Medicare Advantage may become the default for new seniors turning 65

CMS is exploring whether beneficiaries who take no action at age 65 could be automatically enrolled in Medicare Advantage rather than traditional Medicare; officials have not introduced a formal proposal or started rulemaking.

Federal health officials are discussing a possible change to how people first enter Medicare when they turn 65. Currently, people who do not choose a plan are placed into traditional Medicare Parts A and B. Medicare Director Chris Klomp said CMS is weighing whether new beneficiaries who take no action could instead be automatically enrolled in Medicare Advantage. No formal proposal or rulemaking has been launched. What is known: - Under current rules, individuals who turn 65 and do nothing are automatically enrolled in traditional Medicare Parts A and B. - The idea under consideration would default new beneficiaries into Medicare Advantage plans administered by private insurers while preserving opportunities to opt out or change coverage during enrollment periods. - Officials have not introduced a formal proposal and say changes would likely be tested through pilot programs or require additional administrative steps. - Medicare Advantage already covers nearly half of beneficiaries; the article mentions UnitedHealthcare, Humana, and Aetna as providers of those plans. - Analyses cited in the article, including work by the Medicare Payment Advisory Commission and KFF, suggest Medicare Advantage payments can exceed traditional Medicare spending and that auto-enrollment could increase overall spending and, in some cases, premiums paid by seniors. - Advocates note extra benefits and coordinated-care models in many Medicare Advantage plans, while critics point to network limits, prior authorization requirements, possible denials, and regional access challenges, especially in rural areas. Summary: Shifting the default enrollment could change the initial coverage pathway for many new Medicare enrollees and raise questions about access, out-of-pocket costs, and federal spending. Officials describe the idea as exploratory, and any change would likely proceed through pilots or formal rulemaking if pursued. Current beneficiaries would not be affected by this discussion. Undetermined at this time.