2014 Medicare Advantage Choices Involve Tradeoffs Between Premiums and Quality

 A new analysis from HealthPocket examines government star ratings of Medicare Advantage(MA) plans and weighs them against financial attributes of the plans, including monthly premiums and annual limits on out-of-pocket expenses. The study of every plan available in each county of the United States found that plans rated highly with four or more stars come with an average monthly premium of $85 versus the average of all plans of $58. It also found that the incidence of lower out-of-pocket caps was consistent across all star ratings, with about 30 percent of plans offering annual limits of $3,400 or below.

 

MA plans serve 14.4 million Americans and have 28 percent of the Medicare-eligible population market share. These plans are growing in popularity compared to traditional Medicare, and consumers base their choices on multiple factors, including premium cost and finding their physician in a plan network. The Medicare plan quality star rating system is one key factor in helping enrollees differentiate plans, and reflects scores for treatment, preventive care, and customer satisfaction. This study found that for 2014, highly rated four and above star MA plans are available to residents of over half of U.S. counties.

 

“The good news for Medicare Advantage customers is that the overall quality of these plans is rising, and their limits on out-of-pocket expenses provide good insurance protection,” said Steve Zaleznick, executive director for Consumer Strategy and Development at HealthPocket. “But not all regions in the U.S. have access to four plus star plans, and some highly rated plans have higher premiums than lesser rated plans. Therefore, consumers would be wise to do thorough research into how the quality and costs of their available options fit their personal situation.”

 

This HealthPocket Infostat is part of a series using health plan data to produce unbiased market analysis and guidance for consumers navigating America’s changing health insurance environment. Sub-ratings for each MA plan are available on HealthPocket’s plan detail page.