Report: MA Insurance Company Member Satisfaction is Declining due to Lack of Trust

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Report: MA Insurance Company Member Satisfaction is Declining due to Lack of Trust

According to a latest report from JD Power, member satisfaction and trust in the Medicare Advantage program are declining.

JD Power is a company focused on consumer insights, consulting services, and data and analytics. The 2025 U.S. Medicare Advantage Study is based on responses from 10,888 MA program members in 10 states: California, Florida, Georgia, Illinois, Michigan, New York, North Carolina, Ohio, Ohio, Pennsylvania, and Texas. It takes place from January to June.

It found that the overall customer satisfaction rate in the MA program was 623 points of 1,000, down 29 points from last year. The study measures member satisfaction based on eight factors: level of trust, ability to access health services, helping save time or money, product/coverage meets needs, ease of business operations, people (such as representatives or call center agents), problem solving or complaints, and digital channels.

The biggest factor that leads to a decrease in member satisfaction is the lack of trust in the MA program, which saw an overall decline of 39 points compared to last year. In addition, products that do not meet patient needs and business difficulties lead to a decrease in member satisfaction.

The study also found that first-year members often deal with a lot of confusion in their MA programs. Only 38% of first-year respondents said their insurance companies “realize their service expectations.” However, in a plan that has been planned for more than one year, this number has increased to 45%.

New members often cite challenges such as not understanding benefits and finding in-network providers, and issues with having deductibles, prior authorization and use of their health savings/healthy retirement accounts, the report said.

JD Power said that when comparing the highest performing MA program with the lowest performing plan, the key factor is “the ability to interact with members through digital channels.” Members who performed best health programs reported digital satisfaction scores on average 98 points higher than those with the lowest performing programs. Additionally, 85% of members of high-performance plans use their member portal, compared to 76% of those with underperforming plans. About 52% of people find website tools very easy to use, compared to only 40% of underperforming plans.

“Excellent performance programs invest in strong new member onboarding, increased transparency, new digital tools, wider networking and social support services demonstrate that they have the ability to maintain trust and satisfaction among members, and even in turbulent environments,” said Christopher Lis, Director of Global Health Intelligence at JD Power. “In particular, these digital tools can help improve personalization, automation and more consistent onboarding and increase transparency and through real-time updates that members need.”

The report also lists the MA insurers with the highest customer satisfaction of the 10 states evaluated. They include: