Medicare advantage is the type of medical or health insurance that pays for managed health care on the basis of monthly fee per enrolee. These are the medical and hospitals insurance that are provided by the private companies rather than the federal government. These are also known as Part C Plans that provide the same coverage as that of Plan A (Hospital) and Plan B (Medical). They usually provide Plan D (Drugs) coverage as well, hence are more attractive than the government or Medicare plans.
Market Growth Factors
Modern Medicare advantage plans have successfully gained the market due to various benefits that they provide over traditional Medicare plans. These MA plans have improved the process and are more customers centric to improve the plan quality and consumer satisfaction. MA plans allows the insurers to structure their plans so that to maximize their attractiveness to consumers. Also the highly subsidized MA plans for the employers largely fill the same gap as that of the traditional Medicare for retiree but is less expensive and hence is more attractive to the consumers. All these factors are leading to the improved market growth.
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Based on the type of Medicare Advantage (MA) plans the market has been segmented into Health maintenance organizations (HMO), preferred provider organizations (PPO), special need plans, and private fee for service, medical savings accounts and others. HMO and PPO plans accounts for the major market share of the global Medicare advantage market. As these plans are mainly offered by private insurance companies that are approved by Medicare, there are number of differences or alterations between the plans, including additional coverage (such as dental and routine vision, wellness or hearing coverage), costs, and rules for getting services. On the basis of method the market has been segmented as agents or brokers, and direct writing. HMO plans, those with point-of-service options, have been the main type of coverage in the segment for several years.
North America commands the major market share of the global Medicare advantage market owing to the maximum population in the countries opting for such plans. There are more private or individual enrolments in Medicare advantage segments than group enrolment in health insurance market in the region. Europe commands the second largest share due to increasing privatization and hence the improvement in Medicare. Asia Pacific is expected to provide larger opportunities to the market players with the continual economic developments and increasing awareness among the people.
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The major market players include
- Kaiser Permanente
UnitedHealth is one of the major market players which retain its position as the top Medicare Advantage organization in the world. On the other hand Humana experienced the largest gain in 2016 in terms of membership. UnitedHealth ,Humana, and Anthem together expected to command the major market share of the global Medicare advantage market.
In October 2017, Anthem acquired America’s First Choice that offers “HMO products, including some special need plans under its Freedom and Health Optimum brands in Florida with the major aim of expanding its business of providing health benefits to seniors in the country.
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