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Denied care fuels new scrutiny of Medicare Advantage
Medicare Advantage now covers over half of Medicare beneficiaries, but audits and investigations have found wrongful denials and misleading marketing. This cause focuses on stronger enforcement so plans follow Medicare rules and seniors get timely, medically necessary care. Winning means fewer rule violations and fewer improper denials within a clear timeline.
Over half of people on Medicare are in Medicare Advantage, or 30.9 million seniors as of 2023. Many choose these plans for extra benefits and lower costs.
But government audits and investigations have found “widespread and persistent problems,” including care being denied or delayed even when it should be covered under Medicare rules. When needed care is held up—like chemo, imaging, or rehab—health can worsen and families can face stress and unexpected costs.
Medicare Advantage is a major business line for insurers, and the industry pushes back on tighter oversight. That resistance can slow or weaken enforcement and rule changes.
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