The Kaiser Family Foundation recently released new findings about what coverage new Medicare enrollees choose. This information is important for understanding what beneficiaries want from their coverage and how best to serve people with Medicare where they are.
When people first become eligible for Medicare, either upon turning 65 or because they have a disability that makes them eligible, they have a decision to make. Will they stay in the default program, referred to as original or traditional Medicare, or will they choose a Medicare Advantage (MA) plan? There is no one right choice. The best choice for an individual depends on their personal circumstances and their preferences. If they have a trusted provider, for example, they may not want to join an MA plan that might require them to change doctors. Or they may be drawn to MA’s out-of-pocket maximum because they expect their health care costs to be high.
According to the report, around 22% of new enrollees chose Medicare Advantage in 2011. This number increased to around 29% in 2016, the most recent year of the report. These numbers are nationwide, but the rate of enrollment varies considerably depending on the enrollee’s geographic location, their age, and whether they are eligible for Medicaid in addition to Medicare.
Importantly, when people with high needs enter the Medicare program, they are less likely to choose MA. This could mean that these new enrollees want to avoid potential issues with narrow provider networks and are not drawn to MA benefits like gym memberships that may be tailored to enrollees who are in excellent health.
The reasons newcomers choose to remain in traditional Medicare or switch to MA are important. But whatever the reason, it is clear that the majority of people with Medicare are in the original program. At Medicare Rights, we urge Congress and the Trump administration to protect and strengthen original Medicare to ensure this majority has access to high quality, affordable health coverage for decades to come.