Press ReleasesBLOG POST: Beneficiaries like MA the way it is – with emphasis on value

June 28, 2022

A survey of 2,848 Medicare Advantage enrollees conducted by web broker eHealth found high levels of satisfaction with MA plans, with 88% of respondents indicating they were very or somewhat satisfied with their coverage. 1 Nearly as many — 86% — said they would recommend an MA plan to a friend or family member.

The data underscores the importance of value for enrollees, with 73% saying they would be unable to pay more than $50 per month in premiums if they had to find health insurance somewhere else. And 74% of enrollees said they can’t manage annual out-of-pocket costs of more than $1,000. Nearly half of respondents (49%) said affordable premiums were a top reason for selecting MA, and the same percentage cited affordable medications as a top draw for MA plans.

The findings may have importance for regulatory action. CMS has proposed tighter oversight of network adequacy for new or expanding MA plans, but the eHealth survey suggests networks may be a selling point for some MA enrollees. 1, 2 More than half of respondents cited coverage of their preferred hospital, physician or pharmacy as a top reason for selecting MA. Meanwhile, just 13% think the MA program needs more government regulation.

In addition, denials for care were uncommon. Just 13% of people had a claim or prior authorization denied, and in many cases, the care involved services Medicare does not routinely cover, such as vision or dental care.

The high satisfaction with MA plans likely plays a role in the continued upward trend in MA enrollment, which reached 28 million beneficiaries this year, according to The Chartis Group. 3 MA plans accounted for 45% of total Medicare enrollment, a figure that is projected to continue to grow. As interest among enrollees grows, so will competition among plans, which seem to have set a high bar for satisfaction. The plans that balance member experience, access to care and affordability appear to be best positioned to thrive.

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References

  1. eHealth. Spotlight on Medicare Advantage: An eHealth Survey. June 2022.
  2. CMS. CY 2023 Medicare Advantage and Part D Proposed Rule (CMS-4192-P) Fact Sheet. Jan. 6, 2022. https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-advantage-and-part-d-proposed-rule-cms-4192-p
  3. The Chartis Group. Medicare Advantage Enrollment Continues to Surge in an Increasingly Complex and Competitive Landscape. February 25, 2022. https://www.chartis.com/insights/medicare-advantage-enrollment-continues-surge-increasingly-complex-and-competitive.
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