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So you want to start a Medicare Advantage plan…Benefits and member premiums offered in the first five years

14 May 2021

In this article, we focus on some of the tactics frequently taken by new entrants to design an attractive benefit plan with competitive premiums in their first five years in the Medicare Advantage market. This is the fourth article in this white-paper series on Medicare Advantage startups. The first three articles focused on enrollment, service area expansion, and star ratings achieved over the first five years for Medicare Advantage organizations (MAOs). The paper discusses ways to grow enrollment in the first year, and which MAOs are included in the study. We also cover what percentage of MA plans enter the market with a $0 premium plan and enrich their benefits after their first year. The paper then discusses how the total beneficiary cost can affect benefit and premium strategy. We conclude with key takeaways.


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