it should be withdrawn from the Medicare system and transferred to the Medicaid system. Medicare Advantage plans are very beneficial in many ways, but they do come with their pros and cons and should be carefully analyzed before making a decision to go down that path.

Answered by Larry Dalton on March 26, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Brian Moore · Answer

Medicare spending crossed the $1 trillion threshold, with a significant 52% of this now going towards Medicare Advantage plans, up from 39% in 2019, indicating a shift in how care delivery and financing are evolving.

Answered by Brian Moore on February 16, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent

David Bell · Answer

Since 2004, as Medicare Advantage has evolved, we have seen more and more extra benefits added to the plans. Dental, vision, hearing, gym memberships and over-the-counter credits are the most notable. All money spent by the plans to care for their members. Additionally, they are well accepted by doctors and facilities.

Answered by David Bell on April 15, 2025

Agent Licensed in ID, AZ, CA & 8 other states

Answered by David Bell Medicare Insurance Agent

Mary Turner · Answer

The biggest changes I've seen in Medicare advantage plans is with the extra benefits.  Dental, vision, OTC, fitness benefits have expanded or been added over the years.

Yasmery Vargas · Answer

The dental and hearing benefits are underused. It caused many insurance companies to not only reduce benefits but also reduce other benefits like otc spend with restrictions.

Sean Davis · Answer

A notable shift in Medicare spending has been the increasing enrollment in Medicare Advantage plans, which typically showcase a trend of higher spending per beneficiary compared to Original Medicare. This growth reflects a preference among many beneficiaries for the additional benefits, such as vision and dental coverage, that Medicare Advantage plans often offer. Additionally, while Medicare Advantage plans may initially seem cost-effective due to lower premiums, the overall spending on healthcare services, including potential out-of-pocket costs, has been rising. This shift highlights the need for continuous evaluation of how these plans align with beneficiaries healthcare needs and financial situations.

Answered by Sean Davis on March 26, 2025

Broker Licensed in NY, LA, MD & 6 other states

Answered by Sean Davis Medicare Insurance Agent

Walt Smith · Answer

Medicare Advantage plans have evolved over the last several years. Most of them are now PPOs, which means you can go to doctors not in the network. They’ve added benefits that Medicare does not cover like dental coverage, eyeglass coverage, over-the-counter items, even hearing aids. And majority of the seniors or people on Medicare now has this type of coverage

Answered by Walt Smith on March 25, 2025

Agent Licensed in NJ, PA & VA

Answered by Walt Smith Medicare Insurance Agent

Fred Manas · Answer

Medicare spending has shifted towards Medicare Advantage plans, with spending on these plans exceeding traditional Medicare for Part A and Part B benefits since 2023. This shift is driven by rising enrollment in Medicare Advantage and higher payments to these plans compared to traditional Medicare. 
Here's a more detailed look:
Increased Enrollment:
The percentage of beneficiaries enrolled in Medicare Advantage has steadily increased, reaching over 50% of eligible Medicare beneficiaries in 2020. 
Growing Spending:
Payments to Medicare Advantage plans have nearly tripled between 2011 and 2021, growing from 26% to 47% of total Part A and B spending. 
Higher Payments:
Medicare pays more per beneficiary in Medicare Advantage plans than in traditional Medicare, with estimates suggesting an extra $83 billion in 2024 due to upcoding, favorable selection, and quality bonuses. 
Projected Growth:
Medicare spending on Medicare Advantage benefits is expected to continue growing, reaching 60% of total Part A and B spending by 2031, according to a KFF analysis. 
Reasons for Growth:
The shift is fueled by factors like zero-premium plans, extra benefits (vision, dental, etc.), out-of-pocket limits, and a desire for more convenient access to care. 
This shift raises questions about Medicare's long-term solvency and affordability, as Medicare Advantage plans are paid on average significantly more than traditional Medicare for similar beneficiaries.

Vachik Chakhbazian · Answer

spending on these plans significantly increasing as a percentage of total Medicare spending. ith Medicare Advantage enrollment growing rapidly and representing a larger portion of Medicare spending than traditional Medicare. Furthermore, Medicare Advantage plans are, on average, paid more per beneficiary than traditional Medicare.

Answered by Vachik Chakhbazian on April 17, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

What shift has been observed in Medicare spending, particularly regarding Medicare Advantage plans?

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What shift has been observed in Medicare spending, particularly regarding Medicare Advantage plans?

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