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  • Medicare Advantage in 2025: Enrollment Update and Key Trends

    Issue Brief

    In 2025, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.

  • Policy Options for Improving Dental Coverage for People on Medicare

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. This brief examines five potential ways to make oral health care more available and affordable for the Medicare population. This brief reviews the limits of dental coverage permitted under current Medicare law, then describes each of the policy options, with an analysis of likely implications for key stakeholders, including Medicare beneficiaries, taxpayers, insurers, and dental professionals

  • Medicare Beneficiaries Without Supplemental Coverage Are at Risk for Out-of-Pocket Costs Relating to COVID-19 Treatment

    Policy Watch

    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.

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    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.

  • Medicare Advantage 2015 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

    Report

    This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid benefits to dually eligible beneficiaries. These demonstrations aim to improve the quality of care and the coordination of benefits for people dually eligible for Medicare and Medicaid. The report finds considerable variation in the experience of states and health plans participating in these demonstrations, and discusses the potential implications for beneficiaries and plan oversight.

  • Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations

    Report

    This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.