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📢 Action Needed: Tell Congress to Protect Federal Funding

Medicare Advantage

People who choose Medicare Advantage (MA) face additional hurdles during the initial enrollment and annual plan selection processes. The MA plan choice landscape is cluttered, complicated, and confusing. Other MA features, like prior authorization, narrow provider networks, and predatory plan marketing, can worsen decision-making and access problems. It is also expensive. MA costs more, both overall and per enrollee, than Original Medicare. This drives up spending for the program, beneficiaries, and taxpayers; though little is known about how plans are using these dollars, or about overall plan quality. As MA enrollment grows, addressing its financing flaws and programmatic pitfalls becomes ever-more important. We support comprehensive reforms to ensure all beneficiaries can rely on their earned Medicare coverage.

Comparing Original Medicare and Medicare Advantage

Around half of people with Medicare get their health coverage from Original Medicare and the other half from Medicare Advantage, also known as a Medicare private health plan or Part C. Individual needs, preferences, and priorities typically guide these enrollment choices. This fact sheet outlines key considerations beneficiaries often keep in mind when deciding between the two coverage pathways.

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Medicare Advantage History: Legislative Milestones

Created in 1965, Medicare initially included Inpatient/Hospital insurance (Part A) and Outpatient/Medical insurance (Part B) and paid providers directly on a fee-for-service basis. The program has seen many legislative reforms over the years, including the addition of Medicare Advantage (Part C) in 1996. Although this change formally allowed enrollees to receive their Medicare benefits from a private insurance plan that contracts with the federal government, health plans have long played an important role in Medicare. In this fact sheet, we trace that evolution.

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Comparing Original Medicare and Medicare Advantage

Around half of people with Medicare get their health coverage from Original Medicare and the other half from Medicare Advantage, also known as a Medicare private health plan or Part C. Individual needs, preferences, and priorities typically guide these enrollment choices. This fact sheet outlines key considerations beneficiaries often keep in mind when deciding between the two coverage pathways.

Medicare Advantage History: Legislative Milestones

Created in 1965, Medicare initially included Inpatient/Hospital insurance (Part A) and Outpatient/Medical insurance (Part B) and paid providers directly on a fee-for-service basis. The program has seen many legislative reforms over the years, including the addition of Medicare Advantage (Part C) in 1996. Although this change formally allowed enrollees to receive their Medicare benefits from a private insurance plan that contracts with the federal government, health plans have long played an important role in Medicare. In this fact sheet, we trace that evolution.