Private Payers News

Prescription Coverage Draws Beneficiaries to Medicare Advantage

Nearly 30 percent of respondents cited prescription coverage as their reason for selecting a Medicare Advantage plan for 2021.

prescription drug coverage, Medicare Advantage, Medicare, prescription drug spending, coronavirus

Source: Getty Images

By Kelsey Waddill

- Many Medicare beneficiaries are transitioning from another Medicare plan to Medicare Advantage, with the migration driven in part by the opportunity for prescription coverage under Medicare Advantage, according to a survey conducted by MedicareAdvantagePlans.org.

The MedicareAdvantagePlans.org survey covered 700 participants who were eligible for and enrolled in a Medicare Advantage health plan in 2021. An online platform called Pollfish fielded the survey.

Forty-five percent of respondents said that they were switching to Medicare Advantage from a different Medicare plan.

Thirty-five percent of survey participants had previously enrolled in a Medicare Advantage plan and were enrolling in it in 2021 based on that experience.

Nearly three in ten respondents (29 percent) were attracted to Medicare Advantage plans because it covered prescription drugs.

They have a larger number of Medicare Advantage with Part D plans to choose from now than three years ago. The number of Medicare Advantage-Part D plans grew by 1,500 plans in three years, CMS recently announced. Additionally, healthcare spending for Medicare Part D plans has been dropping, particularly for insulin, making it more attractive to beneficiaries.

Sixteen percent of respondents cited affordability as their reason for picking a Medicare Advantage plan in 2021, indicating that the Medicare Advantage plan was more financially accessible than Original Medicare.

The remaining 22 percent of respondents were divided between choosing Medicare Advantage for the first time, selecting it for the supplemental benefits, and none of the above.

When it came to supplemental benefits, dental and vision continued to lead the pack as significant motivators for enrolling in Medicare Advantage. Of those who said supplemental benefits were a primary factor for their decision to enroll in Medicare Advantage, 62 percent were motivated by the dental benefits and 52 percent were motivated by the vision benefits.

Most Medicare Advantage plans offer vision and dental benefits, with 98 percent offering vision and 91 percent offering dental in 2021, according to a recent Avalere study.

The Avalere study also noted that 34 percent of health plans would be offering coronavirus-related benefits.

Of the MedicareAdvantagePlans.org survey respondents who chose Medicare Advantage due to the supplemental benefits, coronavirus-related benefits ranked as the fourth most popular benefit, after dental, vision, and over-the-counter.

“Medicare Advantage plans were already surging in popularity, but it looks like the coronavirus pandemic will further catalyze that surge because beneficiaries can likely have their COVID-19 related costs covered through specific supplemental benefits,” the report stated.

Further down the list, telehealth benefits also gained some traction with respondents. Almost three in ten of those who chose Medicare Advantage based on the supplemental benefits (27 percent) indicated that they were attracted to the telehealth benefits. Coronavirus-era waivers helped boost Medicare Advantage members’ access to telehealth.

The survey indicated that beneficiaries have made progress in researching their health plan options. Over half of the respondents indicated that they had compared all possible plan options before making their choice.

In contrast, Medicare beneficiaries were unlikely to switch plans in 2016, Kaiser Foundation found. Over a third of the survey respondents (35 percent) reported that comparing Medicare plans was “very” or “somewhat” difficult, indicating that the challenges of plan comparison could be a major barrier to switching from Original Medicare at the time.

However, the MedicareAdvantagePlans.org survey discovered that 65 percent of its participants reported reviewing all of their options before selecting a healthcare plan.

Another 26 percent of the participants responded that they did a “brief amount of research” before making their decision. According to these responses, only seven percent of beneficiaries did not research their options before enrolling or rarely researched their options.

This result is at odds with Kaiser Family Foundation research from earlier in 2020 which found that 57 percent of Medicare beneficiaries did not review their health plan options every year. Forty-three percent of respondents in the Kaiser Family Foundation survey would compare their health plan options on an annual basis.

The MedicareAdvantagePlans.org report acknowledged this discrepancy.

“Is it possible that the benefits of Medicare Advantage plans so outweigh original Medicare coverage that all it takes is a bit of research to understand which option is generally more consumer-friendly?” the report asked.

The authors did not put forward further explanation.