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Medicare Advantage Plan Switching: Exception or Norm?

Each year, Medicare Advantage enrollees have the opportunity to change plans during an annual enrollment period. This opportunity is important because Medicare Advantage plans can make changes in their benefits, cost-sharing, provider networks, and premiums each year, and beneficiaries’ health needs may change from one year to the next. The open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. It is also the time when beneficiaries in traditional Medicare can switch to Medicare Advantage plans.

Little is known about the extent to which Medicare Advantage enrollees change plans during the annual open enrollment period. Prior research shows that roughly the same share of beneficiaries, 5 percent, shift between Medicare Advantage and traditional Medicare each year,1 that most enrollees tend to stay in a Medicare Advantage plan once in Medicare Advantage,2 and that switching rates from Medicare Advantage to traditional Medicare are higher among high-need, high-cost patients.3,4

This analysis focuses on enrollees in Medicare Advantage plans with prescription drug coverage (MA-PDs) who change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings. The analysis is based on a five percent sample of Medicare claims data merged with plan data from 2007 to 2014 (see Methods).

Issue Brief

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.