Knowledge, Awareness of Medicare Advantage Plans Remain Low Despite High Enrollment

Many Americans who receive Medicare benefits seem to lack knowledge and awareness on all of the options available to them, especially those who are older, according to a recent study by GoHealth.

Even while Medicare Advantage enrollment across the country has been much higher than it has ever been, the study shares many Medicare beneficiaries do not understand all of Medicare's benefits and services from Medicare Supplement; Part A,B and D, to Medicare Advantage.

Older adults

Part A and Part B are significant health resources for many seniors, but original Medicare alone doesn’t cover all healthcare costs. Outside of adding a Part D prescription drug plan and a Medicare Supplement plan to a Medicare plan, a growing number of seniors are instead enrolling in Medicare Advantage (Part C), the study said.

However, of 1,000 Medicare Advantage beneficiaries and 1,000 original Medicare beneficiaries, there is a difference in their knowledge of options. Of the 2,000 U.S. citizens aged 65 and older polled, original Medicare beneficiaries were less knowledgeable than Medicare Advantage beneficiaries in several areas.

According to the study, some of these areas include:

• 78% of Medicare Advantage beneficiaries cite cost savings as a reason for their choice.
• 30% of Original Medicare beneficiaries believe Medicare Advantage is more expensive.
• 65% of Original Medicare beneficiaries don’t know that Medicare Advantage plans provide Part A and Part B coverage.
• 86% of Original Medicare respondents believe Original Medicare alone provides out-of-pocket maximum (it does not).

"Such misconceptions can be harmful if they cause a person not to seek out the coverage and care they need," said GoHealth Chief Medical Officer, Paul Hain, MD. "We've always aimed to educate our customers first. For many people, we're their only point of contact regarding Medicare and how it works. Clearing up misconceptions and providing helpful information has always been at the forefront of what we do. However, we are starting to see just how negatively those misconceptions can affect the average Medicare-aged American. How can we help the 21% who have never reviewed their plan, or the 11% who only do so every few years?"

Original Medicare Enrollees

A significant group impacted by this knowledge gap appears to be original Medicare enrollees.

• 40% of Original Medicare beneficiaries weren't also enrolled in either a Medicare Supplement or Part D plan, or weren't sure.
• 36% of Original Medicare beneficiaries do not know that Medicare Advantage has benefits Original Medicare does not offer.
• 35% of Original Medicare beneficiaries will not switch to Medicare Advantage because they fear losing their coverage.
• 62% believe that Medicare Advantage plans can change without informing the beneficiary.
• In all, just 18% of Original Medicare enrollees said they were "very familiar" with Medicare Advantage; 30% are either unsure or not at all familiar with Part C plans.
• 53% falsely believe their Original Medicare covers long-term care, which may set them up for a costly disappointment if a serious medical issue arises.

Medicare Advantage Beneficiaries

While Medicare Advantage enrollees seem to be more knowledgeable about Part C in general, engagement with their plans often ends when they enroll in Medicare Advantage.

• 61% immediately enrolled in Medicare Advantage when they were first eligible for Medicare Parts A and B.
• 70% of Medicare Advantage enrollees have never switched to another Part C plan

This issue points to a lack of engagement in their policy. While beneficiaries may have taken the extra steps to learn about and enroll in a Medicare Advantage plan in the past, the same plan beyond year one may not be the most health- or cost-effective option available to them as their health needs, provider networks and circumstances change.

Perhaps most telling is that 19% of respondents with Medicare Advantage worry they are not getting maximum cost savings from their plans, and 53% of them are not aware of any resources to help find the answers they need.

"The fact that so many people don't know whom to ask when they have questions, to me, was startling," said Hain. "It's clear that while Medicare Advantage enrollment is growing each year, there's still a sizable gap in what the average American knows about it. That also extends to those in Original Medicare who don't know they may have better options available."