Medicare Advantage Articles & Sources

Are you or a family member exploring the choices for Medicare coverage? The articles below provide more information about Traditional Medicare, Medicare Advantage, and the risks you can face when enrolling or making a change.

• Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries (Kaiser Family Foundation)

• Refusal of Recovery: How Medicare Advantage Insurers Have Denied Patients Access to Post-Acute Care (U.S. Senate Majority Staff Report)
  • This Majority staff report reveals how Medicare Advantage insurers are intentionally using prior authorization to boost profits by targeting costly yet critical stays in post-acute care facilities. Insurer denials at these facilities, which help people recover from injuries and illnesses, can force seniors to make difficult choices about their health and finances in the vulnerable days after exiting a hospital.
• Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage (Journal of the American Medical Association)
  

  • The results of this study suggest that Medicare Advantage patients receive fewer home health visits and have worse functional outcomes compared with traditional Medicare.

• Medicare Advantage: Beneficiary Disenrollments to Fee-for-Service in Last Year of Life Increase Medicare Spending (U.S. Government Accountability Office)
  
  • This study found that Medicare Advantage beneficiaries in the last year of life disproportionately disenrolled to enroll in fee-for-service, indicating possible issues with their care. Shifting end-of-life costs to fee-for-service increased Medicare spending by hundreds of millions of dollars.
• Special Report: The Real Impact of Medicare Advantage for Beneficiaries and Medicare Funding (Center for Medicare Advocacy)
  
  • At a time when over half of all Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans, the MA program is costing significantly more than what traditional Medicare spends on a given beneficiary, adding stress to Medicare’s finances. This extra spending, however, does not translate to better health outcomes or more affordable care for those enrolled in MA plans.
• Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients (Journal of Clinical Oncology)
  
  • Compared with traditional Medicare, Medicare Advantage beneficiaries had lower access to high-volume hospitals and increased 30-day mortality for stomach, pancreas, or liver surgery.
• Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023 (KFF)
  • MA insurers denied 3.2 million, or 6.4%, of prior authorization requests in 2023.
• The Health Insurance Prior Authorization Memo That You Helped Write (New York Times)
• 3 Reasons Retirees Should Not Enroll in Medicare Advantage for 2025 (The Motley Fool)
• Uncovered: How the Insurance Industry Denies Coverage to Patients (ProPublica)
• “Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care (ProPublica)
• Former Insurance Executive Says: Older adults should avoid Medicare Advantage in 2025 (Becker’s Payer Issues)
• The Pros and Cons of Medicare Advantage (Consumer Reports)
• AMA Survey Indicates Prior Authorization Wreaks Havoc on Patient Care (American Medical Association)
• User of Prior Authorization in Medicare Advantage Exceeds 46 Million Requests in 2022 (Kaiser Family Foundation)
• Association of Medicare Advantage Enrollment With Financial Burden of Care (Annals of Family Medicine)