Survey results indicate a need for people to become better informed about their coverage, which is both a challenge and an opportunity for insurers.
Mallory Hackett, Associate Editor SEP 11
More than two-thirds of Medicare beneficiaries find their
insurance confusing and difficult to understand, according to a recent survey
by MedicareAdvantage.com,
which also revealed that many don't grasp basic insurance terminology.
The study sample included 1,000 respondents enrolled in Medicare
and took place from August 17 to 19. Participants were quizzed about topics
ranging from Medicare enrollment and benefits to insurance terms and
definitions.
Less than half of the respondents could correctly define
deductible or coinsurance. Just over half (52%) could describe what a premium
is.
When it came to cost-related questions, the respondents didn't
fare much better. More than 85% thought that Medicare Part A deductibles were
annual, when in reality they operate on a cycle of "benefit
periods."
About 70% of respondents falsely said that the Centers for
Medicare and Medicaid Services will send a notice when it's time to enroll and
that Medicare Part A and Part B have yearly out-of-pocket spending
limits.
On a brighter note, over half (54%) knew that they can enroll
late in Part B, but a late-enrollment penalty may be applied for every month in
the plan. And more than three quarters knew that they must pay the Part B
premium every month, even if they don't end up using it.
COVID-19 highlighted how little beneficiaries know about their
Medicare plans. Only 14% knew that Medicare would cover six COVID-19-related
services, including lab tests, a vaccine, medically necessary hospitalizations,
telehealth for mental health counseling and preventative health screenings, and
virtual visits with physical therapists.
Despite their overall lack of knowledge of Medicare, respondents
were confident in their coverage decisions. Over three quarters said they are
enrolled in the best Medicare coverage options for their healthcare needs and
budget, and more than 80% said their Medicare benefits are worth the time and
effort needed to enroll in and use the coverage.
WHAT'S THE IMPACT?
The overall misunderstanding of Medicare insurance could lead to
unnecessarily high out-of-pocket costs, poor healthcare choices and diminished
overall health among beneficiaries, according to the study's author, Christian
Worstell.
The results also indicate a need for people to become better
informed about their coverage, which is both a challenge and an opportunity for
insurers.
"In the Medicare space, the fact that many customers are
unaware of the out-of-pocket costs and coverage gaps associated with Medicare
means that insurance carriers have every incentive to educate beneficiaries of
those costs and gaps, especially if the private Medicare plans they offer can
help fill some of those needs," Worstell told Healthcare Finance
News.
Further, when members are uneducated about their plans, it might
lead to high unexpected medical bills or necessary services that aren't
covered.
"This can lead to dissatisfaction with their insurance
plan, which carriers surely want to avoid," Worstell said. "If insurers
can clearly explain to beneficiaries the ways their coverage works and saves
them money, they may have a better chance of retaining them as customers."
THE LARGER TREND
Research from as early as the 1980s has revealed a
knowledge gap in Medicare beneficiaries' knowledge about their health
insurance.
CMS has created initiatives to help people gain an understanding
over the years, including the "Medicare & You" handbook and
the Medicare website.
Still, this most recent survey indicates that the knowledge gap
continues to persist, which could present an obstacle for the upcoming Medicare
Annual Enrollment Period in October.
ON THE RECORD
"And when you consider that over 62.6 million Americans are
enrolled in Medicare, there could be as many as 43 million seniors – including
your parents, your grandparents, or even yourself – who fail to receive
the best care for their needs simply by not fully understanding their own
coverage," Worstell said in the study.
Twitter: @HackettMallory Email
the writer: mhackett@himss.org
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