MA, Part D Recipients Satisfied With Coverage, But Worried About Future Costs

February 28, 2023

Nearly 90% of Medicare Advantage or supplement coverage recipients are satisfied with their current coverage, according to a recent survey, but many still believe politicians are not listening to the concerns of beneficiaries and are concerned about future costs.

The online health insurance marketplace eHealth released a research report this month on consumer sentiment, surveying about 4,500 enrollees in Medicare Advantage (MA), Medicare Supplement, or Medicare Part D plans purchased through eHealth.

“Findings in this report demonstrate that while a strong majority of beneficiaries are satisfied with their coverage, many still feel unheard by the political leaders and policymakers who shape the Medicare program,” the report says.

The survey found that 88% of respondents said they were either “satisfied” or “very satisfied” with Medicare coverage, while only 4% said they were dissatisfied. They were more likely to say Medicare policy was moving in the right direction (39%) than the wrong direction (19%), although a plurality, 43%, were unsure. More than 80% of respondents said coverage options available meet their personal needs.

Lower-income beneficiaries were more likely to say they were happier with their coverage now than they were a year ago, with 42% saying their satisfaction had increased.

Despite that, 60% said political leaders do not listen to Medicare enrollees about their needs. Only 19% of respondents said political leaders were responsive to their needs. Majorities of all party affiliations said they felt unheard, including 67% of Republicans, 63% of independents, and 55% of Democrats.

Concerns about the cost of health care for beneficiaries vary, the report says. Three-quarters of respondents said they were “somewhat worried” or “very worried” about their ability to pay their maximum out-of-pocket cost if they are seriously ill or injured. Younger beneficiaries and those on fixed incomes are most worried about out-of-pocket costs, with 64% of those on fixed income and 58% of those ages 65-70 saying their savings would not cover the costs.

Additionally, 43% said they were somewhat or very worried about their ability to pay monthly premiums. Asked about the impending end of the federal COVID-19 public health emergency, 62% said they were worried it would result in increased costs for testing and care.

The report also says concerns about future medical care differ by income level. Overall, 37% said they were most concerned about being unable to afford care in the future and 28% said they were most concerned about Medicare benefits being reduced. For those with an annual income below $25,000, future affordability of care was the top concern. For those with incomes between $50,000 and $75,000, it was potential future reduction of benefits. And for those above $100,000, it was lack of access to prescription drugs.

Beneficiaries’ top concerns when choosing an MA or supplemental coverage plan were coverage of preferred doctors and hospitals (31%), affordable monthly premiums (24%), and affordable copays and deductibles (17%).

The report says 95% of respondents agreed it was important for beneficiaries to review their Medicare coverage options every year, and 39% have been enrolled in their current plan for a year or less. However, only 10% new the dates of the open enrollment period for changing their plan or returning to traditional Medicare.

The nonprofit Commonwealth Fund also recently advocated for CMS to share more information about MA disenrollment to help guide other enrollees’ decisions.

In a Feb. 22 blog post, the Commonwealth Fund wrote that information about the rates of voluntary disenrollment from MA plans could help beneficiaries decide which to enroll in.

The rate of MA enrollees choosing to leave their plans increased 70% between 2017 and 2021, according to CMS data, from 10% to 17% on average. Beneficiaries have the option of switching to another MA plan or to traditional fee-for-service Medicare.

“Looking at disenrollment rates can shed light on the quality of MA plans,” the blog post said. “High voluntary rates of disenrollment likely mean poor patient experiences and suggest a plan may not be meeting beneficiaries’ needs. People also disenroll from plans when they learn that different coverage options may be a better fit for their needs.”

Reasons for disenrollment, the Commonwealth Fund wrote, may include requirements that make the plan harder to navigate, like prior authorization or coverage limits. People with chronic conditions or low incomes are more likely to leave MA plans, according to National Institutes of Health (NIH) research.

In a CMS disenrollment survey, patients reported that their reasons for leaving plans included coverage limits, cost issues like high premiums and out-of-pocket spending, or perception that another plan had superior benefits.

The Commonwealth Fund wrote that information on disenrollment rates and beneficiaries’ reasons for leaving their plan could help prospective enrollees decide whether to remain on their current plan, chose another, or revert to traditional Medicare. That information could be especially helpful for patients with particular needs for coordinated care, it said.

While information on disenrollment is available through Medicare’s plan finder tool, the blog post said, it is reported at the level of the insurer contract, which can include multiple plans. Information about an individual plan is less available to the public.

“More detailed performance data that include disenrollment rates and reasons for disenrollment -- overall and by selected beneficiary characteristics (e.g., dual eligibility status, chronic condition) -- would provide beneficiaries with more accurate data to assist in informed decision-making,” it said. -- Jessica Karins (