Since the 1970s, Medicare beneficiaries have had the option to receive their Medicare benefits through private health plans, mainly Health Maintenance Organizations (HMOs), as an alternative to the federally administered traditional Medicare program. The Balanced Budget Act (BBA) of 1997 named Medicare’s managed care program “Medicare+Choice” and the Medicare Modernization Act (MMA) of 2003 renamed it “Medicare Advantage.”  In 2019, the majority of the 64 million people on Medicare are covered by traditional Medicare, but one-third (34%) are enrolled in Medicare Advantage plans. Over the past decade, the number of beneficiaries enrolled in private plans has nearly doubled from 11.1 million in 2010 to 22.0 million in 2019.

  • Your Selections:

Refine Results

date

Topics

Content Type

Tags

A Dozen Facts About Medicare Advantage

Medicare Advantage plans have played an increasingly larger role in the Medicare program over the past decade. More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2018. This data note provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes new analyses of Medicare Advantage plans’ extra benefits, use of prior authorization, and bonus payments paid by Medicare.

Prior Authorization in Medicare Advantage Plans: How Often Is It Used?

Medicare Advantage enrollees are encouraged to select their plan based on a number of factors, including premiums, cost-sharing, extra benefits, drug coverage, quality of care, and provider networks, but a potentially overlooked factor is access to covered services and the potential impact of prior authorization requirements. In this data note, we examine the share of Medicare Advantage enrollees that are in plans requiring prior authorization and approval before covering the costs of services.

People on Medicare Will Be Able to Choose Among 24 Medicare Advantage Plans and 27 Medicare Part D Drug Plans, on Average, During the Open Enrollment Period for 2019, New Analyses Find

With Medicare Advantage playing an increasingly larger role in Medicare, the average person on Medicare will be able to choose among 24 plans during the annual Medicare open enrollment period that began Oct. 15, finds a new analysis from KFF (the Kaiser Family Foundation). The new analysis, Medicare Advantage Plans…

Medicare Advantage 2019 Spotlight: First Look

In 2019, more than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This issue brief provides an overview of the Medicare Advantage plans that will be available in 2019, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market for the first time and also examines the insurers exiting the market.

Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing

This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.

Medicare Advantage 2018 Data Spotlight: First Look

This data note analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries, and also describes changes in the health care insurers offering private health plans in 2018. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

Medicare Advantage Networks Included 46 Percent of Physicians in a County, On Average  

Medicare Advantage plan networks included 46 percent of all physicians in a county, on average, according to a new analysis from the Kaiser Family Foundation. The study, using 2015 data, is the first to examine the size and composition of physician networks among increasingly popular Medicare Advantage private plans, which…

Medicare Advantage: How Robust Are Plans’ Physician Networks?

This report takes an in-depth look at Medicare Advantage plans’ physician networks. The analysis draws upon data from 391 Medicare Advantage plans serving beneficiaries in 20 diverse counties in 2015. The report examines the size and composition of plans’ physician networks, the variation across counties, the inclusion of physicians by specialty, and the relationship between network size and other plan features, such as premiums and quality star ratings.