Seniors Paid Billions in Extra Premiums Due to Alleged Medicare Overpayments

A congressional committee finds that controversial practices like adding diagnoses in Medicare Advantage triggered higher bills

By Christopher Weaver and Anna Wilde Mathews of The WSJ. Excerpts:

"The average American senior’s Medicare premiums last year were about 10% higher, or more than $200 annually, because of alleged overpayments to private Medicare Advantage plans, congressional investigators found.

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"

"Overpayments to Medicare Advantage insurers increased Part B premiums by $13.4 billion in 2025"

"Medicare Advantage costs the federal government more than traditional Medicare, partly because of insurers’ billing practices. The insurers are paid more to cover enrollees who have more health conditions, and they can boost their reimbursement by recording more diagnoses."

"in 2025 Medicare Advantage cost roughly 20% more than traditional Medicare."

"insurer practices contribute to potential overpayments. For instance, insurers sent nurses to patients’ homes, where they documented diagnoses that trigger more payments."

"Medicare officials nevertheless moved in January to remove some of the tools insurers use to increase their payments, such as certain behind-the-scenes reviews of medical charts that can lead to extra diagnoses."