Medicare study reveals confusing, complicated enrollment process

An independent survey of more than 1,000 Medicare beneficiaries reveals an enrollment process that is unjustifiably overcomplicated, outdated and, once enrolled, beneficiaries do not fully understand their plans.

This may not be a surprise to anyone who has interacted with the Byzantine Medicare maze, but with enrollment approaching 20% of the U.S. population and more than 10,000 boomers retiring every day, the survey portrays a system that invites fraud, errors, and high-pressure sales tactics from some of those selling Medicare services to unsuspecting, and trusting, seniors.

Mindset 'needs to change'

“There’s a mindset that needs to change,” said Rafal Walkiewicz, CEO of online Medicare platform Hella Health, which conducted the survey. “The whole perception in the marketplace, is that it’s very complicated and there's no way you can understand it. That’s wrong. It's not rocket science, particularly if you if you have the right tools at your disposal.”

Hella’s survey found that more than 70% of respondents believe the Medicare enrollment process should be improved, and that 72% did not fully or clearly understand their current Medicare plan features.

“It just invites a lot of broad overselling and hard sales tactics,” said Walkiewicz. “And then there is this humongous machine of regulation that's driven by this wrong premise that it’s over complicated.”

Hella’s survey, perhaps surprisingly, found that three-quarters of the respondents said they were comfortable using the Internet to select their Medicare plans. This flies in the face of the stereotype that seniors aren’t savvy with the online enrollment processes.

Seniors growing comfortable online

“If you are 40 or 50 now, you’ve grown up with computers and the digital world,” said Walkiewicz. “It has become natural. And even among the senior population, more and more are accustomed to the digital environment which was of course exacerbated by the isolation during COVID-19.”

Among the survey’s other findings:

• 40% said they found plan selection and enrollment the most difficult to understand aspect of Medicare overall.
• 62% said they enrolled in Medicare plans using methods that weren’t online despite more than 76% saying they were comfortable using the Internet to select plans.
• Only 38% said they intend to change their Medicare plans during the next annual election period.

“The millions of Americans enrolled in Medicare need to be better protected and better informed,” the survey concluded. “Plan selection can directly impact health outcomes, and thousands of Americans may be selecting plans that come with unnecessary out-of- pocket costs. It’s also worthwhile to note that almost half of the survey’s respondents had household incomes below the U.S. median household income.”

The survey noted that Medicare will soon cover 20% of the U.S. population, more than 66 million people, and the issues that continuously occur in the process today will only become exacerbated.

Overhaul planned

The Biden administration has announced plans to improve access to health care by overhauling Medicaid enrollment and reducing red tape and simplifying the enrollment process overall.

New rules proposed by the Centers for Medicare & Medicaid Services, if finalized, would standardize eligibility and enrollment policies, such as limiting renewals to once every 12 months, allowing applicants 30 days to respond to information requests, requiring pre-populated renewal forms, and establishing clear, consistent, renewal processes across states.

Hella Health’s Walkiewicz says that may not be enough.

“Everybody focuses on the on the initial transaction,” he said. “And that's usually the end of the relationship, which is actually the opposite of what should happen. There should be ways to help people all along the way, not just at point zero.”

Doug Bailey is a journalist and freelance writer who lives outside of Boston. He can be reached at [email protected].

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Doug Bailey is a journalist and freelance writer who lives outside of Boston. He can be reached at [email protected].