Since the 1970s, Medicare beneficiaries have had the option to receive their Medicare benefits through private health plans, mainly Health Maintenance Organizations (HMOs), as an alternative to the federally administered traditional Medicare program. The Balanced Budget Act (BBA) of 1997 named Medicare’s managed care program “Medicare+Choice” and the Medicare Modernization Act (MMA) of 2003 renamed it “Medicare Advantage.”  In 2019, the majority of the 64 million people on Medicare are covered by traditional Medicare, but one-third (34%) are enrolled in Medicare Advantage plans. Over the past decade, the number of beneficiaries enrolled in private plans has nearly doubled from 11.1 million in 2010 to 22.0 million in 2019.

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Brief Examines Five Potential Ways to Improve Dental Coverage for People on Medicare

Medicare does not cover routine dental care, and two-thirds of the Medicare population have no dental coverage at all. With limited or no dental coverage, some incur high out-of-pocket costs, while others forgo need dental care because they can’t afford it. Policymakers in Washington and others are exploring ways to…

Policy Options for Improving Dental Coverage for People on Medicare

Medicare does not cover routine dental care and the majority of Medicare beneficiaries do not have dental coverage. This brief examines five potential ways to make oral health care more available and affordable for the Medicare population. This brief reviews the limits of dental coverage permitted under current Medicare law, then describes each of the policy options, with an analysis of likely implications for key stakeholders, including Medicare beneficiaries, taxpayers, insurers, and dental professionals

The Facts on Medicare Spending and Financing

This issue brief examines the latest facts about Medicare spending and financing, including the most recent historical and projected Medicare spending data from the Centers for Medicare and Medicaid Services Office of the Actuary, the 2019 annual report of the Boards of Medicare Trustees, and the 2019 Medicare baseline and projections from the Congressional Budget Office. It discusses historical and projected spending trends, program financing, Medicare’s financial condition, and the future outlook.

As Policymakers Debate Medicare-for-All, Analysis Finds the Medicare Advantage, Individual and Group Health Insurance Markets Appear to Be Profitable, Especially Medicare Advantage

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers, according to a new KFF analysis. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or…

Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.

A Dozen Facts About Medicare Advantage in 2019

Medicare Advantage enrollment has grown rapidly over the past decade, and Medicare Advantage plans have taken on a larger role in the Medicare program. More than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2019. This data note provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes analyses of Medicare Advantage plans’ extra benefits and prior authorization requirements.

What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?

The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.

Medicare Advantage

This fact sheet includes the latest information and data about the Medicare Advantage program, including enrollment, plan information, spending and financing for the program, and payment and program changes made by the Affordable Care Act as well as other laws.

Beneficiaries Who Switch to Medicare Advantage Have Lower Medicare Spending and Use Fewer Services – In the Prior Year – Than Those Who Stay in Traditional Medicare

Medicare Advantage plans gain beneficiaries from traditional Medicare who have lower average spending and use fewer health services than similar beneficiaries who choose to remain in traditional Medicare, according to a new KFF analysis. The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had…