Plans Have Big Opportunities to Improve New-Member Onboarding
The Medicare Advantage program has undergone significant policy changes during the past year, affecting deductibles, out-of-pocket costs, provider networks and prior authorization determinations. According to the J.D. Power 2025 U.S. Medicare Advantage Study,℠ released today, these changes have contributed to increased confusion, lower member satisfaction and a widespread lack of trust among Medicare Advantage plan members.
“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. 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.”
Following are some of the key findings of the 2025 study:
- Lack of trust drives satisfaction decline: Overall customer satisfaction with Medicare Advantage plans is 623 (on a 1,000-point scale), down 29 points from a year ago. The primary cause of this decline in customer satisfaction is a 39-point drop in members’ overall level of trust in their Medicare Advantage plan. Other factors showing significant declines in this year’s study are product/coverage offerings meet needs and ease of doing business.
- High-performing plans deliver on digital: One key criterion that separates the highest-performing Medicare Advantage plans from the lowest-performing plans1 is the ability to engage with members via digital channels. Digital satisfaction among members of the highest-performing plans are 98 points higher, on average, than among those of the lowest-performing health plans. What’s more, 85% of members of high-performing plans have used their member portal (vs. 76% of low-performing plans), and 52% of members of high-performing plans find the features or tools offered on their plan’s website very easy to use (vs. 40% of low-performing plans).
- First-year member satisfaction lags: When new members join a Medicare Advantage plan, their first year often comes with confusion, unmet expectations and administrative challenges. Only 38% of first-year members say their insurer fulfills their service expectations. That number rises to 45% among established members, or those who have been with the same plan for more than one year. Common challenges cited by new members include explanation of benefits, how to find in-network doctors, deductibles, prior authorizations and usage of their Health Savings Account (HSA)/Health Retirement Account (HRA).
______________________________ 1 High Performer health plans identified as top 10 in overall satisfaction rankings; Low Performer health plans identified as bottom 10 in overall satisfaction rankings. |
Study Rankings
Kaiser Permanente ranks highest in overall customer satisfaction with Medicare Advantage plans in California for a second consecutive year, with a score of 675. SCAN Health Plan (672) ranks second and Alignment Health Plan (658) ranks third.
Freedom Health ranks highest in overall satisfaction with Medicare Advantage plans in Florida, with a score of 670. Humana (640) ranks second and Wellcare (623) ranks third.
UnitedHealthcare ranks highest in overall satisfaction with Medicare Advantage plans in Georgia for a second consecutive year, with a score of 648. Anthem Blue Cross and Blue Shield (625) ranks second.
Blue Cross Blue Shield of Illinois ranks highest in overall satisfaction with Medicare Advantage plans in Illinois, with a score of 654. UnitedHealthcare (631) ranks second.
Blue Cross Blue Shield of Michigan ranks highest in overall satisfaction with Medicare Advantage plans in Michigan, with a score of 675. HAP (660) ranks second and Priority Health Medicare (656) ranks third.
Excellus BlueCross BlueShield ranks highest in overall satisfaction with Medicare Advantage plans in New York for a third consecutive year, with a score of 648. Healthfirst (617) ranks second.
UnitedHealthcare ranks highest in overall satisfaction with Medicare Advantage plans in North Carolina for a second consecutive year, with a score of 663. Blue Cross NC (641) ranks second.
Anthem Blue Cross and Blue Shield ranks highest in overall satisfaction with Medicare Advantage plans in Ohio for a second consecutive year, with a score of 680. Aetna Medicare (655) ranks second.
UPMC For Life ranks highest in overall satisfaction with Medicare Advantage plans in Pennsylvania for a third consecutive year, with a score of 708. Highmark Blue Cross Blue Shield (682) ranks second and Independence Blue Cross (653) ranks third.
Blue Cross Blue Shield of Texas ranks highest in overall satisfaction with Medicare Advantage plans in Texas for a third consecutive year, with a score of 639. UnitedHealthcare (617) ranks second and Cigna Healthcare (616) ranks third.
See the rank chart for each segment at http://www.jdpower.com/pr-id/2025091.
The U.S. Medicare Advantage Study, now in its 11th year, measures member satisfaction with Medicare Advantage plans—also known as Medicare Part C or Part D—based on eight factors (in order of importance): level of trust; able to get health services how/when I want; helping to save me time or money; product/coverage offerings meet my needs; ease of doing business; people—representatives, call center agents; resolving problems or complaints; and digital channels.
The 2025 U.S. Medicare Advantage Study is based on the responses of 10,888 members of Medicare Advantage plans in 10 market-based U.S. regions: California, Florida, Georgia, Illinois, Michigan, New York, North Carolina, Ohio, Pennsylvania and Texas. It was fielded from January through June 2025.
For more information about the U.S. Medicare Advantage Study, visit https://www.jdpower.com/business/resource/us-medicare-advantage-study.
About J.D. Power
J.D. Power is a global leader in consumer insights, advisory services, and data and analytics. A pioneer in the use of big data, artificial intelligence (AI) and algorithmic modeling capabilities to understand consumer behavior, J.D. Power has been delivering incisive industry intelligence on customer interactions with brands and products for more than 55 years. The world's leading businesses across major industries rely on J.D. Power to guide their customer-facing strategies. J.D. Power has offices in North America, Europe and Asia Pacific. To learn more about the company's business offerings, visit JDPower.com/business. The J.D. Power auto-shopping tool can be found at JDPower.com.
About J.D. Power and Advertising/Promotional Rules: www.jdpower.com/business/about-us/press-release-info
View source version on businesswire.com: https://www.businesswire.com/news/home/20250819910457/en/
Contacts
Media Relations Contacts
Geno Effler, J.D. Power; West Coast; 714-621-6224; media.relations@jdpa.com
John Roderick; East Coast; 631-584-2200; john@jroderick.com