This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.
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 2017, the majority of the 57 million people on Medicare are covered by traditional Medicare, with one-third (33%) enrolled in a Medicare Advantage plan. Since 2004, the number of beneficiaries enrolled in private plans has more than tripled from 5.3 million (13%) to 19.0 million in 2017 (33%).
Featured Medicare Advantage Resources
This fact sheet includes the latest information and data about the Medicare Advantage program, including enrollment, plan information, spending and financing for the program, and payment and program changes made by the Affordable Care Act as well as other laws.
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Related Medicare Advantage Resources
- Medicare Advantage Hospital Networks: How Much Do They Vary?
- Medicare Advantage 2018 Data Spotlight: First Look
- Medicare Advantage 2017 Spotlight: Enrollment Market Update
- Medicare Advantage Plan Switching: Exception or Norm?
- Traditional Medicare…Disadvantaged?
- Medicare Advantage and Traditional Medicare: Is the Balance Tipping?
- Medicare Advantage: Total Enrollment
- Some Counties May Lack an ACA Marketplace Insurer Next Year – But Many More Lack Medicare Advantage Plans Today
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.
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This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).
This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.
This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.
Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market
As federal and state governments advance efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid benefits, this brief examines how insurers now serving these markets view the opportunities and challenges, including a look at Medicare Advantage Special Needs Plans.
This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2013, premium levels and other plan features. It
Seniors' Knowledge and Experience With Medicare's Open Enrollment Period and Choosing a Plan: Key Findings from the Kaiser Family Foundation 2012 National Survey of Seniors
These key findings from the Foundation’s 2012 National Survey of Seniors relate to seniors’ knowledge and experience with Medicare’s open enrollment period and choosing a plan. The survey finds one in four seniors say they are unaware of this annual opportunity to review and change their Medicare coverage, with even…
The Kaiser Family Foundation has issued a series of data spotlights and examining the Medicare Advantage plan options available in 2012 and trends affecting the Medicare Advantage marketplace. These analyses were prepared by researchers at Mathematica Policy Research Inc. and the Kaiser Family Foundation. Plan Availability and Premiums Enrollment Market…
This data spotlight examines the growth in private Medicare Advantage plan enrollment in 2012, with a record 13 million Medicare beneficiaries enrolled as of March, representing 27 percent of all Medicare beneficiaries. Enrollment jumped by more than 1 million enrollees from the previous year and increased in every state except…