Half of Medicare Beneficiaries Are Enrolled in Medicare Advantage

Half of all Medicare beneficiaries are enrolled in Medicare Advantage, according to the most recent enrollment data from CMS.

The CMS data found that, as of January 2023, 30.19 million of the 59.82 million people with Medicare Part A and B were enrolled in a private Medicare Advantage plan.

Medicare Advantage enrollment has grown every year since 2007 when just 19 percent of all eligible Medicare beneficiaries were enrolled in the private program.

In the last five years, the share of beneficiaries enrolled in Medicare Advantage increased from 37 percent in 2018 to 48 percent in 2022 and finally to 50 percent in 2023.

Part of this growth may be attributed to the supplemental benefits the program offers, including vision, hearing, and dental services. Additionally, Medicare Advantage plans may lead to lower out-of-pocket spending compared to traditional Medicare without supplemental coverage.

A survey from the Commonwealth Fund found that almost a quarter of Medicare Advantage beneficiaries chose the private program because of the additional benefits that traditional Medicare does not offer. The survey also revealed that one in five beneficiaries enrolled in Medicare Advantage because of the out-of-pocket spending limits.

Medicare Advantage’s popularity may also be growing due to the simplicity of not needing a separate Part D prescription drug plan or supplemental coverage, the KFF policy watch noted.

Medicare Advantage beneficiaries tend to report high satisfaction with their plans. Last year, overall member satisfaction was 809 on a 1,000-point scale, according to the JD Power 2022 US Medicare Advantage Study.

Similarly, an eHealth report from March 2023 found that 89 percent of Medicare Advantage beneficiaries were satisfied with their coverage.

Despite these benefits, Medicare Advantage plans often use utilization management tools like prior authorization that can adversely impact care access, the KFF policy watch mentioned. In 2021, beneficiaries submitted 35 million prior authorization requests, 2 million of which were denied. Only 11 percent of the denials were appealed.

Medicare Advantage plans also typically require beneficiaries to receive care from in-network providers or pay more out-of-pocket for out-of-network care.

Even as Medicare Advantage enrollment grows, a review from KFF determined that there are few differences between the private program and traditional Medicare. For example, care satisfaction and care coordination were generally similar for beneficiaries in the two programs.

However, Medicare Advantage beneficiaries were more likely to have a usual source of care and better experiences getting prescription drugs. Meanwhile, traditional Medicare beneficiaries reported fewer cost-related barriers.