Medicare Advantage policy changes fuel confusion, skepticism among beneficiaries

Medicare Advantage this year got worse ratings for customer service from beneficiaries who said program changes are increasing their confusion and skepticism, not quality and trust.

Customer service analyst J.D. Power published its 2025 Medicare Advantage Study that noted “significant policy changes” during the last year. Patient deductibles, out-of-pocket costs, provider networks and prior authorizations all were affected — and beneficiaries noticed.

Overall customer satisfaction with Medicare Advantage plans is 623 on a 1,000 point scale. That is down 29 points from a year ago, largely due to a 39-point drop in members’ overall trust in Medicare Advantage, the J.D. Power news release said.

“With so much rumbling in the marketplace right now about increased government oversight, policy changes and profitability challenges confronting Medicare Advantage plans, it can be misleading for plans to conclude that the significant decline in member satisfaction is a byproduct of changes that are outside their control,” said Christopher Lis, managing director of global healthcare intelligence at J.D. Power.

“Yet top-performing plans that invest in robust new-member onboarding, increased transparency, new digital tools, broader networks and social support services are proving that they are better equipped to maintain member trust and satisfaction — even in a volatile environment,” Lis said in a news release. “These digital tools in particular can help drive increased personalization, automated and more consistent onboarding and increased transparency with real-time updates that members need.”

Patients want digital access

Engaging members via digital channels is a key factor separating high-performing Medicare Advantage plans from the lower performers, according to J.D. Power.

For digital satisfaction, the high performers have an average 98-point greater score than the lower performers. In the high-performing plans, 85% of members have used member portals, compared with 76% of members in the low-performing plans. High performers’ websites were rated easy to use by 52% of members, compared with 40% of low-performing plans, the report said.

Getting to know MA

New MA members listed a number of challenges getting started with the program. Those include getting adequate explanations of benefits, finding in-network doctors, amount of deductible, prior authorizations, and use of health savings accounts and health retirement accounts, according to J.D. Power.

“When new members join a Medicare Advantage plan, their first year often comes with confusion, unmet expectations and administrative challenges,” the J.D. Power report said. “Only 38% of first-year members say their insurer fulfills their service expectations.”

Satisfaction rises to 45% for member who have been with the same plan at least a year.