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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 2017, the majority of the 57 million people on Medicare are covered by traditional Medicare, with one-third (33%) enrolled in a Medicare Advantage plan. Since 2004, the number of beneficiaries enrolled in private plans has more than tripled from 5.3 million (13%) to 19.0 million in 2017 (33%).

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New England Journal of Medicine: Medicare Advantage Checkup

In this October 2018 New England Journal of Medicine article, KFF’s Tricia Neuman and Gretchen Jacobson examine the extent to which Medicare Advantage plans are achieving goals with respect to benefits, out-of-pocket costs, plan choice, federal spending and quality.

A Dozen Facts About Medicare Advantage

Medicare Advantage plans have played an increasingly larger role in the Medicare program over the past decade. More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2018. This data note provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes new analyses of Medicare Advantage plans’ extra benefits, use of prior authorization, and bonus payments paid by Medicare.

Prior Authorization in Medicare Advantage Plans: How Often Is It Used?

Medicare Advantage enrollees are encouraged to select their plan based on a number of factors, including premiums, cost-sharing, extra benefits, drug coverage, quality of care, and provider networks, but a potentially overlooked factor is access to covered services and the potential impact of prior authorization requirements. In this data note, we examine the share of Medicare Advantage enrollees that are in plans requiring prior authorization and approval before covering the costs of services.

People on Medicare Will Be Able to Choose Among 24 Medicare Advantage Plans and 27 Medicare Part D Drug Plans, on Average, During the Open Enrollment Period for 2019, New Analyses Find

With Medicare Advantage playing an increasingly larger role in Medicare, the average person on Medicare will be able to choose among 24 plans during the annual Medicare open enrollment period that began Oct. 15, finds a new analysis from KFF (the Kaiser Family Foundation). The new analysis, Medicare Advantage Plans…

Medicare Advantage 2019 Spotlight: First Look

In 2019, more than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This issue brief provides an overview of the Medicare Advantage plans that will be available in 2019, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market for the first time and also examines the insurers exiting the market.

Medicare Open Enrollment FAQs

This list of Frequently Asked Questions (FAQs) about Medicare Open Enrollment covers a range of topics related to Medicare enrollment, Medicare Advantage, Part D, Medigap, employer/retiree coverage, Medicaid and other low-income assistance, Medicare and the Marketplaces, and more.

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 (CMS) Office of the Actuary (OACT), the 2018 annual report of the Boards of Medicare Trustees, and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO). It discusses historical and projected spending trends, program financing, Medicare’s financial condition, and the future outlook.

Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing

This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.

An Overview of Medicare

This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with permanent disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

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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.