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This data note analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries, and also describes changes in the health care insurers offering private health plans in 2018. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.
This brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.
This brief examines 10 key facts about women with Medicare and presents new statistics on the health, economic and functional status of women with Medicare.
The Centers for Medicare and Medicaid Services has recently taken actions to increase transparency in Medicare Advantage, however substantial data gaps remain that limit the ability of policymakers and researchers to conduct oversight and assess the program's performance, and for Medicare beneficiaries to compare Medicare Advantage plans offered in their area.
People who are dually eligible for both Medicare and Medicaid coverage can get their Medicare coverage in a variety of ways. The brief breaks out the data for traditional Medicare, Medicare Advantage plans that are available to all Medicare beneficiaries, and plans that are designed specifically for dual-eligible beneficiaries.
For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits.
A review of the 2025 Medicare Advantage plans available for individual enrollment shows that the total number of plans declined by 7% (from 3,959 to 3,699). The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, just 2 fewer than the 36 options available in 2024. Since 2018, the number of plans available to the average beneficiary has doubled.
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2025 and key trends over time. Two-thirds of all Medicare Advantage plans with Part D prescription drug coverage (MA-PDs) (67%) will charge no premium (other than the Part B premium) in 2025, similar to 2024 (66%). Nearly all Medicare Advantage plans (97% or more) are offering vision, dental and hearing, as they have in previous years. However, the share of plans offering certain benefits has declined, such as over-the-counter benefits (85% in 2024 vs. 72% in 2025), remote access technologies (74% in 2024 vs. 53% in 2025), meal benefits (72% in 2024 vs. 65% in 2025) and transportation (36% in 2024 vs. 29% in 2025).
Nearly 50 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2023, of which 3.2 million (6.4%) were denied. Just 11.7% of denied requests were appealed, though 81.7% of appeals overturned the initial denial in Medicare Advantage. Substantially fewer prior authorization requests were made in traditional Medicare, reflecting the small number of services subject to prior authorization requirements.
This analysis looks at traditional Medicare spending among people who choose to disenroll from Medicare Advantage and obtain coverage under traditional Medicare during the annual Medicare open enrollment period. It compares their traditional Medicare spending (Parts A and B) in the year following disenrollment to similar people who were continuously covered by traditional Medicare, using data from the Medicare Beneficiary Summary File (MBSF) for 2021 and 2022.
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