CHICAGO, February 25, 2021 — While Medicare Advantage enrollment across the country is higher than it has ever been, a recent survey of Medicare beneficiaries by GoHealth (Nasdaq:GOCO) showed that general awareness of the plan and its options is not keeping pace. And though the Centers for Medicare and Medicaid Services (CMS) project a record-breaking 26.9 million Medicare Advantage enrollees in 2021, that only represents 42% of all beneficiaries. That could mean millions more Americans may miss out simply due to a lack of knowledge and awareness around the full menu of Medicare, from Medicare Supplement and Part D, to Medicare Advantage.
65% of Original Medicare beneficiaries do not know that Medicare Advantage plans provide Part A and Part B coverage.
Only 18% of Original Medicare beneficiaries are ‘very familiar’ with Medicare Advantage plans.
31% of Original Medicare beneficiaries are unsure if Medicare Advantage and Medigap are the same thing.
“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,” said Hain. “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?”
GoHealth commissioned 2,000 online interviews between Jan. 21 and Jan. 26, 2021. All respondents were U.S. citizens aged 65 and older, split evenly between Original Medicare enrollees (1,000 respondents) and Medicare Advantage enrollees (1,000).
Key Findings: Original Medicare Enrollees
A significant group impacted by this knowledge gap appears to be Original Medicare enrollees. These respondents demonstrate low awareness and utilization of options beyond Part A and Part B. Also, their answers reflect misconceptions about Medicare Advantage plans.
- 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.
- 30% of those with Original Medicare believe Medicare Advantage is more expensive, even though 78% of Part C enrollees cited at least one cost savings as a reason for their choice.
Even worse, this lack of Medicare knowledge could have lasting impacts on their futures:
- 86% incorrectly believe their Original Medicare plans have out-of-pocket maximums, which without a supplemental plan could leave them susceptible to high financial costs.
- 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.
Key Findings: 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
Why does this matter? This kind of plan “loyalty” may point to a lack of engagement in their policy. While they 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.”
For more insights, or to check out the full report, “How Confusing Is Medicare for Seniors?” visit https://www.gohealth.com/a-new-gohealth-study-reports-older-americans-are-familiar-with-original-medicare-but-lack-awareness-understanding-of-the-alternative-option/
About GoHealth, Inc.
As a leading health insurance marketplace and Medicare-focused digital health company, GoHealth’s mission is to improve access to healthcare in America. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science and deep industry expertise to match customers with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare and individual and family plans. For more information, visit https://www.gohealth.com/.