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In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials
This issue briefs lays out 10 reasons why Medicare Advantage enrollment has been growing and why we can expect more growth in the years to come.
This analysis examines the extent to which large private and non-federal public employers that offer retiree health benefits are turning to Medicare Advantage and why they are making this shift, using data from the 2024 Employer Health Benefits Survey. We find that slightly more than half (56%) of large employers offering retiree health benefits to Medicare-age retirees offer coverage to at least some retirees through a contract with a Medicare Advantage plan, more than double the share in 2017 (26%).
Following a pledge by insurance companies to reduce the burden of prior authorizations, KFF's Health Tracking Poll examines the publics experience with the process. The poll finds that most view insurers' delays and denials as a problem, and few are aware of the newly announced pledge.
Higher market concentration in Medicare Advantage insurance markets may lower the incentive for insurers to compete for potential enrollees by making plans more appealing through more comprehensive benefits or lower costs.
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 analysis documents the different sources of coverage among people with Medicare and examines variation in beneficiary characteristics by source of coverage.
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.
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