Medicare Advantage

This policy watch examines monthly premiums for Medicare Part D stand-alone drug plans in 2025, as changes to the Part D benefit are being implemented in 2025, including a new $2,000 cap on out-of-pocket drug spending.

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.

With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and…

This brief analyzes the different types of coverage that people with Medicare have and the demographic characteristics of Medicare beneficiaries with these different coverage types.

In 2024, federal spending on Medicare Advantage bonus payments will total at least $11.8 billion, as nearly three-quarters of enrollees are in a plan that received bonus payments. The average bonus payment is higher for employer plans and lowest for special needs plans, raising questions about the implication of the quality bonus program for equity.

Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year, according to a new KFF analysis of federal data. That was a higher share of denials…

Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year. The volume of prior authorization requests, the share denied, the share of denials that were appealed, and the share that were overturned upon appeal varied across Medicare Advantage insurers.

In 2024, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.

This brief provides information about Medicare Advantage plans in 2024, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.