Are the Tradeoffs from Prior Authorization Worth It?
In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs.
View the Latest: Medicare Advantage
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Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026
Issue BriefVirtually all (98.9%) of the 2.6 million Medicare beneficiaries enrolled in a Medicare Advantage plan that terminated coverage at the end of 2025 have at least one MA-PD available in 2026, including more than two-thirds (68.7%) who have the option of enrolling in a plan sponsored by the same insurer.
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Analyzing Changes in Medicare Part D Enrollment for 2026
Issue BriefThe Medicare Part D prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). New data from CMS shows that 56 million people are enrolled in Part D plans as of February 2026, with more in MA-PDs than PDPs, reflecting higher overall enrollment in Medicare Advantage than in traditional Medicare. Enrollment in group MA-PD plans decreased while group PDP enrollment increased.
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Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans
Issue BriefJust over 35 million people are enrolled in Medicare Advantage in February 2026, an increase of 1.1 million since a year ago. The increase was largely driven by increased enrollment in special needs plans.
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Health Insurer Financial Performance in 2024
Issue BriefThis analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.
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Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024
Issue BriefNearly 53 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2024, of which 4.1 million (7.7%) were denied. Just 11.5% of denied requests were appealed, though 80.7% 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.
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A Snapshot of Sources of Coverage Among Medicare Beneficiaries
Issue BriefThis analysis documents the different sources of coverage among people with Medicare and examines variation in beneficiary characteristics by source of coverage.
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Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits
Issue BriefThis brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
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Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings
Issue BriefThis brief provides an overview of the Medicare Advantage plans that are available for 2026 and key trends over time. In 2026, the average Medicare beneficiary has a choice of 32 Medicare Advantage prescription drug (MA-PD) plans, two fewer than the 34 in 2025. Virtually all Medicare Advantage plans for 2026 provide multiple extra benefits like vision, hearing, and dental benefits, similar to last year.
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How Medicare Pays Medicare Advantage Plans: Issues and Policy Options
Issue BriefThis brief explains how Medicare Advantage payments are determined and provides an overview of policy options to change the Medicare Advantage payment system.