Medicare Advantage Members Rarely Review or Switch Plans

Dive Brief:

  • *Very few beneficiaries with Medicare Advantage or Medicare Part D stand-alone coverage voluntarily switch plans during open enrollment, according to a report from the Kaiser Family Foundation.
  • *The analysis found a “substantial majority” of enrollees in MA plans did not voluntarily switch during enrollment from 2007 to 2016. The number of people changing plans knowingly ranged from 6% to 11% over that time period.
  • *KFF also said more than one in three Medicare beneficiaries reported difficulty comparing plan options — especially those with poor self-reported health or multiple chronic conditions. Nearly half of those on Medicare said they rarely or never review their choices.

Dive Insight:

Medicare open enrollment for 2020 in currently underway and ends Saturday. Insurers have been touting their MA plans with new or additional benefits that address social factors, like pest control services and transportation assistance trying to pique interest from consumers.

But the KFF study shows it’s far from clear patients understand what to look for when they decide on a plan, and may simply be passing on the chance to shop around for the best coverage.

The study authors acknowledge that people could be sticking with their MA plans simply because they are satisfied with what they have, but the high percentages of those who report difficulty understanding their options suggests beneficiaries may find comparing plans too challenging or not be aware of open enrollment.

The nearly 30 MA and stand-alone Part D plans available to beneficiaries on average vary widely. Provider networks, premium rates, deductibles, co-pays and formularies are all issues for consumers to consider.

“Comparing all of these factors simultaneously is the best way to maximize value and lower costs, but it is also time consuming and challenging, especially for beneficiaries with cognitive impairments or serious health needs,” according to the report.

During the open enrollment period for the 2018 plan year, 8% of those without low-income subsidies voluntarily switched MA plans while 3% involuntarily switched. For Medicare Part D plans, 10% voluntarily changed and fewer than 1% did so involuntarily, according to the analysis of CMS data.

CMS promotes the idea of consumers shopping around for plans. About three months ago, the agency updated is Medicare Plan finder tool, which allows side-by-side comparisons of pricing and other information, to make it easier to use .

The KFF study authors note the findings don’t necessarily bode well for Democratic presidential contenders pushing for an expanding role of Medicare in a public option or single-payer system.

“Given that some presidential candidates and policymakers are discussing proposals to build on Medicare and the marketplace model or to broaden the role of private plans in Medicare, understanding the barriers that people on Medicare experience will continue to be important for policy discussions,” they wrote.

 

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