Senators call for Medicare Advantage improvements. Here's what you can do now.

By Alessandra Malito

32 million Americans rely on Medicare Advantage

Millions of Americans are enrolled in Medicare Advantage, and dozens of senators on both sides of the aisle are urging the Centers for Medicare and Medicaid Services to improve the security and efficiency of the program.

More than 32 million Americans, including seniors and people with disabilities, are enrolled in Medicare Advantage plans - insurance plans offered by private companies that build on Medicare coverage. For example, traditional Medicare does not offer vision, hearing or dental coverage, but some Medicare Advantage plans do.

The plea from legislators comes as Cigna Group said it agreed to sell its Medicare Advantage business to Health Care Service Corp. for about $3.7 billion in cash.

The program has become so widely used that 61 senators, Democrat and Republican, issued a letter to the Biden administration on Jan. 26 urging it to protect Medicare Advantage in advance of any updates to the program by the Centers for Medicare and Medicaid Services. In their letter, the senators, among them Utah Republican Mitt Romney and New York Democrat Charles Schumer, highlighted the need to thwart predatory marketing practices and bolster transparency by providing clear and accurate information about cost and coverage options.

"As the Administration considers updates for plan year 2025, we request that you ensure payment and policy stability for the Medicare Advantage program, to protect and strengthen this critical choice for current and future Medicare beneficiaries," the letter said.

But beneficiaries don't have to wait to make sure they are getting the healthcare they need. They still have two months to look at their current coverage and change to something that is a better fit for their circumstances, if necessary.

Medicare Advantage has its own annual enrollment period between Jan. 1 and March 31, one that is separate from the annual enrollment period for traditional Medicare, which runs between Oct. 15 and Dec. 7 every year. This particular enrollment period is only available to current Medicare Advantage beneficiaries, who can switch between plans with or without drug coverage or move back to original Medicare.

Any changes made during this enrollment period are effective the first day of the month following the request. For the Medicare annual enrollment period in the fall, coverage always begins on Jan. 1 of the next year.

All enrollees, even those who are happy with their current insurance plan, should look over their coverage options. Half of all Medicare Advantage enrollees have been on the same plan for at least two years, according to an eHealth report released last year, mostly because they were happy with what they had. But while their insurance plans may hold up for their medical needs, insurance companies can change what's covered from year to year. There may also be new developments in a person's life, such as a new diagnosis or a move to another city, so looking at all the options is always a good idea.

When looking at coverage options, enrollees should carefully consider what doctors, medical facilities, prescription drugs and procedures are covered, as well as how copayments and coinsurance could affect what they owe during the year.

Medicare Advantage enrollees accounted for more than half of all eligible Medicare beneficiaries in 2023, according to KFF. The number of beneficiaries under Medicare Advantage has been steadily increasing over the years, KFF reported, although some of the major health-insurance players that offer these plans have had mixed earnings results lately.

Humana (HUM) said recently that growth was not as strong as anticipated during the company's earnings release in January, and shares of UnitedHealth Group (UNH) and Cigna (CI) also fumbled. Not all companies suffered during last year's enrollment period, however: CVS (CVS), another Medicare Advantage plan provider, said at the beginning of the year that 2024 enrollment exceeded expectations.

-Alessandra Malito

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01-31-24 1113ET

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