The average 2021 premium for Medicare Advantage (MA) plans will be the lowest in 14 years, according to the Centers for Medicare & Medicaid Services (CMS).

Seniors who enroll in an MA plan during the 2021 open enrollment period will have more plan choices with expanded benefits and lower costs, CMS announced on Thursday.

The MA average monthly plan premium is estimated to drop 11 percent to $21 from an average of $23.63 in 2020. In the last three years, the average monthly premium has decreased roughly 34 percent, the lowest cost since 2007. Some states, including Alabama, Nevada, Michigan, and Kentucky, will see their average premium decreases of more than 50 percent since 2017.

Furthermore, seniors will have more plan choices when open enrollment begins Oct. 15. There will be 4,800 MA plans available in 2021, a 76.6 percent increase since 2017. The average number of plan choices per county will increase from 39 plans in 2020 to 47 plans in 2021. Rural counties will also see more choices. CMS said the number of options in rural areas have gone up 18 percent from 2,450 in 2020 to 2,900 in 2021.

CMS also announced that seniors who use insulin will have more than 1,600 MA and Part D prescription drug plans to choose from that will offer insulin at no more than a $35 monthly copay beginning in January.

The agency also expects MA enrollment projections to increase in 2021 to an all-time high of 26.9 million beneficiaries. Currently, 24.4 million seniors are enrolled in MA plans. Part of the increase is due to CMS’ previous announcement that Medicare beneficiaries with End Stage Renal Disease will now have the option to enroll in an MA plan in 2021.

Enrollees will also see extra benefits in their choices this year that typically are not covered in traditional Medicare:

  • Most (94 percent) of MA plans will offer additional telehealth benefits. In 2020, only 58 percent of plans offered telehealth benefits.
  • Fifty-three MA plans will offer increased access to palliative care and integrated hospice care to their enrollees through the MA Value-Based insurance Design Model.
  • Nearly 730 plans will offer supplemental benefits, such as adult day health services, caregiver support services, in-home support services, therapeutic massage, or home-based palliative care.
  • An estimated 500 plans will offer enrollees with certain conditions, such as diabetes and congestive heart failure, with access to lower copayments or additional benefits such as meals and transportation.
  • Roughly 920 plans will offer benefits tailored to people which chronic conditions to help them better manage these benefits. Some of these benefits include pest control, home cleaning services, meal home delivery, and transportation for non-medical reasons such as trips to the grocery store.
  • The 440 MA plans that participate in the 2021 MA Value-Based Insurance Design Model will feature additional benefits, such as healthy foods and meals, transportation support, reduced cost-sharing, and rewards and incentives aligned with Part D drugs. CMS said it will release a request for applications, including for the hospice benefit component, for the MA Value-Based Insurance Design Model 2022 plan year later this fall.

“Today’s announcement confirms that market competition works,” said CMS Administrator Seema Verma in the news release. “Historically low premiums, massive savings on insulin, and more supplemental benefits represent the welcome fruit of the creative, patient-oriented policies that this administration has made its calling card. Medicare beneficiaries will feel the difference–in their health as well as their pocketbook.”