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How are Seniors Choosing and Changing Health Insurance Plans?

Many seniors on Medicare find the process of choosing a plan to be arduous and frustrating.  They think they did their homework the first time, and should not need to revisit the decision.  Unless they have a particularly bad experience with their plan – such as a substantial increase in costs, a loss of a valued benefit or provider, or a major change in their health condition that identified a mismatch between their needs and coverage – they are reluctant to compare or switch plans during the open enrollment period. The prevailing view is that it is not worth the hassle and the grass is not necessarily greener in another plan.  Even in extreme circumstances (such as their drug plan dropping coverage of their prescription drug), beneficiaries will go to great lengths to adapt to their plan (by switching drugs or getting samples from their doctor) rather than make a change.  When they feel they have no choice but to find another plan, seniors are eager to find shortcuts in making the selection with the least amount of stress and hassle, often preferring to get advice from a trusted advisor, such as an insurance agent or a plan representative, or suggestions from family, friends, and medical professionals.  Focus groups identified a high demand for clear, concise, and easily comparable information presented in a digestible format focusing on the factors most important to the individual, namely cost, provider networks, and coverage.  Few described the materials they have received as easy to use, and even fewer said they would turn to Medicare Compare during the next open enrollment season.

Seniors in our focus groups said they appreciate being able to choose among many plans, and do not want their number of choices to be limited; however, they would like to have additional help with selecting their plan.  Many beneficiaries seek to make well-informed and financially sound decisions but do not feel confident in their ability to do so under the current system.  Making it easier for beneficiaries to compare and switch plans, when it is in their interest to do so, would help achieve the goal of having consumers choose a plan that best meets their individual needs and preferences. In addition, if more beneficiaries switch to lower-cost plans, the result could be lower costs for themselves and for the Medicare program.

What do beneficiaries suggest to improve the system?

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.