The Value of Medicare Advantage Employer Group Waiver Plans in the Public Sector: An Introduction

Employer Group Waiver Plans (EGWPs) are becoming an increasingly popular choice among employers providing health care coverage to their retirees through Medicare Advantage (MA). Over half of all eligible Medicare beneficiaries are now enrolled in Medicare Advantage, and between 2018 and 2022, total MA-EGWP enrollment increased by nearly 27%, from 4.1 to 5.2 million. As health care costs continue to climb, public sector purchasers increasingly turn to MA-EGWPs to maintain or enhance coverage for beneficiaries, while reducing immediate costs and long-term liabilities.

This foundational report explores the various benefits and adaptability of MA-EGWPs, particularly amongst public sector health care purchasers, including robust coverage and supplemental benefits for seniors, greater payment stability for plan sponsors, and advancements in health equity and social risk factors.