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Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.
Most Medicare Advantage enrollees are in plans that have waived cost sharing for COVID-19 treatment, and many other beneficiaries in traditional Medicare have their cost sharing covered by supplemental insurance. This blog post discusses the 6 million Medicare beneficiaries without supplemental coverage who would face out-of-pocket costs if they require treatment for COVID-19.
As the coronavirus continues to spread, the number of people on Medicare admitted to the hospital for COVID-19 related illness is expected to rise. We analyze how much Medicare beneficiaries could pay out-of-pocket for an inpatient hospital admission under traditional Medicare (assuming no supplemental coverage) or Medicare Advantage plans.
In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.
Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage and many go without needed care, according to a new KFF brief on dental coverage and costs for Medicare beneficiaries. Rates are even higher among black and Hispanic beneficiaries, and those with low incomes.
Medicare does not cover routine dental care and the majority of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, Medicaid, and private plans, but almost half of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. The brief reviews the state of oral health for people on Medicare, describing the consequences of foregoing dental care, current sources of dental insurance, use of dental services, and beneficiaries’ out-of-pocket spending.
While Medicare Advantage enrollment is highly concentrated among a small number of firms, UnitedHealthcare has seen the largest and fastest growing share of enrollees over the past decade. Learn more in this Chart of the Week.
This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and other plan features, including premiums, quality star ratings, per capita Medicare spending, parent organization, and plan tax status.
This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.
A Kaiser Family Foundation analysis of private Medicare plan networks finds that Medicare Advantage plans include about half of area hospitals in their network, on average, while one in five plans have no Academic Medical Center in-network.
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