Medicare choices spark revolving door for older adults

At the moment, tens of millions of older adults and people with severe disabilities have to make a choice throughout the country: whether they stick to their current medicare option, or change during open registration.

On average, the research shows, 3% of people with traditional Medicare switch to an MA plan each year. But when the researchers looked closely at these “switchers,” they found that switching to MA was more than twice as common – 6.5% – among those who had switched from MA to traditional Medicare just one to three years earlier.

Medicare Advantage plans now cover more than half of all Americans with Medicare, so truly understanding these types of patterns is important from a policy perspective. What we discovered here is that it’s not an open-and-shut case that everyone who leaves Medicare Advantage is permanently dissatisfied and will never return. But what we need to understand more is what controls this revolving door. “

One factor that they could not look at directly, but tried to investigate, was whether people returned to Medicare Advantage after they were in the traditional medicine, because they could not get a medigap plan because of their health status to give part of their own cover costs. They can occur in traditional Medicare.

He notes that the multiple switching behavior from the new study can be an indication that people behave as smart consumers at the Medicare Advantage-Marktplaats. That’s because those who returned to Medicare Advantage after being in traditional Medicare for a year or more were much more likely to choose an MA plan with a higher star rating for quality, or a plan with a broader network.

“They can shop in a logical way,” he said. Or it may be that MA plans could target them for marketing material based on the information that the plans had collected from their earlier registrations.

Whatever happens, he said, the costs of the administrative tasks required to transition someone from one form of Medicare coverage to another will add up — both in staff time on the federal government’s side and the insurance companies, and for the time spent by participants and their healthcare providers. .

For individuals and their care providers, Hoffman advises to be very careful during this open registration season to look at the total costs and access to care providers and hospitals, and not only to the monthly premiums, with the decision to stay in Medicare Advantage, to switch or get out.

This is important, but potentially overwhelming, given the large number of choices available to many beneficiaries. Although the Medicare PlanFinder contains cost information, individuals should go to the websites of plans, providers and hospitals to determine which are in network.

It is also important to understand the policy of a state with regard to a medigap-coverage guarantee if you decide whether you want to switch to traditional Medicare after a period in Medicare Advantage. Only a handful of states have protections to guarantee the purchase of those plans.

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Both Hoffman and Maust, and co-authors Hyungjin (Myra) Kim, Sc.D., MA and Lillian Min, MD, MSHS, are members of the UM Institute for Healthcare Policy and Innovation. Other co-authors are Zhaohui Fan, MD, MPH and Yang Amy Jiao MPP

The study was funded by the NIA, which is part of the National Institutes of Health, through grant R01AG074944. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging.