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Federal spending on the Medicare Advantage quality bonus program has more than quadrupled since 2015, rising to at least $12.7 billion in 2025. Most Medicare Advantage enrollees are in a plan that receives a bonus payment in 2025, with employer- and union-sponsored plans receiving the highest bonus payments and special needs plans receiving the lowest bonus payments, on average.
This Health Policy 101 chapter explores Medicare, a federal health insurance program covering more than 68 million people, established in 1965 for people age 65 or older and later expanded to cover people under age 65 with long-term disabilities. In addition to detailing Medicare eligibility, coverage, and spending, the chapter examines the increased role of private plans in providing benefits and the financing challenges posed by increasing health care costs and an aging population.
The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese - a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact on Medicare spending.
This glossary serves as a guide to the sometimes arcane terms that inhabit the world of Medicare Advantage, the private plan alternative to traditional Medicare.
This brief explains how Medicare Advantage payments are determined and provides an overview of policy options to change the Medicare Advantage payment system.
This brief considers how default enrollment into Medicare Advantage might work, potential challenges with this approach, and implications for beneficiaries, insurers, providers, agents and brokers, and the federal budget.
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.
This issue brief merged beneficiary-level Medicare and Medicaid data from 2021 to document sources of coverage for dual-eligible individuals nationwide and by state.
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
This 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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