Most Medicare beneficiaries don’t compare coverage options during open enrollment

October 20, 2021  by  Allzone MS   275

most-medicare-beneficiaries-dont-compare-coverage-options-during-open-enrollment

Since not shopping around can have an impact on enrollees’ coverage and costs, CMS recommends they review and compare plans each year.

The numbers are similar across both Medicare Advantage and traditional Medicare, with 68% of MA beneficiaries saying they don’t compare medical plans, and 73% of those in traditional Medicare claiming the same.

The analysis examines the share of Medicare beneficiaries who compared plans during the 2018 open enrollment period for coverage in 2019, the share who compared drug coverage in Medicare Advantage and stand-alone drug plans, and variation by demographic characteristics, based on an analysis of the 2019 Medicare Current Beneficiary Survey, the most recent year available.

WHAT’S THE IMPACT?

Among the key highlights are that the share of beneficiaries who said they did not compare their options was higher among beneficiaries who are Black (74%) and Hispanic (79%), ages 85 and older (84%), with low incomes (85%), and those enrolled in both Medicare and Medicaid (87%).

When it comes to Part D drug coverage, 81% of Medicare Advantage drug plan enrollees and 72% of Medicare stand-alone drug plan enrollees said they did not compare the drug coverage offered by their current plan to other plans.

Meanwhile, nearly half of all beneficiaries with Medicare said they had never visited the official Medicare website for information, 53% reported they had never called the helpline and 31% said they did not read the Medicare & You handbook.

Medicare beneficiaries with traditional Medicare can compare and switch Medicare Part D stand-alone prescription drug plans or join a Medicare Advantage plan, the privately run alternative to traditional Medicare. At the same time, enrollees in Medicare Advantage can compare and switch MA plans or elect coverage under traditional Medicare with or without a stand-alone drug plan.

Coverage and costs vary widely among both MA plans and Part D prescription drug plans. Plans can change from one year to the next, as can beneficiaries’ healthcare needs. These factors could lead to unexpected and avoidable costs, and disruptions in care, for beneficiaries who stay put and do not at least review their options annually, KFF found.

Because failing to shop around can have impacts on enrollees’ coverage and costs, the Centers for Medicare & Medicaid Services advises that beneficiaries review and compare Medicare plans every year.

THE LARGER TREND

A recent analysis from the Commonwealth Fund has found that Medicare Advantage enrollees do not differ significantly from beneficiaries in traditional Medicare in terms of their age, race, income, chronic conditions, satisfaction with care, or access to care, after excluding Special Needs Plan (SNP) enrollees.

Both groups reported waiting more than a month for physician office visits, while similar shares of Medicare Advantage and traditional Medicare enrollees report that their out-of-pocket costs make it difficult to obtain care.

Ultimately, MA and traditional Medicare are serving similar populations, with beneficiaries having comparable healthcare experiences. The care management services provided by Medicare Advantage plans appear to neither impede access to care nor reduce concerns about costs.

The Centers for Medicare and Medicaid Services said in late September that the average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared with $21.22 in 2021. However, Part D coverage is rising to $33 per month, compared with $31.47 in 2021.

Enrollment in MA continues to increase, CMS said. In 2022, it’s projected to reach 29.5 million people compared with 26.9 million enrolled in a Medicare Advantage plan in 2021

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