By Sneha S K
March 11 (Reuters) – A congressional committee’s investigators released a report on Tuesday that found the average American senior’s Medicare premiums last year were about 10% higher due to alleged overpayments to private Medicare Advantage plans.
Medicare Part B premiums that most seniors pay were partly pushed up by controversial health-insurer practices such as adding diagnoses to trigger higher payments, according to the Joint Economic Committee, a bipartisan group of lawmakers that advises Congress on financial matters.
Medicare is a U.S. government program for individuals aged 65 and older or those with disabilities. The government reimburses private health plans, called Medicare Advantage, a set amount for each patient but pays more if patients are sicker.
Medicare Part B provides coverage for outpatient services including doctor visits, diagnostic tests and physician-administered drugs.
The committee found that in 2025 the federal government paid health insurers who offer Medicare Advantage plans up to $84 billion more than it would have cost to cover the same beneficiaries under its own government-run Medicare plans.
It estimates Medicare overpayments increased Part B premiums by $212 for enrollees in 2025, totaling $13.4 billion in higher premiums.
These higher Part B premiums negatively impact seniors as they are deducted directly from their social security checks.
By 2035, per-person premiums are projected to double from $2,440 to about $5,000, the report found, making the plans less affordable to seniors.
The Committee calculated the overpayments based on findings by the congressional Medicare Payment Advisory Commission, or MedPAC.
“Numerous experts continue to warn that making policy based on MedPAC’s fundamentally flawed data, methodology and extrapolations could harm 35 million Medicare beneficiaries who choose MA for more affordable, high-quality health care coverage and who will renew their coverage in October of 2026,” said a spokesperson for AHIP, an association representing U.S. health insurers.
Government investigators have been probing how health insurers’ billing practices have contributed to Medicare Advantage costs.
(Reporting by Sneha S K in Bengaluru; Editing by Krishna Chandra Eluri)
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