Medicare Advantage is a privatized alternative to traditional Medicare that covers adults 65 and older and some people with disabilities.
November 20, 2025
high
descriptive
Describes the nature and target population of Medicare Advantage plans.
Medicare Advantage plans commonly require members to receive care from a specified network of contracted doctors, hospitals, and other providers.
November 20, 2025
high
descriptive
Explains a typical plan design feature that distinguishes many Medicare Advantage plans from traditional Medicare.
The Centers for Medicare & Medicaid Services (CMS) can impose sanctions on Medicare Advantage plans that fail to meet provider network adequacy requirements â including marketing and enrollment freezes, civil monetary penalties, or plan termination â and can grant special enrollment periods allowing beneficiaries to change plans or enroll in traditional Medicare midyear when they lose access to contracted providers.
November 20, 2025
high
policy
Describes CMS enforcement tools and beneficiary relief options related to network adequacy and midyear provider contract terminations.
Annual open enrollment for traditional Medicare and Medicare Advantage begins on October 15 (in 2025, the period began on 2025-10-15).
October 15, 2025
high
temporal
Scheduled annual enrollment period for Medicare coverage selection.
Between 2016 and 2022, the Centers for Medicare & Medicaid Services sent letters to five insurers after seven Medicare Advantage plans failed to meet provider network adequacy requirements.
December 31, 2022
high
temporal
Counts of CMS enforcement actions identified in agency documents produced in response to a records request covering 2016â2022.
Medicare Advantage plans typically require members to use selected networks of doctors, hospitals, and other providers and often offer lower out-of-pocket costs and extra benefits such as vision, dental, and hearing coverage.
December 31, 2022
high
definitional
Common structural features and benefit trade-offs of Medicare Advantage plans compared with traditional Medicare.