Medicare Advantage

Medicare Advantage plans denied two million prior authorization requests for health care services in whole or in part in 2021, or about six percent of the 35 million requests submitted on behalf of enrollees that year, a new KFF analysis finds. Prior authorization is intended to ensure that health care…

This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.

This brief provides an overview of Medicare spending and financing, based on the most recent historical and projected data from the Medicare Trustees and the Congressional Budget Office (CBO). The brief highlights trends in Medicare spending and key drivers of spending growth, including higher enrollment, growth in health care costs, and increases in payments to Medicare Advantage plans.

Few employers offer retiree health benefits, and those that do increasingly are turning to Medicare Advantage plans to provide that coverage – a shift that has implications both for retirees and for federal spending, finds a new KFF analysis. Among the relatively small share of large firms (200 or more…

Nearly all enrollees in Medicare Advantage plans sponsored by the seven largest firms in the market are in a plan that offers some vision, hearing, fitness, and/or dental benefits. Other benefits, including over the counter, remote access technologies, meals, acupuncture and transportation, vary widely across firms, and in-home support services, bathroom safety, Part B rebates, telemonitoring and caregiver support are relatively uncommon

For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will also offer telehealth benefits in 2023.

As Medicare’s annual open enrollment period gets underway, two new analyses from KFF suggest that a relatively small share of the nation’s 65 million Medicare beneficiaries will shop around among the many coverage options for 2023 or switch plans. That decision could have a significant impact on enrollees’ coverage and…

During the Medicare open enrollment period for 2020, Medicare beneficiaries had an average of 24 Medicare Advantage prescription drug plans and 28 stand-alone Part D prescription drug plans to choose from for their coverage. Despite having so many Medicare options, relatively few Medicare private plan enrollees opted to switch their coverage.

With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage. A new KFF review of 62 studies published since 2016 that compares Medicare Advantage and…

This literature review examines 62 studies published since 2016 that compare Medicare Advantage and traditional Medicare based on measures of beneficiary experience, affordability, service utilization, and quality.