Plan Comparison Was Low During Medicare Open Enrollment 2018

October 13, 2021 - Most Medicare beneficiaries did not review their health plan options during open enrollment in 2018, according to a Kaiser Family Foundation (KFF) issue brief.

“The marketplace of Medicare private plans operates on the premise that people with Medicare will generally compare plans to select the best source of coverage, given their individual needs and circumstances. This analysis finds that most Medicare beneficiaries did not compare plans during the 2018 open enrollment period for coverage in 2019, and most people in stand-alone drug plans and Medicare Advantage drug plans did not compare the drug coverage offered by their PDP or MA-PD to other drug plans in 2019,” the issue brief stated.

The researchers examined data from the Centers for Medicare & Medicaid Services (CMS) Medicare Current Beneficiary Survey (MCBS) 2019 survey file to draw their conclusions.

The results indicated that Medicare Advantage beneficiaries were slightly more likely to have compared plans than traditional Medicare beneficiaries. The gap was not very large, however. 

Approximately a third of 21.4 million Medicare Advantage beneficiaries report that they had compared plans (32 percent), as opposed to 27 percent of the 29.2 million beneficiaries under fee-for-service coverage.

Although Medicare Advantage plans overall had a slight edge on Medicare in this area, beneficiaries in Medicare Advantage-prescription drug plans and individuals with stand-alone Medicare Part D plans were unlikely to compare their drug plan options. 

Eight out of ten Medicare Advantage-prescription drug plans did not compare their drug plan options along with a little over seven out of ten beneficiaries in Medicare Part D plans

Certain minorities were less likely to report that they had compared Medicare plans. In particular, almost three-quarters of all Black Medicare beneficiaries (74 percent) had not compared plans and almost eight in ten Hispanic beneficiaries also did not compare health plans (79 percent).

Furthermore, older beneficiaries—who are more likely to experience dramatic health changes and, as a result, should be more aware of their Medicare enrollment options—were also less likely to compare health plans during the 2018 open enrollment period. Only 16 percent of beneficiaries ages 85 and older reported that they had compared their health plan options.

Only 15 percent of individuals with incomes that were less than $10,000 and 25 percent of individuals with incomes between $10,000 and 19,000 said that they had compared health plans before making their selection during the 2018 open enrollment period. 

In contrast, a third of beneficiaries with incomes of $40,000 or higher had perused their health plan options. 

Of all of the demographics that the brief analyzed, this income bracket demographic had one of the top three highest rates of health plan comparison. Only beneficiaries with a bachelor’s degree or higher and beneficiaries between ages 64 and 75 had better rates of plan comparison.

Beneficiaries who were in fair or poor health likewise more often neglected to consider changing health plans when compared to beneficiaries who said that they were in good, very good, or excellent health.

These poor results may be all the more disheartening given the number of resources that are available for Medicare beneficiaries to support their plan comparison processes. Medicare offers a plan finder website, a toll-free customer support line, and a handbook, but many beneficiaries reported not making use of these tools.

More than half of all Medicare beneficiaries did not call the 1-800-MEDICARE support line and 47 percent did not leverage the Medicare.gov website. 

The Medicare & You handbook gained the most traction among beneficiaries, with 51 percent of beneficiaries saying that they had used this resource, 31 percent stating they had not used the handbook, and 18 percent reporting that they were unaware that the handbook existed or whether they had received it.

“This analysis builds on previous KFF analyses which suggest that the marketplace of Medicare plans may not be working as intended,” the issue brief concluded.

The brief suggested that the lack of plan comparison among beneficiaries could be due to beneficiaries being content with their current Medicare plan. In the plan year that followed the open enrollment period that this issue brief studied, most Medicare beneficiaries reported overall satisfaction with their Medicare coverage and care.

However, the results could also underscore that beneficiaries are confused about their Medicare plan options and plan comparison processes. Almost four in ten Medicare beneficiaries (37 percent) stated that they were confused about Medicare open enrollment resources.

Beneficiaries’ confusion over Medicare open enrollment support will be crucial for payers to address during the upcoming open enrollment season.