America's Benefit Specialist December 2022

MEDICARE MATTERS

Advantage enrollees. About one in five ben eficiaries (18%) relied on friends and family to help make coverage decisions. Relatively small shares of people used the Medicare.gov website and hotline and State Health Insurance Assistance Programs, or SHIPs. A somewhat larger share of beneficiaries with the lowest incomes used Medicare.gov (12% of those with incomes below 100% of FPL and 14% of those with incomes between 100% and 200% of FPL) compared to those with the highest incomes (three percent of those with incomes above 400% of FPL). Marketing: Complaints about misleading or false marketing made against Medicare plans and their contractors more than doubled year-over-year between 2020 and 2021.5 Overall, about six percent of survey respondents reported that marketing was a source of information in choosing a

plan. However, about 12% of black survey respondents reported that advertisements were helpful to them, compared to only five percent of white respondents. Likewise, 12% of beneficiaries in the lowest-income category (below 100% of FPL) said they had been informed by advertising and market ing efforts, compared to only two percent of those in the highest-income category (above 400% of FPL). POLICY IMPLICATIONS Medicare beneficiaries, regardless of their source of coverage, seem to most frequently rely on the one-on-one help provided by brokers and agents in choosing a Medicare plan. While government-funded SHIPs are designed to provide unbiased, one-on-one help, these programs remain underutilized. That’s perhaps because they rely heavily on volunteers, and because their staff lack

the capacity that brokers and agents have to reach beneficiaries, many of whom may not be aware of SHIPs. The relatively low percentage of respondents who used Medi care.gov or the Medicare hotline also raises questions about whether these resources are known to beneficiaries and are meeting their needs. A growing number of older Americans are choosing Medicare Advantage plans over traditional Medicare, and beneficiaries are reaching for different sources of informa tion and support to make their coverage decisions. It’s important to learn how these sources inform beneficiaries, whether they are equitably accessible, and what kinds of services and information are needed to fill any gaps. Regardless of where beneficiaries get information for making their coverage decisions, having accurate, easy-to-use tools would help them evaluate their options.

THE AVERAGE MEDICARE BENEFICIARY HAS A CHOICE OF 43 MEDICARE ADVANTAGE PLANS AND 24 PART D STAND ALONE PLANS FOR COVERAGE IN 2023.

In addition, the typical beneficiary has a choice of 24 Medicare Part D stand-alone prescription drug plans for 2023, a second KFF analysis finds, one more than in 2022. More than 28 million Medicare benefi ciaries—48% of all eligible beneficiaries— are enrolled in Medicare Advantage plans, which are mostly HMOs and PPOs offered by private insurers. Enrollment is project

For 2023, the typical beneficiary has a choice of 43 Medicare Advantage plans as an alternative to traditional Medicare, a new KFF analysis finds. That’s an increase of five plans on average from 2022, adding even more choices to the Medicare Advantage marketplace, which is poised to become the dominant way Medicare beneficiaries get their health coverage and care.

ed to cross the 50% threshold as soon as next year. For 2023, a typical beneficiary has 43 Medicare Advantage plans to choose from in their local market, including 35 plans that offer Part D drug coverage. In total, 3,998 Medicare Advantage plans will be available across the country.

28 ABS | benefitspecialistmagazine.com