Each fall, seniors gather at a boot camp in Birmingham, Ala., for people entering Medicare to help them better understand the program and what they should consider when it comes time to choose a plan. The University of Alabama at Birmingham Health System's Viva Health, an HMO, hosts the event.
Its outreach efforts have grown as patients have asked more and more questions about an increasingly complicated program.
“They will come in to see their doctor and they’ll have pages printed out and they’ll say, ‘You know, I’ve got to make a decision’ … it really puts providers in a hard place,” said Thalia Baker, associate vice president of primary care at UAB Medicine in Birmingham, Ala.
Providers often find themselves trying to describe Medicare’s alphabet soup—Parts A, B, C and D—to their patients during an office visit instead of delivering care. Not only can that be frustrating for doctors and their patients, but it’s an effort that can seem futile at times because many patients just don’t understand how Medicare works. That can strain the relationship between providers and their patients. “Ninety percent of them don’t have a clue,” Baker said. “Most of our patients that are (dual-eligible), they’re not even quite sure what the differences are between Medicaid and Medicare.”
And more than half of seniors don’t understand the differences between Medigap and Medicare Advantage plans, according to an online poll conducted for the Better Medicare Alliance, an insurer-funded Medicare Advantage advocacy group, by Morning Consult.
That trend is reflected in the annual deluge of news articles explaining Medicare plan choices as the program’s open enrollment period approaches. And the effects of consumer befuddlement about Medicare coverage are mounting because the U.S. population is aging, thanks to the baby-boomer generation.
“Older adults and people with disabilities find the options and Medicare Advantage programs, in general, confusing,” said Fred Riccardi, president of the Medicare Rights Center, a consumer advocacy organization.
The CMS did not respond to requests for comment.
MA plans often cover prescription drugs and may cover vision, dental or hearing services for a higher premium. The plans increasingly offer additional health-related benefits such as meal delivery or carpet cleaning thanks to new flexibilities afforded by Congress and the Trump administration. They’re designed to help plans address seniors’ social determinants of health.
Policymakers had expected that more Medicare beneficiaries would opt for MA plans as baby boomers age into retirement because, unlike earlier generations, many of them have experience with managed care through their employer-based coverage. But only about a third of them choose an Advantage plan during their first enrollment period. Less than half of beneficiaries even knew about Medicare Advantage when they initially enrolled in Medicare, according to a survey by the Better Medicare Alliance.