Too Few Seniors Have a Good Understanding Of Medicare And Medicare Advantage

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Contributor, Benzinga
July 15, 2022

The majority of Americans do not have a good understanding of Original Medicare and only slightly more understand Medicare Advantage coverage options. Yes, Medicare offers a health plan and drug plan, but some seniors want extra options that align with their medical needs, health care service they need and an affordable health insurance coverage that’s available to them.

A just released study of over 1,000 adults ages 64 and older found that only 20% of Medicare-eligible individuals have a good understanding of Original Medicare. The study revealed that less than one-third (31%) have a good understanding of Medicare Advantage, also referred to as Medicare Part C.

73 Million Medicare Enrollees Need Better Understanding

Some 64 million Americans are currently enrolled in the Medicare program with 11,000 joining daily. Experts predict 73 million Americans will be enrolled in the program by 2030.  More could potentially participate if the Medicare enrollment age drops to 60. A significant number choose to enroll in Medicare Advantage (MA) plan options.

The latest study, sponsored by Healthpilot, found that seniors enrolling in Medicare face a process fraught with challenges. The findings reveal gaps in knowledge of what is Medicare.  It is vital to better understand the different components which can range from simply Original Medicare or may include Medicare Advantage and Medicare Supplement options. 

According to the study, 63% of respondents are “overwhelmed” by Medicare advertising, making choosing health insurance, finding a health care provider and the prescription drug coverage all the more confusing. In recent years, seniors share being confused by the numerous Medicare advertisements appearing almost continuously across cable television channels.

Medicare eligible seniors often fail to comprehensively evaluate their plan options when initially selecting affordable healthcare plans. Only 31% of the study participants “strongly agree” that they can make effective selection decisions for affordable health coverage. As a result, the authors note that many are enrolling in plans that fail to best reflect and support their evolving healthcare needs. Remember, the cost of healthcare is rising and many seniors are leaving behind the comfort of employer health coverage.

CMS Aims To Tighten Rules To Benefit Consumers

The Centers for Medicare & Medicaid Services (CMS) recently issued a 360-page proposed ruling that aims to improve Medicare beneficiaries’ experiences with MA and Medicare Part D prescription drug programs. Prescription drug plan types vary because the cost of prescription drugs can shift depending on how the plan is administered.

Moreover, coverage for prescription drugs or other services may shift depending on whether you have supplemental or Medicare Advantage plans that address specific types of medications. This is because the cost of health care and the cost of health coverage can diverge significantly.

The government agency said that it has received an increase in beneficiary complaints about the marketing practices of third-party marketing organizations that sell multiple MA and Part D products. There was wide spread problems when seniors responded to television commercials featuring celebrities who promoted rich health benefits for MA plans.

In 2020, CMS said it received 15,497 complaints related to marketing. In 2021, excluding December, the number of complaints increased to 39,617.

Nearly Half Fail To Re-Evaluate Plans On Yearly Basis

Medicare beneficiaries are provided with opportunities to regularly evaluate their current plan. More than half (58%) of the study participants, stay in their current Medicare plan each year rather than reviewing plan options. Experts note that regular plan comparison can result in added benefits, lower costs and finding more suitable coverage for evolving healthcare needs. And, if they do, they could be caught up by health care fraud schemes. This is why it’s important to search with Benzinga and only speak with reputable carriers.

Over 14 million Americans currently have Medicare Supplement coverage, commonly called Medigap. According to the 2022 Medicare Insurance Price Index published by the American Association for Medicare Supplement Insurance, costs for coverage can vary significantly. A man turning 65 in Dallas could purchase Medigap Plan G coverage for as little as $109-per-month. Virtually identical coverage from another insurer will cost $226-monthly. In addition, insurers can add policy fees or offer household discounts that can reduce monthly costs by as much as 14%. With a better health insurance plan, health outcomes improve.

Information Available From Multiple Sources

Securing information is vital to the process of comparing Medicare plan options.  There are 166 Medicare Advantage (Part C) plans available in Illinois for 2022. That compares to 145 plans in 2021. Some plans have no premium cost but do have potential costs and added benefits that can vary. Remember, this includes inpatient care, outpatient care, extra benefits, preventive services, coverage for prescription drugs and more.

Seniors in Dallas County have few choices, Still, the options can be daunting. Some 52 different Medicare Advantage plans are available in 2022. In addition, 10 standardized Medicare Supplement plans are available in Texas, plus 2 high deductible plans.

The study concluded that 33% of those surveyed have a financial advisor. But only 2% use that advisor to help with plan selection. Those calling toll-free numbers promoted via television ads may be speaking to someone representing only one plan option. Or, they may be able to compare several plans but have a favored option to recommend.

Experts suggest consumers seek information from at least two different sources. Obtaining online information to find the best Medicare Advantage plans is an excellent way to start. While Medicare is a national program, plan options can vary based on where you live. As a result, speaking to a local Medicare insurance agent can be beneficial.

A free directory listing local Medicare insurance agents by Zip Code is hosted by the American Association for Medicare Supplement Insurance. Agents identify whether they can offer Medicare Advantage as well as Medicare Supplement options. There is no cost to access the directory which does not require inputting any personal information. Learning about your monthly premium and available health services or health insurance coverage is a good way to prepare for the future and understand Medicare’s offerings.

About Jesse Slome

Medicare Expert – Director Long Term Care Insurance Association, Medicare Supplement Insurance & Critical Illness Insurance Association