Member satisfaction and trust in Medicare Advantage plans are dropping, according to a recent report from J.D. Power.
J.D. Power is a company focused on consumer insights, advisory services and data and analytics. The 2025 U.S. Medicare Advantage Study is based on responses from 10,888 members of MA plans in 10 states: California, Florida, Georgia, Illinois, Michigan, New York, North Carolina, Ohio, Pennsylvania and Texas. It was conducted from January to June.
It found that overall customer satisfaction in MA plans is 623 points on a 1,000-point scale, a 29-point drop from last year. The study measured member satisfaction based on eight factors: level of trust, ability to get health services, helping save time or money, product/coverage offerings meeting needs, ease of doing business, people (such as representatives or call center agents), resolving problems or complaints, and digital channels.
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The biggest factor contributing to the reduction in member satisfaction is members’ lack of trust in their MA plan, with a 39-point drop in overall trust in MA compared to last year. In addition, products not meeting patients’ needs and difficulty doing business contributed to the decline in member satisfaction.
The study also found that first-year members often deal with a lot of confusion in their MA plan. Just 38% of first-year member respondents said that their insurer “fulfills their service expectations.” However, among those who have been with the same plan for more than a year, this number increases to 45%.
New members often cite challenges like not understanding benefits and finding in-network providers, as well as issues with deductibles, prior authorizations and using their Health Savings Account/Health Retirement Account, according to the report.
When comparing the highest-performing MA plans with the lowest-performing plans, a key factor is “the ability to engage with members via digital channels,” J.D. Power stated. Members of top-performing health plans report digital satisfaction scores that are, on average, 98 points higher than those in the lowest-performing plans. Additionally, 85% of members in high-performing plans use their member portal, versus 76% in low-performing plans. About 52% find the website tools very easy to use, compared to only 40% in low-performing plans.
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“Top-performing plans that invest in robust new-member onboarding, increased transparency, new digital tools, broader networks and social support services are proving that they are better equipped to maintain member trust and satisfaction—even in a volatile environment,” said Christopher Lis, managing director of global healthcare intelligence at J.D. Power, in a statement. “These digital tools in particular can help drive increased personalization, automated and more consistent onboarding and increased transparency with real-time updates that members need.”
The report also listed the highest-ranked MA insurers by customer satisfaction in the 10 states it evaluated. They include:
- Kaiser Permanente in California with a score of 675 on a 1,000-point scale
- Freedom Health in Florida with a score of 670
- UnitedHealthcare in Georgia with a score of 648
- Blue Cross Blue Shield of Illinois in Illinois with a score of 654
- Blue Cross Blue Shield of Michigan in Michigan with a score of 675
- Excellus BlueCross BlueShield in New York with a score of 648
- UnitedHealthcare in North Carolina with a score of 663
- Anthem Blue Cross and Blue Shield in Ohio with a score of 680
- UPMC For Life in Pennsylvania with a score of 708
- Blue Cross Blue Shield of Texas in Texas with a score of 639
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