Benefit Design and Potential Trade-offs of Medicare Advantage Affinity Plans for Asian Beneficiaries

As Medicare Advantage (MA) continues to expand, an increasing number of MA plans are marketed to specific affinity groups, including Asian Medicare beneficiaries in the US. Little is known about the potential trade-offs of these emerging Asian-oriented affinity plans.

To evaluate the prevalence of MA Asian-oriented affinity plans and the characteristics of their Asian beneficiaries, to understand the differences in plan-benefit design between these affinity plans and other MA plans, and to compare the breadth of MA physician networks of Asian-oriented affinity plans vs other MA plans.

This cross-sectional study used 2023 national Medicare data to identify Asian-oriented affinity plans. MA plans were identified as Asian-oriented affinity plans if the difference in Asian enrollment between the plan and its service area exceeded the 99th percentile of the Box-Cox-transformed normal distribution. When comparing Asian-oriented affinity plans with other MA plans, the sample was restricted to states where Asian-oriented affinity plans were offered. Data analyses were performed from June 2024 to June 2025.

Asian-oriented affinity plan classification.

Cost-sharing, supplemental benefits, Medicare Star Ratings, and network breadth. Enrollee-weighted, adjusted regression models were used to assess differences in plan-benefit design, Medicare Star Ratings, and network breadth between Asian-oriented affinity plans and other MA plans.

The sample included 4224 MA plans in 2023, of which 27 were identified as Asian-oriented affinity plans. These 27 plans were offered in California, New York, Texas, and Massachusetts and enrolled 16.1% (109 906 of 684 764) of Asian beneficiaries in these states. Asian enrollees in these plans (mean [SD] age, 73.0 [7.19] years; 57 729 females [52.5%]) were more likely to be older, male, without disability, and dually eligible for Medicaid-Medicare benefits. Compared with other MA plans, Asian-oriented affinity plans had a higher likelihood of $0 Part C premiums (adjusted difference, 10.8 [95% CI, 10.8-10.9] percentage points), Part B premium reductions (adjusted difference, 6.7 [95% CI, 6.5-6.9] percentage points), and lower monthly Part D premiums (adjusted difference, -$7.18 [95% CI, -$14.24 to -$0.12]). Asian-oriented affinity plans were more likely than other MA plans to provide culturally relevant benefits, including acupuncture (adjusted difference, 23.2 [95% CI, 23.0-23.4] percentage points) and alternative therapies (adjusted difference, 4.8 [95% CI, 4.7-5.0] percentage points). However, Asian-oriented affinity plans were less likely to cover annual physical examinations (adjusted difference, -41.7 [95% CI, -41.9 to -41.5] percentage points), had lower Medicare Star Ratings, and had narrower physician networks compared with other MA plans.

In this cross-sectional study, while MA Asian-oriented affinity plans offered more culturally relevant benefits and favorable premiums, they came with important trade-offs, including narrower physician networks, lower Medicare Star Ratings, and reduced coverage of certain traditional benefits. Enrollment growth and performance of Asian-oriented affinity plans should be closely monitored to ensure that they address the health care needs of Asian beneficiaries.