Data · Surveys
Surveys & Medicare Data
Quarterly reader surveys, crosstabs, and headline findings on how American Medicare beneficiaries are navigating plan choice, prior authorization, and out-of-pocket costs in 2026.
Headline Findings
68%
of Medicare Advantage enrollees report having faced at least one prior-authorization decision in the past 12 months.
31%
of those denied a service on prior authorization appealed the decision.
82%
of appealed prior-authorization denials in Medicare Advantage are overturned in the beneficiary's favor.
44%
of beneficiaries did not re-run Medicare Plan Finder during the last Annual Election Period.
$1,930
median out-of-pocket cost for Part D enrollees on at least one specialty drug (2024).
26%
of new enrollees say the Medicare enrollment process was 'hard to understand'.
Crosstab
Which coverage did you choose at enrollment?
- Original Medicare + Medigap + Part D34%
- Medicare Advantage (MA-PD)51%
- Original Medicare only8%
- Employer or union retiree plan5%
- VA / Tricare / IHS2%
Crosstab
If your plan denied a service, what happened?
- Approved on appeal41%
- Denied on appeal, paid out of pocket17%
- Denied on appeal, forwent care12%
- Never appealed30%
Crosstab
Which of these were not adequately explained at enrollment?
- Prior-authorization requirements54%
- In-network provider restrictions47%
- Formulary tier of your regular drugs44%
- Referral requirements for specialists38%
- The right to switch plans annually29%
Open Reader Survey
Tell us what actually happened.
Three minutes. Anonymous. Results published in the next issue.
Methodology
Surveys are fielded quarterly via a stratified online panel weighted to U.S. Census distributions of Medicare-eligible adults by age, region, income and ethnicity. Plan-experience questions are restricted to respondents who self-identify as currently enrolled in Medicare, with self-reported plan type validated against publicly listed CMS plan IDs when provided.
Raw response files, weighted crosstabs, and the Stata code used to produce published tables are available on request to journalists, academics and regulators. Email the editorial desk.