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Medicare Advantage overpays insurers by $7B yearly, funding extra benefits and insurer profits.

Market News
22 May 2026
24/7 Wall Street
View Source
Bearish
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A Congressional committee found Medicare Advantage overpays insurers by $212 per enrollee, totaling about $7 billion annually. This overpayment funds insurer profits and supplemental benefits like dental and vision care, which traditional Medicare lacks. The excess stems from risk adjustment coding, payment benchmarks, and upcoding practices. While CMS audits and DOJ probes are increasing, Medicare Advantage payments are set to rise in 2027, potentially reducing supplemental benefits and changing plan attractiveness for retirees.

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