Public Payers News

2020 Medicare Open Enrollment Saw Low Rates of Plan Comparison

Comparing health plans should be a critical process during Medicare open enrollment season, but only a small share of Medicare beneficiaries engage in the activity.

Medicare, Medicare Advantage, health literacy

Source: Getty Images

By Kelsey Waddill

- During 2020 Medicare open enrollment which took place in 2019, less than a third of Medicare beneficiaries compared their health plans with other available Medicare plans, according to an issue brief from Kaiser Family Foundation (KFF).

“Coverage and costs vary widely among both Medicare Advantage plans and Part D prescription drug plans. Plans can change from one year to the next, which could lead to unexpected and avoidable costs and disruptions in care for beneficiaries who do not review their options annually,” KFF researchers explained.

Three in ten Medicare beneficiaries reported that they compared their existing coverage with the other options in their areas. Beneficiaries sharing one or more of four key characteristics exhibited clear patterns in their likelihood to compare coverage options: income, race and ethnicity, age, and dual eligibility.

Less than one-fifth of individuals with incomes of less than $10,000 compared their Medicare coverage options. In contrast, 31 percent of those with incomes of $40,000 or above compared their health plan options. Hispanic Medicare beneficiaries were less likely to compare plans (19 percent) than White (30 percent) and Black beneficiaries (26 percent).

Older beneficiaries and those under the age of 65 with long-term disabilities were less likely to compare coverage. Additionally, individuals who were not dually eligible were more likely to compare plans than those who were dual eligibles.

Comparing plans is not the only important habit for Medicare beneficiaries during open enrollment season. It is also crucial that beneficiaries look at their current plans to assess the costs for the next year and to be aware of important changes in their benefits or cost-sharing requirements.

Among Medicare Advantage enrollees, 54 percent of beneficiaries reported that they checked their health plans to assess potential changes. Medicare Advantage beneficiaries are thought to have higher healthcare literacy.

Only three out of ten Medicare Advantage enrollees who were Hispanic and five out of ten Black enrollees reviewed their current coverage for changes, while six out of ten White beneficiaries did the same. Three out of ten Medicare Advantage beneficiaries who had low incomes reviewed their health plan benefits, compared to more than five out of ten beneficiaries with higher incomes.

Four out of ten enrollees with cognitive impairment reviewed their health plan benefits, as opposed to six out of ten enrollees without cognitive impairments. Individuals who were not dually eligible beneficiaries were more likely to review their current coverage than dual eligible beneficiaries.

Both in Medicare Advantage drug plans and in stand-alone drug plans, enrollees were unlikely to compare their plan options. Only 18 percent of Medicare Advantage drug plan enrollees and 27 percent of stand-alone drug plan enrollees reported that they compared plans.

The resource that beneficiaries were most likely to use was the “Medicare & You” handbook, with nearly half of all beneficiaries reporting reading thoroughly or partially. Over half of all beneficiaries were aware of the 1-800-MEDICARE number but did not call it for support. Only 43 percent of beneficiaries were aware of the Medicare.gov website and chose not to leverage it.

Although it was the most used resource, the “Medicare & You” handbook was also the most likely resource to be unknown. Nearly a quarter of respondents said that they did not receive it or did not know if they received it (22 percent).

“With a growing number of Medicare private plan choices available each year, the fact that a small share of Medicare beneficiaries report comparing their current plan with other available plans during the open enrollment period warrants attention, given the potential consequences of year-to-year plan changes for beneficiaries’ coverage, access to care, and out-of-pocket costs,” the report concluded.

Although the number of beneficiaries who do not compare Medicare plan options was large in the 2020 open enrollment season, it was by no means unusual. A separate study showed that the 2018 open enrollment period demonstrated particularly low rates of plan comparison.

Other research indicated that the complex process of comparing health plans might dissuade beneficiaries from going through the trouble and looking at their options.