This policy series is designed to help individuals better understand how Medicare is funded, how its resources are spent, and why it matters. The series traces the history of Medicare financing, examines today’s fiscal challenges, and outlines specific policy solutions to strengthen and sustain the program for the future.
This work was supported in part by Arnold Ventures. Medicare Rights Center maintains full editorial control over all of its policy analysis and communications activities.
As the cost of care rises, beneficiaries increasingly look for plans that promise discounts or additional benefits. MA plans take advantage of this and flood potential beneficiaries with marketing calls, mailers, ads, and even in-person solicitation that can be deceptive and easily misunderstood.
Download PDFOriginal Medicare has significant gaps in coverage, including very limited coverage of dental, vision, and hearing care. By advertising supplemental benefits that seem to fill these gaps and help tackle the cost of care and living, MA plans captivate the attention of beneficiaries struggling to afford care. But these benefits are not standardized or clearly communicated, falling short of their original promises.
Download PDFAgents and brokers for MA plans receive commissions per enrollment and often receive additional “administrative” bonuses that balloon MA spending. These financial incentives drive aggressive and misleading marketing aimed at people looking for coverage. As a result, beneficiaries fall into the “MA Trap,” finding themselves enrolled in an MA plan that doesn’t meet their needs and without an efficient way to switch back to Original Medicare.
Download PDFIn recent years, insurance companies have flooded the MA market with plans that are difficult to tell apart, creating overwhelm and confusion that costs both beneficiaries and the Medicare program more than Original Medicare. This part addresses the causes and consequences of the rapid proliferation of Medicare Advantage (MA) plans in the absence of adequate consumer guidance and federal regulation.
Download PDFThis part of the series explores the origins and structure of Medicare financing. Through an issue brief, infographic, and video, it outlines the various sources of funding for the three major parts of Medicare and lays out how projections and costs have fluctuated over the program’s history.
Download PDFUnder current site-specific payment rates, the same service can cost patients and Medicare vastly different amounts based on the location and hospital affiliation of the provider. This part of the series explains how these payment rules incentivize hospitals to vertically integrate routine care in order to drive up profits. Site-neutral payments offer a more rational alternative that would minimize arbitrary differences in cost and protect Medicare sustainability.
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