Baby boomers choosing Medicare Advantage

Each day, 10,000 Americans turn 65. The Baby Boomers are reaching Medicare eligibility at a rapid rate, and more and more are choosing Medicare Advantage to help them manage their health.

Medicare Advantage is an alternative to Original Medicare, which includes the Medicare plans managed by the federal government. Medicare Advantage is offered through private insurers, and in the last five years, enrollment has surged by nearly 50 percent across the country to approximately 18 million. Not even the “age wave” of Baby Boomers accounts for this explosive growth, as the Medicare-eligible population has increased only 18 percent over the same period.

The surge in Richmond is even more dramatic, with Medicare Advantage enrollment growing by 71 percent since 2011.

This health-care shift may be fueled by three characteristics of Medicare Advantage plans: predictable costs, additional benefits and care coordination.

Original Medicare generally covers about 80 percent of beneficiaries’ health care costs, leaving them responsible for covering the remaining 20 percent out of pocket with no annual limit. Medicare Advantage plans, on the other hand, have a preset cap on how much a member must pay out of his or her pocket, making it easier to budget for health-care expenses.

Original Medicare covers the basics like hospital stays and doctor visits, but not some of the staples people have come to expect from their health-care plans, like routine vision and hearing exams. Many Medicare Advantage plans cover these benefits, and most plans include prescription drug coverage. Some plans cover hearing aids and preventive dental care, and offer services like house call visits, access to 24-7 nurse phone lines and fitness memberships.

The health-care landscape is complex and can be difficult to navigate. Medicare Advantage supports a collaborative, team-based approach by connecting doctors and other health-care providers with the latest data and information. This coordination can help doctors deliver the right care at the right time and simplify the patient experience. And, to emphasize quality rather than quantity, many Medicare Advantage plans are shifting towards paying doctors based on patient outcomes rather than simply the number of procedures performed.

These are a few of the reasons we may be seeing this Medicare Advantage growth trend playing out in Richmond and across the country.

2011 and 2016 enrollment data sourced from Centers for Medicare & Medicaid Services Medicare Advantage State/County Penetration reports.