The Centers for Medicare and Medicaid Services (CMS) recently posted a giant collection of 2019 Medicare Advantage plan cost data: a file that shows what each plan will cost, in each county.
The file also shows what the plan’s annual prescription deductible will be, and what the plan’s annual in-network maximum out-of-pocket (MOOP) spending limit will be.
The file, the 2019 MA Landscape Source Files spreadsheet, is available here.
(Related: Medicare Looms Over Health Agents’ Meeting)
We used the spreadsheet to come up with statewide cost averages.
To do that, we converted the monthly premium figure for each plan into an annualized figure, by multiplying the monthly figure by 12. We then added the annualized premium figure to the MOOP to come up with a total annual cost figure.
We also tried to improve the fairness of the cost comparisons by limiting the information used in the calculations to data for reasonably similar types of plans. We filtered the spreadsheet to include only the data for local health maintenance organization plans, local preferred provider organization (PPO), plans and regional PPO plans, and only the data for plans that offer both Medicare Part D prescription drug coverage and enhanced alternative drug benefits.
Of course, our assumptions may fit some enrollees better than others. Medicare enrollees who expect to be healthy may prefer a plan with low, or no, monthly premiums to a plan with a low MOOP.
But clients who can afford it probably ought to budget for the possibility that they will use enough medical care to reach the MOOP.
We found that the state with lowest MOOP and annualized premium total was Nevada.
The average monthly premium there was about $45 per month, the average MOOP was $3,992, and the sum of the annualized premiums and the MOOP was $4,538.
The median premium-MOOP total, and the maximum was $7,246.
For a list of the states with 10 highest premium-MOOP totals, see the idea cards above.
— Read U.S. Health Insurers Are Doing All Right: Mark Farrah, on ThinkAdvisor.