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.