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  • Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

    Issue Brief

    People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate of flu vaccination among adults ages 65 and older covered by Medicare, and reasons cited for not getting vaccinated, based on data from the 2018 Medicare Current Beneficiary Survey.

  • Medigap May Be Elusive for Medicare Beneficiaries with Pre-Existing Conditions

    Issue Brief

    This issue brief analyzes federal and state guaranteed issue rules and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing conditions and those under age 65 with long-term disabilities. This brief also explores a recently finalized rule: Nondiscrimination in Health Programs and Activities regarding Section 1557 of the Affordable Care Act that may have implications for the Medigap market.

  • 2025 Medicare Advantage Plan Choices are Stable, Following Years of Steady Growth

    Policy Watch

    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.

  • Nearly 7 in 10 Medicare Beneficiaries Did Not Compare Plans During Medicare’s Open Enrollment Period

    Issue Brief

    This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.

  • A Backlash Against Health Insurers, Redux

    Perspective

    In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.

  • Will the Trump Administration Fast Track the Privatization of Medicare?

    Policy Watch

    The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It's not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications for beneficiaries, health care providers and insurers, and is worthy of serious debate.

  • Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023

    Issue Brief

    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.