8 months ago

The annual blitz of ads for Medicare Advantage plans has become a rite of fall, as health insurers, brokers and other third parties seek to court enrollees for these private plans, which are offered to the 65 million people with Medicare during the program’s open enrollment season.

In advance of the open enrollment period starting on October 15, KFF reviewed more than 1,200 unique television ads that aired more than 643,000 times last year to examine these marketing strategies in depth.

Based on its research, KFF found a heavy reliance on celebrity endorsers, liberal use of what appear to be official hotlines and images of government-issued Medicare cards, and suggestions that seniors who do not sign up for a plan could miss out on benefits to which they are entitled.

More than 85 percent of airings, or 9,500 ads per day, were for Medicare Advantage, the private plans that now enroll more than half of all eligible people with Medicare. Most of the remaining ads were for Medicare drug plans or Medicare supplemental insurance (Medigap).

Ads rarely mentioned traditional Medicare, or potential limitations with plan coverage, such as provider networks or prior authorization requirements, leaving beneficiaries with an incomplete view of their coverage options and the tradeoffs among them. Open enrollment runs annually from Oct. 15 to Dec. 7, with advertising permitted to begin on Oct. 1.

“There’s no question that Medicare has become a lot more complex. As enrollment in Medicare Advantage plans has grown, the annual marketing madness can create confusion for people who are trying to make difficult decisions about coverage,” said KFF President and CEO Drew Altman. “We heard directly from seniors in focus groups that the ads were often perceived as misleading and left them feeling overwhelmed. This isn’t a good basis on which to make a choice that will affect your health and pocketbook.”

Key insights from the research include:

• More than a quarter of all airings of Medicare Advantage ads (27%), included an official Medicare card or an image that resembled it. Additionally, more than 80% of airings sponsored by brokers and other third parties urged viewers to call a toll-free number described as “Medicare” hotline. But the number was not the official 1-800-Medicare hotline, and the entities behind such messages did not represent the government. New CMS rules in effect for the upcoming open enrollment period prohibit misleading use of the Medicare name, logo, or card in private marketing and communication materials, or any use of the Medicare card without prior approval from CMS.
• Some ads suggest that seniors may miss out on financial savings, or benefits to which they are entitled, if they don’t sign up for a Medicare Advantage plan. While Medicare Advantage plans do typically offer extra benefits, that can leave viewers with the impression that they have incomplete coverage if they have traditional Medicare, and that they have an entitlement to extra benefits under Medicare Advantage.
• Nearly all Medicare Advantage ad airings emphasized extra benefits, such as dental, vision, and hearing (92%) or the potential for lower out-of-pocket spending (85%). Less than 4 percent of airings referenced quality star ratings, even though CMS created the ratings in part to help shoppers compare Medicare Advantage plans.
• One-in-four Medicare Advantage ad airings (26%) showed physically robust seniors engaging in activities such as hiking, yoga, tennis, and even bouncing on a trampoline. This may suggest that they are targeting relatively healthy, lower cost enrollees. Few ads showed people with visible disabilities (4%) or the appearance of serious illness (1%), though one-fifth of Medicare beneficiaries are in fair or poor self-reported health.
• Celebrity endorsers, including actor William Shatner, comedian J.J. Walker and former Arkansas governor Mike Huckabee, appear more often in Medicare Advantage ads sponsored by brokers and other third-party entities than in ads sponsored by insurers. The celebrity endorsers are almost always men. Ex-NFL star Joe Namath was the most prolific, appearing in ads that aired nearly 56,000 times over the period, or about 10 percent of all airings of Medicare Advantage ads that season. More than two-thirds of ad airings sponsored by brokers and other third parties mentioned getting money back in your Social Security check, even though just 17% of Medicare Advantage plans offered in 2023 include this benefit.

As part of this research, KFF also released a second report that was based on focus groups conducted in fall 2022, which confirms that many Medicare beneficiaries and their family members feel overwhelmed by the annual onslaught of TV ads and are sometimes confused about whether the government or private companies are behind them.

In the focus groups with beneficiaries and other Medicare plan shoppers, many participants thought TV advertisements were misleading and said they did not trust the content of the ads, particularly those that marketed a slew of “free” benefits. Many participants said they relied on agents and brokers when making coverage decisions. Few used government resources, such as the Medicare Handbook or 1-800 Medicare, but those who did generally found them helpful.

The two KFF reports come at a time when lawmakers in Congress, state insurance regulators and officials in the Biden administration are taking steps to address rising consumer complaints about deceptive marketing practices in Medicare ads. Such complaints, which numbered fewer than 16,000 in 2020, increased to nearly 40,000 in the first eleven months of 2021, according to the Centers for Medicare and Medicaid Services (CMS). The rise has coincided with an increase in advertising by third-party marketing organizations such as agents, brokers, lead generation businesses and media firms in recent years.

Finally, a third new KFF resource answers key questions about the Medicare open enrollment period. It addresses topics such as what sorts of changes beneficiaries can make during open enrollment; how features of traditional Medicare compare to Medicare Advantage; how supplemental coverage like Medigap plans or retiree health benefits factor into Medicare coverage decisions.

The Medicare ad study by KFF analyzed TV ad data that was compiled by the Wesleyan Media Project, which collaborated with KFF on the research. Ads were obtained from Vivvix (formerly Kantar) CMAG, a data analytics and consulting firm, and were coded by the Wesleyan Media Project and analyzed by KFF.

KFF also worked with PerryUndem to conduct focus groups with Medicare beneficiaries and other Medicare plan shoppers in the Fall of 2022, during the annual Medicare open enrollment period.

The full reports are available collectively here or individually at:

“How Health Insurers and Brokers Are Marketing Medicare: An Analysis of Medicare Advantage, Medigap and Prescription Drug TV Ads For the 2023 Open Enrollment Period”

“What Do People with Medicare Think About the Role of Marketing, Shopping for Medicare Options, and Their Coverage?”

“What to Know about the Medicare Open Enrollment Period and Medicare Coverage Options”