Medicare Open Enrollment Insights

By: SmartFinancial
NEWPORT BEACH, Calif. - Sept. 21, 2023 - PRLog -- Medicare Open Enrollment starts October 15.
  • In 2023, 30.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 51 percent, of the eligible Medicare population, and $454 billion (or 54%) of total federal Medicare spending (net of premiums).
  • The average Medicare beneficiary in 2023 has access to 43 Medicare Advantage plans, the largest number of options ever.
  • Medicare Advantage enrollment as a share of the eligible Medicare population has jumped from 19% in 2007 to 51% in 2023.
  • Between 2022 and 2023, total Medicare Advantage enrollment grew by about 2.3 million beneficiaries, or 8 percent – a similar growth rate to the prior year (8%).
  • One in five (about 5.4 million) Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union.
  • During 2023, the out-of-pocket limit for Medicare Advantage could not exceed $8,300 for in-network services and $12,450 for in-network and out-of-network services combined. In 2024, these limits will increase to $9,450 and $18,900.
  • There is no limit on out-of-pocket expenses with Original Medicare.
  • Medicare Advantage Plans have coverage for fitness programs, vision, hearing, and dental services.  
  • Plan Types:
    • HMO insurance covers treatments from doctors and facilities who contract with the insurance plan but generally doesn't cover out-of-network care.
    • HMO-POS insurance covers visits to both in-network and out-of-network healthcare providers, although you will have to pay more out of pocket when you go to an out-of-network provider.
    • MSA insurance combines a high-deductible health plan and a savings account with money from Medicare that you can use to pay for covered medical expenses before you hit your deductible.
    • PPO insurance covers treatments from both in-network and out-of-network healthcare providers and doesn't require you to select a primary care physician or get a referral to see a specialist.
    • PFFS insurance allows you to visit both in-network and out-of-network providers, although out-of-network providers can decline to treat you if they don't agree to the terms of your PFFS plan.

Michael Orefice, SVP of Operations at SmartFinancial ( says:

"Most seniors are on a fixed income, so it's important for them to find savings wherever they can. Sometimes, that means choosing a Medicare option that saves them out-of-pocket costs. It's also important not to get fooled by a zero-dollar premium; some Medicare Advantage plans have high deductibles and out-of-pocket costs. However, a good plan can save a senior some money and even cover dental, hearing, vision and fitness-related expenses. It's important to compare plans carefully before deciding which is the best one."

Fran Majidi
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Location:Newport Beach - California - United States
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