CMS and Health Policy Facts

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.

traditional Medicare Traditional Medicare Medicare Advantage

Despite complaints of gaps in Medicare Advantage n

The Centers for Medicare & Medicaid Services (CMS) can impose sanctions on Medicare Advantage plans that fail to meet provider network adequacy requirements — including marketing and enrollment freezes, civil monetary penalties, or plan termination — 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.

Centers for Medicare & Medicaid Services Medicare Advantage traditional Medicare

Despite complaints of gaps in Medicare Advantage n

CMS and Health Policy

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