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Medicare Advantage: What You Need to Know

More than 33 million Americans—more than 50% of people eligible to enroll—choose MA because it delivers better services, better access to care, and better value. Medicare Advantage is a public-private partnership where health insurance providers deliver comprehensive medical coverage to Americans 65+ and individuals with disabilities, covering everything fee-for-service Medicare covers and more.

Why Do 33 Million Americans Choose MA?
More than 33 million Americans— more than 50% of people eligible to enroll—choose MA because it delivers better services, better access to care, and better value.

It delivers affordable coverage by decreasing costs, and offering additional benefits that fee-for-service Medicare doesn’t cover, such as integrated vision, hearing, and dental benefits, a cap on out-of-pocket costs, wellness programs, in-home caregiver support, and innovative telehealth options.

Better for the Federal Trust Fund and Good for Taxpayers

Medicare Advantage is good for your health — and the federal trust fund.

  • The Medicare Part A Trust Fund could be extended by as much as 17 years if Part A services in the fee-for-service Medicare program were used at the same level as Medicare Advantage.
  • Fee-for-service Medicare uses hospital and post-acute services at a higher rate than Medicare Advantage.
  • The solvency issue at the heart of the Medicare Part A Trust Fund (which pays for hospital and post-acute care) is often incorrectly attributed to Medicare Advantage rather than the lower-value care in fee-for-service Medicare.
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Better Health Outcomes

People have better health experiences than people in fee-for-service Medicare.

  • Avoidable hospitalizations in fee-for-service Medicare were 1.7 times higher than in Medicare Advantage
  • Fee-for-service Medicare readmissions were 3.8 times higher than Medicare Advantage.
  • Rates of inappropriate high-risk medication use were 1.4 times higher in fee-for-service Medicare than Medicare Advantage.
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Better Preventive Care

Medicare Advantage has better preventive treatment for the seniors and people with disabilities that rely on it.

  • Medicare Advantage outperformed fee-for-service Medicare in 10-of-11 preventive measures.
  • People are more likely to complete treatments, like a course of beta-blockers after a heart attack and statin therapy for cardiovascular disease.
  • People are more likely to receive treatments, like disease-modifying drugs for rheumatoid arthritis and corticosteroids for chronic obstructive pulmonary disease.
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Better for Rural Americans

  • Research from The American Journal of Managed Care (AJMC) found that more Medicare Advantage penetration in counties in 14 states was associated with an increase in hospital financial stability, and a reduction in risk of closure.
  • Every percentage point increase in Medicare Advantage penetration was associated with a 4% reduction in risk of hospital closure.
  • Researchers say likely reason that Medicare Advantage stabilizes health care in rural communities is that “rates are more generous in rural areas.”
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Better Service to Everyone, Everywhere

Medicare Advantage serves a more diverse population by age, race, ethnicity, gender, income, and health status.

  • Medicare Advantage has a higher overall share of diverse populations (29%) compared to fee-for-service Medicare (19%).
  • 4 million Medicare Advantage enrollees live in rural areas.
  • Medicare Advantage has a higher share of Americans (38%) with annual incomes less than $25,000 than fee-for-service Medicare (23%).
  • Just under 94% of counties* and about 99% of Medicare Advantage-eligible Americans will have access to at least one Medicare Advantage Part D prescription drug plan with a $0 total premium (Medicare Advantage and Part D prescription drug coverage) in 2023.
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Health Insurance Providers Actions Concerning Medicare Advantage

More than 33 million seniors and people with disabilities choose MA because it delivers better services, better access to care, and better value. Learn about the actions health insurance providers are taking concerning Medicare Advantage.

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