What You Should Know:
– A new report from J.D. Power reveals a significant decline in member satisfaction with Medicare Advantage (MA) plans. The J.D. Power 2025 U.S. Medicare Advantage Study reveals that satisfaction dropped to an average score of 623 out of 1,000, which is down 29 points from the previous year.
– According to the study, the primary cause for this decline is a 39-point drop in members’ overall trust in their plans. This trend is occurring in the wake of significant policy changes to the Medicare Advantage program, which have affected deductibles, out-of-pocket costs, provider networks, and prior authorization rules.
Digital Tools and Trust as Key Differentiators
Despite the broader decline, top-performing plans are better equipped to maintain member trust and satisfaction, even in a volatile environment. These high-performing plans are those that invest in robust new-member onboarding, increased transparency, and new digital tools.
The study found a strong correlation between digital engagement and satisfaction. Digital satisfaction among members of the highest-performing plans is, on average, 98 points higher than among those of the lowest-performing plans. The data also shows that members of high-performing plans are more likely to use their member portal (85% vs. 76%) and find their plan’s website features very easy to use (52% vs. 40%).
First-Year Member Experience Lags Behind
The study also highlights a specific challenge with new members. First-year members often experience confusion and unmet expectations, with only 38% saying their insurer fulfills their service expectations. This number rises to 45% among established members who have been with the same plan for more than a year.
Common challenges for new members include understanding their explanation of benefits, how to find in-network doctors, deductibles, prior authorizations, and the use of their Health Savings Account (HSA) or Health Retirement Account (HRA).
Study Rankings
The 2025 study measures member satisfaction across eight factors, with “level of trust” being the most important. The study is based on responses from 10,888 members in 10 U.S. regions and includes rankings for each market.
- California: Kaiser Permanente ranks highest for a second consecutive year, followed by SCAN Health Plan and Alignment Health Plan.
- Florida: Freedom Health ranks highest, followed by Humana and Wellcare.
- Georgia: UnitedHealthcare ranks highest for a second consecutive year, followed by Anthem Blue Cross and Blue Shield.
- Illinois: Blue Cross Blue Shield of Illinois ranks highest, followed by UnitedHealthcare.
- Michigan: Blue Cross Blue Shield of Michigan ranks highest, with HAP and Priority Health Medicare ranking second and third, respectively.
- New York: Excellus BlueCross BlueShield ranks highest for a third consecutive year, followed by Healthfirst.
- North Carolina: UnitedHealthcare ranks highest for a second consecutive year, followed by Blue Cross NC.
- Ohio: Anthem Blue Cross and Blue Shield ranks highest for a second consecutive year, followed by Aetna Medicare.
- Pennsylvania: UPMC For Life ranks highest for a third consecutive year, followed by Highmark Blue Cross Blue Shield and Independence Blue Cross.
- Texas: Blue Cross Blue Shield of Texas ranks highest for a third consecutive year, with UnitedHealthcare and Cigna Healthcare ranking second and third.
The study was conducted from January through June 2025 and measures satisfaction with Medicare Part C and Part D plans.
