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The Trump administration this week backed off a key element of its Medicare Advantage rate proposal, resulting in billions of dollars in additional payments to private insurers.
The new provider search tool on the Medicare Plan Finder could make it easier for beneficiaries to figure out if their doctors are in a Medicare Advantage plan's network despite some data issues.
Certain insurers must now publicly report specific prior authorization metrics, but the new data offer limited insight, providing no information on what types of services are being approved and denied or why as well as no data on prescription drugs.
This brief analyzes out-of-pocket limits in Medicare Advantage plans in 2026, variation by plan type, the distribution of enrollees facing different out-of-pocket limits, and trends over time.
This brief provides information about Medicare Advantage plans in 2026, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
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.
This brief summarizes findings from 20 studies published between January 1, 2018 and April 1, 2023 that compare quality of care and beneficiary experiences between people of color in Medicare Advantage and White enrollees, or the total Medicare Advantage population.
The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…
The Medicare Part D program provides an outpatient prescription drug benefit to 56 million older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment, premiums, and cost sharing in 2026 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).
Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.
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