With Medicare Part A & B coming as a bundle for those who enroll, only some subscribers choose to sign up for the optional plans offered by CMS. Members can make their own decision about whether or not they register for Part C (also known as the Medicare Advantage Plan) and Part D, the prescription drug plan.
Research now shows that 48% of Medicare members subscribe to the Medicare Advantage Plan. This number is expected to reach 50% by mid-2023. This same study showed that 55% of all government spending on Medicare services was attributed to Medicare Advantage. This plan has seen exponential growth since 2007, at which point only 19% of Medicare subscribers were enrolled.
This plan has been around since the 1970s, and its initial version allowed members access to managed care services that were controlled by private insurers. This benefit paused for a short time and resumed in the late 1990s. Providers believe that the creation of Medicare Part D in 2003 helped kickstart interest in the Medicare Advantage Plan.
Medicare and Your Provider Network
Now, Medicare Advantage Plans are partnered with health maintenance organizations (HMOs) such as UnitedHealthcare, Humana, CVS Health, Blue Cross Blue Shield, Cigna, Centene, and Kaiser Permanente. While many of these HMOs have subsidiaries such as local divisions of Blue Cross Blue Shield, most are nationwide.
It’s important to keep in mind that subscribers can only access these Medicare Advantage plans if they are offered by insurers in their area. This is why all insurance companies must work to establish strong provider networks in their area to better attract and retain all members, including Medicare Advantage Plan subscribers.