Medicare Advantage plans, formally Part C of Medicare, offer Medicare beneficiaries an alternative to Original Medicare and have been successful in signing up Medicare-eligible Americans. Medicare Advantage plans are increasingly popular; enrollment in these plans as a share of the eligible Medicare population has jumped from 19% in 2007 to 54% in 2024. That figure represents a huge swath of Americans. In 2024, 54% of eligible Medicare beneficiaries — 32.8 million people out of 61.2 million Medicare beneficiaries with both Medicare Parts A and B — are enrolled in Medicare Advantage plans.
Not all Medicare Advantage programs are alike, however. Plans that provide an easy way of finding care plus low out-of-pocket costs are more likely to win over subscribers, according to the 2024 U.S. Medicare Advantage Study by J.D. Power.
What Medicare Advantage plans offer
Unlike Original Medicare, which is government insurance, Medicare Advantage plans are administered by private insurance companies. These plans cover the same benefits of Original Medicare and typically include extra coverage such as out-of-pocket maximums, minimal dental or hearing coverage, and fitness benefits. Most Medicare Advantage plans also include prescription drug coverage.
In 2024, the out-of-pocket limit for Medicare Advantage plans may not exceed $8,850 for in-network services and $13,300 for in-network and out-of-network services combined. While traditional Medicare has no out-of-pocket cap on spending, Medicare Advantage plans have limited provider networks and apply cost management tools such as prior authorization, which traditional Medicare does not.
Starting in 2025, Medicare Advantage plans will be required to send policyholders a personalized “Mid-Year Enrollee Notification of Unused Supplemental Benefits” in July. It will list all supplemental benefits the person hasn’t used, the scope and out-of-pocket cost for claiming each one, instructions on how to access the benefits and a customer service number to call for more information.
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What Medicare Advantage enrollees like about their plans
The 2024 U.S. Medicare Advantage study by J.D. Power measured the customer satisfaction of Medicare Advantage enrollees and the most important factors driving customer satisfaction. Although local plans ranked lower in the overall satisfaction ratings, they had higher customer service ratings than national providers such as UnitedHealthcare and Humana which have nearly half (47%) of all Medicare Advantage enrollees nationwide, according to KKF.org.
What makes the local plans more appealing? “It can be attributed to the top five drivers of satisfaction in the Medicare Advantage shopping experience, which are: preferred in-network doctors; adequate prescription drug coverage; preferred in-network hospitals and facilities; previous experience with a health plan; and existence of a copay” said Christopher Lis, managing director of global healthcare intelligence at J.D. Power.
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Key findings of the 2024 study:
- The factors that drive customer satisfaction: Respondents gave Medicare Advantage plans an overall customer satisfaction score of 652 (on a 1,000-point scale). The top drivers of customer satisfaction are ease of finding care, low out-of-pocket costs and provider choice.
- Regional plans score higher for customer satisfaction: Although average overall satisfaction scores are highest among national health plans, individual regional Medicare Advantage plans including UMPC For Life, Highmark Blue Cross Blue Shield, Independence Blue Cross, Geisinger Gold and Priority Health Medicare, significantly outperform the top-performing national plans.
- Medicare Advantage plans get higher marks than commercial member plans: Customers of commercial member plans have a lower overall satisfaction by 87 points. Medicare Advantage customers rated their higher in these areas: plans helps me to save time or money (+128 points); ease of doing business (+93); level of trust (+92); and product/coverage offerings meet my needs (+90).
Overall customer satisfaction index ratings for Medicare Advantage plans in surveyed states
Medicare Advantage subscribers in Pennsylvania, Michigan and North Carolina give the highest satisfaction to the Advantage plans in their states with survey respondents giving plans in Pennsylvania the highest marks among the 10 states surveyed. California, Texas and New York had the lowest overall customer satisfaction scores and New York had the lowest of all states in the study.
UnitedHealthcare topped the overall satisfaction rating for four states and Wellcare finished last in every state in the survey. Wellcare’s ratings were significantly lower than the plans that precede it in the rankings.
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How the study was conducted:
The tenth annual U.S. Medicare Advantage Study is based on eight factors (in order of importance): level of trust; able to get health services how/when I want; helping to save me time or money; product/coverage offerings meet my needs; ease of doing business; people—representatives, call center agents; resolving problems or complaints; and digital channels.
The 2024 U.S. Medicare Advantage Study is based on the responses of 10,718 members of Medicare Advantage plans in 10 market-based U.S. regions: California, Florida, Georgia, Illinois, Michigan, New York, North Carolina, Ohio, Pennsylvania and Texas. It was fielded from January through June 2024.
