The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.
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.
Featured Medicare Advantage Resources
In 2020, more than 22 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 data note provides an overview of the Medicare Advantage plans that will be available in 2020, 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.
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- What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?
- A Dozen Facts About Medicare Advantage in 2019
- New England Journal of Medicine: Medicare Advantage Checkup
- Prior Authorization in Medicare Advantage Plans: How Often Is It Used?
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- Medicare Advantage: Total Enrollment
Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.
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A Small Share of People with Medicare Advantage or Stand-alone Medicare Part D Coverage Voluntarily Switch Plans During Open Enrollment
A new KFF analysis finds that a relatively small share of people with Medicare Advantage or stand-alone Medicare Part D prescription drug coverage voluntarily switch plans during Medicare’s open enrollment period, which runs annually from Oct. 15 to Dec. 7. With less than a week remaining for beneficiaries to make…
This data spotlight examines trends in benefits and cost-sharing for Medicare Advantage plans in 2010, including the wide variations found across plans and the rapid increase in cost sharing requirements for some benefits, including stays in skilled nursing facilities. It also examines the annual limits on out-of-pocket spending set by…
Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data
NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. This Kaiser Family Foundation issue brief examines the key changes in this year’s health reform law that will reward bonuses to private Medicare Advantage plans based on quality rating. Medicare currently rates plans on a five-star…
As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs. This primer provides an overview of Medicare spending trends, how the program is…
Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007This March 2007 issue brief, commissioned by the Kaiser Family Foundation, examines the development of consumer-directed health plans in the Medicare program. Medicare Medical Savings Account plans have high deductibles accompanied by a personal savings account that can be used…
This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring…
NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. The Centers for Medicare and Medicaid Services (CMS) rates the relative quality of the private plans that are offered to Medicare beneficiaries through the Medicare Advantage program as a way of aiding beneficiaries who are considering…
This data spotlight examines at enrollment trends in Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Private Fee-for-Service (PFFS) plans. These plans are paid by the government to provide Medicare-covered benefits to those who choose to enroll in them.As of March 2010, a record 11.1…
This issue brief examines the 26 new Medicare Advantage PPO regions and their implications for beneficiaries. The paper describes the characteristics of the new Medicare Advantage regions and the extent to which Medicare Advantage plans are already available in each region. It highlights the substantial gap between the current availability…