As Open Enrollment Approaches, Medicare Enrollees Lack Critical Knowledge to Make Sound Decisions

Independent survey reveals seniors face significant challenges selecting optimal Medicare plans

BALTIMORE, Sept. 7, 2022 /PRNewswire/ -- More than 60 million Americans are preparing for this year's Medicare Open Enrollment period (October 15 to December 7), and most have significant gaps in their knowledge of plan components, are overwhelmed by Medicare advertisements, and fail to consult with external resources before signing up. Most also stay in their current plan when re-enrolling without seeking other options that better meet their changing healthcare needs.

These findings are compiled in a report, Hidden Crisis: The Medicare Enrollment Maze, issued by national healthcare consultancy Sage Growth Partners. The report is based on a survey of 1,142 individuals ages 64 and older, which was commissioned by Healthpilot, an AI-driven, fully digital platform for Medicare education and insurance enrollment.

"As the open enrollment period rapidly approaches, it is more important than ever to acknowledge the challenges faced by seniors in choosing the best plan for their needs," said Dan D'Orazio, Sage Growth Partners CEO. "Our research shows that widespread consumer confusion hurts older Americans and the entire U.S. healthcare system. It's beyond time for changes to be made to better educate and support those enrolling in Medicare every year."

Poor plan selection impacts the health outcomes of Medicare users and increases overall healthcare spending. Sub-optimal options with large out-of-pocket expenses may cause enrollees to put off necessary care or prescriptions due to financial concerns. That, in turn, can translate to worse outcomes and more healthcare spending due to avoidable emergent visits, hospital admissions, readmissions, and long-term care.

The Kaiser Family Foundation forecasts that Medicare outlays will rise from $689 billion in 2021 to nearly $1.6 trillion in 2032, due to growth in the Medicare-eligible population and increases in healthcare costs. The U.S. Census Bureau projects more than 73 million Americans will enroll by 2030.

Among the key findings in Sage Growth Partners' report:                

• 80% of Medicare-eligible individuals failed to correctly describe all the components of Original Medicare; 69% failed to do so for Medicare Advantage.
• 63% are "overwhelmed" by Medicare advertising; only 31% of respondents "strongly agree" that they can make effective selection decisions.
• More than half (58%) stay in their current Medicare plan each year rather than reviewing it and considering other options.
• Only about one-third (30%) strongly agree that they can easily find the information needed to make effective plan decisions.
• Just 12% of respondents used a helpline during the last open enrollment period and of those, 13% had little or no trust in the advice they were given.
• 33% have a financial advisor, but only 2% use that advisor to help with plan selection. 

The survey of Medicare enrollment-eligible individuals took place in April 2022. More than 80% of participants had coverage through Medicare or Medicare Advantage. The respondents came from across the enrollment experience spectrum:

• 10% of respondents were first-time enrollees
• 32% had been enrolled for less than one year to three years
• 35% for 4-9 years
• 23% for 10 years or more.

The full report, Hidden Crisis: The Medicare Enrollment Maze, can be found here. 

About Sage Growth Partners
Sage Growth Partners is a healthcare advisory firm with deep expertise in market research, strategy, and communications. Founded in 2005, the company's extensive domain experience ensures that healthcare organizations thrive amid the complexities of a rapidly changing marketplace. Sage Growth Partners serves clients across the full healthcare spectrum, including GE Healthcare, ProgenyHealth, the National Minority Health Association, Philips Healthcare, U.S. Renal Care, Quest Diagnostics, Livongo, and Syft. For more information, visit sage-growth.com. 

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SOURCE Sage Growth Partners