Opinion

Open enrollment season for Medicare can be confusing but worth the effort

New and returning enrollees should consider benefits of Medicare Advantage

New and returning Medicare enrollees should take the time to learn about the choice between Traditional Medicare and Medicare Advantage and make the right one for themselves, Schwartz writes. (Spencer Platt/Getty Images file photo)

OPINION — It’s that time of year again when the annual Medicare open enrollment period has begun. More than 60 million Americans will make important, personal decisions about their health coverage for the year ahead.

While this is serious business for countless beneficiaries, open enrollment’s recurrence is hardly noticed by most Americans and easy to take as routine. It is hardly that. The decisions made now can have a meaningful impact on Medicare beneficiaries’ health, financial security and well-being. In addition, there are some significant, positive changes happening in Medicare that all beneficiaries should know about and consider when making the choice of how to receive their benefits.

Traditional Medicare vs. Medicare Advantage

This starts with deciding between Traditional Medicare and Medicare Advantage. Seniors are widely familiar with Traditional Medicare. It pays most of the hospital bills and most of the doctor visits as well. Enrollees typically pay out-of-pocket expenses of about 20 percent of the bills, unless the enrollee purchases a supplemental policy than that will cover some or all of these costs.

What too many beneficiaries don’t know enough about is the alternative: Medicare Advantage, or MA. These plans cover all Medicare hospital and medical benefits like Traditional Medicare, but enrollees can choose a plan that works for them, based on the network of doctors, the cost and the benefits. Plans usually include prescription drug coverage, as well as extra benefits not covered by Traditional Medicare. There is no need to buy a supplemental policy. Importantly, there is also an annual cap on out-of-pocket costs. These differences can mean a lower cost burden for seniors, so many of whom live on fixed-incomes.

At Better Medicare Alliance, we encourage new and returning enrollees to take the time to learn about this choice and make the right one for themselves. We have also worked to encourage the federal agencies that provide the information and run the enrollment process to make this information easier to understand and make the enrollment process simpler. New supplemental benefits for 2020

Seniors should know about recent changes in the kind of extra benefits that plans can provide and what it means for them.

For many years, MA plans have been providing extra services like dental, fitness, vision and hearing benefits, which are not covered by Traditional Medicare. A recent report from the Kaiser Family Foundation found that in 2020, 97 percent of MA beneficiaries will have access to a plan with these services.

Recent guidance from the administration, however, has afforded MA plans more flexibility to offer benefits that meet the needs of the whole person in addition to clinical needs. As a result, most plans are covering nonmedical supplemental benefits: from meal benefits (96 percent) to transportation to and from doctors’ appointments (92 percent) to in-home support (54 percent), with particular attention for those with chronic conditions and social needs.

For seniors who are immobile, far from loved ones or facing serious chronic conditions, these benefits are not a luxury but rather a lifeline — one not available outside of an MA plan.

MA enrollment continues to grow

More and more seniors are choosing MA, with over 24 million people expected to be enrolled in 2020. That’s 40 percent of all eligible beneficiaries. They tell us it is for the quality, affordability, simplicity, care coordination and extra benefits. And they are satisfied with their care.

In a soon-to-be-released poll conducted by Morning Consult, we found that a whopping 94 percent of the 2,000 seniors surveyed were satisfied with their MA. It doesn’t hurt that premiums for these plans average $23 a month, and half of all enrollees choose a plan that has no premium at all.

Still, choosing the plan that best suits one’s needs can be a challenge — especially considering the wide array of options available. The average Medicare consumer will have 28 plans to choose from next year.

The administration is working to help consumers make informed choices with more upfront information on Medicare Advantage, yet it remains underrepresented among many official Medicare enrollment resources. Of the 101 published materials featured on Medicare.gov’s free online publications catalog, only three titles reference MA. The only one exclusively on Medicare Advantage, “Understanding Medicare Advantage Plans,” was just released by the administration a few weeks ago, showing movement in the right direction.

We will continue to push Congress and the administration to further improve the consumer shopping and enrollment experience. After all, every Medicare beneficiary deserves to be an active participant in their health coverage by making informed choices based on full and unbiased information.

The bottom line: This open enrollment season offers more options and more benefits to enrollees — and that’s good news. Seniors have a keen understanding of the importance of this time of year, and we at the Better Medicare Alliance will keep working to ensure that policymakers do too.

Allyson Y. Schwartz is the president and CEO of the Better Medicare Alliance. She represented Pennsylvania in the House as a Democrat from 2005 to 2015.

Medicare open enrollment is currently underway and ends Dec. 7.

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