Medicare Advantage enrollees report more prior authorization delays

Medicare Advantage enrollees are more likely to report delays in care than their counterparts in traditional Medicare, according to a survey from the Commonwealth Fund

The survey, published Feb. 22, asked 3,280 adults with Medicare coverage about their experiences accessing care. Among those with MA, 22% reported waiting to receive care because it needed approval in the past year, compared to 13% with traditional Medicare. 

Here are five other key findings from the survey to note: 

  1. Seven out of 10 Medicare Advantage enrollees reported using at least one supplemental benefit in the past year. The most commonly used supplemental benefit was allowance for over-the-counter medications, followed by dental and vision benefits. 

  2. Medicare Advantage and traditional Medicare members reported similar wait times for appointments, with around 1 in 3 beneficiaries in each type of Medicare reporting they waited more than a month to see a physician in the past year. 

  3. Around 1 in 10 MA and traditional Medicare beneficiaries reported Medicare would not cover the care they needed in the past year. A higher percentage of MA beneficiaries (12%) said they could not afford care because of a copayment or deductible in the past year, compared to those in fee-for-service Medicare (7%). 

  4. Around half of Medicare Advantage beneficiaries reported their plans helped them schedule an annual primary care visit, eye exam, and flu or COVID vaccinations. 

  5. MA and traditional Medicare beneficiaries reported similar rates of satisfaction with their coverage, with 65% of MA and fee-for-service beneficiaries reporting their coverage fully met their expectations. 

Read the full survey here. 

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