Seniors Face Difficulty Navigating Choices in Medicare Managed Care

In 1997, Congress approved the Medicare+Choice program, which sought to contain costs and expand seniors' health plan choices by increasing access to managed care plans.

From February 1999 to August 2004, researchers from Mathematica Policy Research, Washington, assessed the implementation of Medicare+Choice (renamed Medicare Advantage in 2003), chiefly focusing on:

  • How beneficiaries navigated among the expanded offerings and made informed decisions.
  • Trends in plan availability and Medicare payments to the plans.

Key Findings

  • Contrary to its goals, Medicare+Choice did not result in a substantially more varied mix of health plan types.

  • Traditional Medicare managed care plans (i.e., HMOs) continue to remain an option primarily for urban Medicare beneficiaries.

  • Over Medicare+Choice's history, premiums for participating plans increased while enrollees saw a drop in benefits, including less coverage for outpatient prescription drugs.

  • The diversity of Medicare beneficiaries makes it difficult to promote informed choice.

  • The vast majority of beneficiaries do not consider their choices on an annual basis, if at all.


  • The research team reported the following conclusion in its report Monitoring Medicare+Choice: What Have We Learned? Findings and Operational Lessons for Medicare Advantage:

    • Medicare+Choice is widely viewed as a failure, with plans leaving the program and fewer, less attractive choices available for beneficiaries.