Cost, Health Literacy Cause for Concern Ahead of Open Enrollment

September 30, 2020 - Entering into Medicare open enrollment 2021, Medicare enrollees and nearly-eligible enrollees continue to struggle with health literacy and healthcare costs, a survey commissioned by GoHealth emphasized.

A third-party surveyor conducted 2,106 online interviews in late July 2020. Respondents were nearly evenly split between two demographics: current Medicare beneficiaries and nearly-eligible beneficiaries between 62 and 65 years of age.

Most respondents (34 percent) were unsure who to trust for advice about Medicare open enrollment 2021 plan selection when given a range of categories. Only sixteen percent trusted their insurance companies. Others trusted their provider (21 percent) or friends and family (19 percent) over their health plans.

Medicare beneficiaries remain confused and overwhelmed by the Medicare open enrollment process.

Twenty percent of survey participants left the decision until the last minute, only beginning to sift through their health plan options after they reached the age of eligibility. Nearly four in ten survey participants (37 percent) said that they did not know where to start when searching for the right plan.

READ MORE: Big Premium Drop, More Medicare Advantage Benefits Slated for 2021

Even leveraging assistive resources such as Medicare.gov can leave beneficiaries with unanswered questions. Thirty-seven percent of participants confessed that they felt confused by Medicare resources.

As a result, one in five beneficiaries may end up in a health plan that fails to cover their healthcare needs, particularly in the areas of specialist care, prescriptions, and long-term care.

Beneficiaries had varying opinions on strategies that would make this process easier for them.

Almost eight in ten beneficiaries (79 percent) stated that easy-to-read websites were the resource most likely to make the enrollment process easier.

Three out of every four beneficiaries noted that engaging with a Medicare expert would make the process easier. They preferred a Medicare professional over a family member for this task.

READ MORE: Medicare Beneficiaries Require More Financial, Coverage Support

More specifically, 76 percent of the participants stated that the process would be easier with a Medicare expert who could recommend plans for them individually, whereas a little less than three-quarters would find the process easier with a Medicare agent to simply advise them.

This is an important distinction as many state programs designed to assist Medicare beneficiaries through the Medicare enrollment process do not allow their agents to promote a particular Medicare health plan option. The study showed that beneficiaries were only slightly more inclined to engage with an expert who would direct them to a specific plan.

Medicare literacy among beneficiaries is a recurrent problem during Medicare open enrollment periods. The GoHealth study found that level of Medicare literacy may be partially related to income.

Beneficiaries with higher incomes were nearly twice as likely as those with lower incomes to indicate that they understood their Medicare options. Three quarters of lower income Medicare beneficiaries did not know what the Medicare plan options were, along with 65 percent of middle class beneficiaries.

While patients across demographics need relief from the financial burdens of healthcare, those nearing Medicare eligibility are particularly concerned about healthcare spending and their ability to pay off medical bills.

READ MORE: Private Payers Pay Hospitals 247% of Medicare Reimbursement Rate

Twenty percent of nearly-eligible individuals are twice as likely as current Medicare beneficiaries to find paying for healthcare expenses a monthly challenge.

Financial struggles can often result in medication and treatment non-adherence.

Among current beneficiaries and nearly-eligible individuals alike there was a common thread of avoiding treatment due to cost, as previous studies have demonstrated. However, nearly-eligible individuals are twice as likely as current Medicare beneficiaries to avoid preventive care (16 percent).

A fifth of all nearly-eligible respondents were considering delaying their retirement so that they can continue on their employer-sponsored health plan instead of switching to Medicare. Those most likely to delay their retirement are middle class earners.

Meanwhile, as the healthcare industry turns to telehealth as a solution to high-cost, difficult-to-access care, potential Medicare beneficiaries are less open to the technology, the survey showed.

Telehealth can expand access to care and potentially offer payers greater control over healthcare spending than in-person care. And in the face of the public health crisis, CMS initiatives and waivers in the face of the public health crisis have effectively boosted telehealth uptake among seniors and nine in ten seniors who used telehealth have reported a positive experience.

However, the GoHealth report identified that nearly a third of current Medicare beneficiaries (31 percent) were not open to engaging with virtual care options. Nearly-eligible respondents were not far off with 26 percent being disinterested in virtual care. Particularly among low-income beneficiaries, virtual care was a hard sell: almost four in ten were not interested (36 percent).

The most common reason that current beneficiaries and nearly-eligible individuals were disinterested in telehealth was that the respondent’s provider had not offered the technology. Three-quarters of the respondents in this survey stated that their providers had not notified them that telehealth was an option.

This data could be crucial as the healthcare industry invests in and leans on telehealth and virtual care. If providers are not proffering these services, patients may not engage with these solutions.

In order to better partner with providers on telehealth, it is essential to offer providers a range of telehealth options that can serve different patients’ needs and allow providers to choose which option is best for their patients. Additionally, payers should ensure that providers are not incentivized to conduct in-person visits when in-person visits are unnecessary.