Seniors Want More In Medicare Plans, But Not If They Have To Pay For It

As those 65 years and older try to decide whether to stick with traditional Medicare or venture into advantage plans, eHealth's recent survey of more than 6,000 Medicare and Medicare Advantage recipients reported the services they want and what insurance companies plan to provide.

First, some basics.

In 2021, more than 26 million Americans were enrolled in Medicare Advantage plans.

That accounted for 42% of the total Medicare population, according to the Kaiser Family Foundation.

The average Medicare beneficiary in 2021 had access to 33 Medicare Advantage plans where they lived, according to the nonprofit health organization that analyzes health care trends. That is the largest number of plans available in the past decade.

What is a Medicare Advantage plan, also known as Medicare Part C?

Medicare Advantage is a type of private health insurance plan that provides Medicare type benefits through a private-sector health insurer.

The plans are often different, which allows the beneficiary to select a plan that best suits their needs. Advantage plans also often offer drug plans. With traditional Medicare, prescription plans are called Medicare Part D drug plans.

Seniors can either choose traditional Medicare or an advantage plan for their health care needs.

eHealth Inc, a private online health insurance marketplace, outlined in a recent survey what seniors wanted in their health insurance.

Of surveyed respondents, 83% wanted the federal government to take action to lower prescription drug costs.

92% of Medicare beneficiaries want dental, vision and hearing benefits added to traditional Medicare coverage. That dropped to 50% if it meant it would increase the beneficiaries' costs.

Among Medicare beneficiaries, 56% of Republicans, 56% of Independents, and 51% of Democrats said Medicare should continue to be operated through public/private options. Of beneficiaries, 16% want the government alone to run the health insurance program.

When it came to private health insurance providers:

55% of insurers surveyed said they are paying out more for member medical care due to COVID.

12% of insurers plan to raise premiums as a result of the pandemic.

38% of insurers are concerned about staffing shortages in their provider networks due to the pandemic or vaccine mandates.

When it came to expanding Medicare, 27% of the general population favor expanding the program to all Americans, 17% favor lowering the eligibility to 60 years old, and 15% say to lower eligibility to 50 years old.

When it came to vaccinations, 55% of general population respondents said they would receive annual or twice-annual COVID booster shots if it were recommended. That rose to 62% when Medicare beneficiaries were surveyed.

Steven Ruiz, Humana's Central and North Florida Medicare president, said seniors should consider some basic factors in deciding on a plan or traditional Medicare.

Ruiz cited a Humana poll that reported that 67% of seniors said having access to all of their healthcare providers will be key in choosing a plan. The poll also reported that 64% stated that low, out-of-pocket costs will be a factor in choosing their plan.

"While I recognize that everyone's health needs are unique, other key considerations may be if the plan includes vision, hearing and dental coverage, if telehealth services will be covered, if transportation to medical appointments are included, or even if a gym membership is offered as a benefit," Ruiz wrote the Chronicle.

Ruiz said there are options to help in deciding the plan that's best for you.

"For example, the Medicare Plan Finder on Medicare.gov can help you compare plans, benefits and get an estimated cost for each plan based on an average member," he said. "If you are interested in Medicare Part D, which helps cover the cost of prescription medications, you can also enter the names of your prescription medications to ensure those medications are covered by the plan you are considering."

Licensed sales agents are also available for one-on-one meetings, Ruiz said.

"I encourage these meetings so individuals can get answers to questions and better understand plan options that can help meet your needs," he said, "both financially and medically. These conversations will help ensure you have the right Medicare plan for you in place come Jan. 1 of next year."

For more information, Medicare eligible individuals can visit www.Medicare.gov or call 800-MEDICARE (800-633-4227).