Public Payers News

Seniors Find Medicare Enrollment Confusing, Avoid Changing Plans

Medicare enrollment can be a mystifying process for seniors, who might resort to staying in the same plan instead of seeking out new options.

Medicare, Medicare Advantage, healthcare literacy, Medicare spending

Source: Getty Images

By Kelsey Waddill

- Medicare-eligible individuals continue to find original Medicare enrollment processes confusing and may overestimate their healthcare literacy, a report conducted by Sage Growth Partners found.

“Many beneficiaries have been burnt by poor experiences with sales agents, leaving them even more hesitant to look at their plan options,” the report stated. 

“As a result, they tend to stick with the same plan year in and year out, even though the plans—and sometimes the pricing—change each year. This puts millions at risk of being in a plan that is no longer a good fit for their current financial or health needs.”

The researchers surveyed over 1,140 Medicare-eligible Americans to assess their understanding of the Medicare enrollment system. The survey was conducted in April 2022. Most enrollees had been enrolled in Medicare or Medicare Advantage for a year or more and 80 percent had coverage through original Medicare or Medicare Advantage.

The survey discovered that one-fifth of Medicare-eligible adults have a good understanding of traditional Medicare. A slightly larger share of the survey participants understood Medicare Advantage (31 percent). 

Overall, three out of ten Medicare-eligible individuals strongly agreed that they could make effective plan selections for their Medicare coverage.

Almost two-thirds of Medicare-eligible individuals (63 percent) stated that they were overwhelmed by Medicare advertising. 

Many Medicare-eligible individuals were also at a loss for how to receive help. Although around a third of the respondents had a financial advisor, almost none of the respondents engaged with that financial advisor to select a Medicare plan (two percent). Additionally, only 12 percent of respondents used a helpline during the most recent open enrollment.

While most Medicare-eligible individuals reported feeling overwhelmed by Medicare advertising, many expressed some confidence in their ability to navigate the system. 

Seven out of ten individuals said somewhat agreed or strongly agreed that they could make effective Medicare plan decisions and that they were able to stay up to date with annual updates to Medicare options. Sixty-four percent said that they somewhat or strongly agreed that they could access out-of-pocket healthcare spending information.

The survey highlights moderate consumer confidence in their own abilities to ultimately select the right Medicare plans, but a test of enrollees’ Medicare knowledge painted a different reality.

The survey confirmed the impact of enrollees’ confusion when the respondents were asked questions about the components of original Medicare and Medicare Advantage: 80 percent answered incorrectly about the original Medicare components and 69 percent answered incorrectly about the Medicare Advantage components.

For many Medicare-eligible individuals, the solution is to find a Medicare plan and stay in it. Almost six out of ten Medicare-eligible individuals remained in the same plan year after year without considering other plan options (58 percent). Four out of ten Medicare-eligible individuals shop annually for their Medicare plans.

Separate studies have indicated that Medicare Advantage enrollees may have higher healthcare literacy than original Medicare enrollees. 

Healthcare literacy may also vary based on gender, a MedicareGuide.com survey indicated. The survey found that male Medicare enrollees were more likely to express confidence in enrolling themselves in a Medicare plan and in their understanding of Medigap plans and Medicare Advantage plans, though confidence levels for the latter were more equally matched.

Healthcare literacy among Medicare enrollees has a significant impact on both Medicare spending and member outcomes, a report from UnitedHealth Group found. 

Education level, language, and health behaviors can all influence a Medicare-eligible individual’s ability to navigate the Medicare system. Higher healthcare literacy corresponded with a higher rate of flu shots as well as lower rates of emergency department visits, hospital readmissions, and unnecessary hospitalizations.