Medicare customers satisfied with coverage, but worry about out-of-pocket costs

The majority of retirees who receive health care through a Medicare plan are satisfied with the care they receive. Further, those who have an opinion on recent changes to Medicare coverage generally approve of those revisions. Yet nearly two-thirds say political leaders aren’t as responsive to the needs of beneficiaries as they should be.

That’s the word from an eHealth survey of Medicare plan members. The report – Medicare Pulse on Consumer Sentiments & Satisfaction – is based on a survey of beneficiaries currently enrolled in Medicare Advantage, Medicare Supplement, or Medicare Part D plans purchased through eHealth. The survey was conducted February 2023, with over 4,500 responses.

Related: CMS’ new Medicare Advantage audit rule, expected to recoup $4.7B in overpayments

“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,” eHealth said. “We see that costs are a big concern, but premiums often come second to other expenses. We also learn how disparities of income may shape the Medicare experience of many beneficiaries.”

The survey results suggest that plan sponsors and their agents could be providing guidance about making good Medicare plan choices to plan members nearing retirement. However, when asked who helped them choose their coverage, employers were not among those mentioned. The study asked where most beneficiaries receive their information about Medicare. Licensed agents (48%) and friends & family (40%) were the best sources for Medicare understanding.

The good news: Most are satisfied with Medicare coverage–a whopping 88% said they were happy with their health care choice. One-third of respondents said they are more satisfied with coverage now than a year ago, and another 53% said they were just as satisfied today as last year. Those with lower incomes or on fixed incomes tended to be more satisfied today than a year ago.

While this group was largely satisfied with their plans, they still feel unheard: 60% say political leaders aren’t really listening to the needs of Medicare enrollees.

eHealth found that beneficiaries are twice as likely to say Medicare is moving in the “right direction” vs “wrong direction.” When invited to consider changes to Medicare coverage in recent years, 39% say it is moving in the right direction, 19% say the wrong direction, 43% are unsure.

Knowledge gaps among beneficiaries emerged. As with the high percentage of those who weren’t sure about Medicare’s direction, a large share said they are unaware of the current Medicare Advantage open enrollment period. Very few Medicare Advantage enrollees (10%) know that, between January 1 and March 31, they can switch to a different Medicare Advantage plan or return to Original Medicare. Despite this, most agree or strongly agree (95%) that it’s important to review their coverage options at least once per year. This knowledge gap represents another educational opportunity for plan sponsors.

Concerns for the future differ by income: Lack of access to the prescription drugs they need is the top concern for the most affluent beneficiaries, while lower- income beneficiaries worry more about benefits being reduced or being able to pay for medical care.

More beneficiaries are worried about being able to afford their out-of-pocket costs (75%) than their monthly premiums (43%).

Related: Retirees will need hundreds of thousands of dollars for post-retirement Medicare costs, report finds

Many fear new costs with the end of the COVID emergency: 62% say they are worried about increased out-of-pocket costs for COVID-related care when the federal emergency declaration ends.

Asked about their chief concerns when beneficiaries think about the future, a Top 4 list included:

• Six in 10 say unaffordable care and reduced benefits are their No. 1 concern;
• 37% say they worry most about not being able to afford medical care in the future;
• 28% worry most about their Medicare benefits being reduced;
• 24% cite affordable monthly premiums; and
• 17% cite affordable copays and deductibles.

Asked how employers can assist plan members before they retire, Bob Rees, VP of Medicare Sales and Member Loyalty for eHealth, said:

“Employers should encourage their future retirees to be realistic about the financial resources they will have. So, for example, people who have the income to afford it may prefer to enroll in Medicare Supplement and Part D, to fill in the gaps in their Original Medicare coverage. Those with lower retirement income may do better with Medicare Advantage, where many plans come with no additional premium beyond what’s already taken from their Social Security check.

“Employers offering HSA-eligible plans should make sure that future retirees understand the potential value they offer. It’s not the right choice for everyone, but if it suits your coverage needs and finances, an HSA allows you to sock away thousands of dollars per year on a pre-tax or tax-deductible basis for a broad range of qualifying medical expenses.”