Do Medicare Advantage enrollees like plans with more prior authorization? On the one han, one would think the answer is a clear ‘no’. However, higher levels of prior authorization could result in lower premiums, a tradeoff many enrollees may prefer.
A paper by Marr, Trivedi and Meyers (2026) aims to answer the question using beneficiary enrollment and contract-level prior authorization data. Using these data, they find that:
First, beneficiaries who live in different areas of the country enrolled in contracts with widely varying prior authorization rates. Second, Hispanic, Asian, Black or African American, and dual-eligible beneficiaries were disproportionately likely to enroll in plans with high prior authorization rates. Third, beneficiaries enrolled in contracts with higher prior authorization rates were more likely to disenroll from their contract—moving either to another Medicare Advantage contract or to traditional Medicare—than beneficiaries in contracts with lower prior authorization rates. Beneficiaries exposed to the highest quartile of prior authorization rates were 4.7 percentage points more likely to disenroll than beneficiaries exposed to the lowest quartile, a 44 percent difference. Higher disenrollment may suggest that beneficiaries are dissatisfied with plans that have higher prior authorization rates.
It looks like the inconvenience of prior authorization more than offsets the cost savings for most Medicare Advantage enrollees. You can read the full paper here.
