Companies often vye for the plans because the federal government helps pay for a portion of premiums, but because CMS isn’t a negotiating party, details and data on how many employers are opting to make the shift are largely obscured. Employers also desire Medicare Advantage’s flexibility in enrolling retirees and its limited network requirements.
“There are as many plans as there are stars in the sky because employers and insurers can design their health benefits any way they want to,” Tatiana Fassieux, a training specialist for consumer group California Health Advocates, told Fortune.
But as enrollment in employer-sponsored Medicare Advantage soars — up more than 3.4 million enrollees since 2008 — the rules that allow Medicare officials to “waive or modify requirements that hinder” employer-sponsored plans also make it difficult for employees to have continuity of care.
One such rule allows employers to have narrower networks, meaning members have harder times staying with or finding a new physician. The struggle is playing out in New York City, where the city’s new Medicare Advantage retirement evoked pushback from former city employees in September 2021.
