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UPDATED: Study Shows Proposed Medicare Advantage Changes Could Double Premiums For Seniors

posted by James Swann

on November 8, 2021

To better understand how changes to Medicare Advantage (MA) payment formulas would impact enrollees in different states, Avalere has updated its September 2021 study. Its findings confirm significant risks for seniors’ pocketbooks.

Today, 27 million seniors and people with disabilities choose MA because it delivers better services, better access to care, and better value – and their coverage and care should be protected. Avalere found that an increase to the MA coding intensity factor could increase premiums by $9 – $25 per month, or an increase of 43% to 115%.

This study also includes a new analysis showing the state-by-state reduction in the availability of $0 premium plans. Notably, the updated research finds that increases to MA coding intensity could mean no MA enrollees would have access to a $0 premium plan, a plan option selected by 55% of MA enrollees in 2021. In fact, 66% of enrollees could pay a monthly premium of more than $25 if the coding intensity factor increased to 9%.