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


As more people on Medicare are enrolled in Medicare Advantage, CMS, policymakers, researchers, and the public have become more focused on how the program is serving people on Medicare. Participants across the spectrum of coverage noted that they experienced aggressive marketing tactics, including unsolicited phone calls, and felt inundated by Medicare television advertising, often for Medicare Advantage plans, that they believed to be both misleading and unhelpful.

Participants with Medicare found the process of selecting their coverage to be overwhelming and difficult, and often relied on brokers to help them review and understand their coverage options. Few participants used Medicare’s official resources to assist in their decision-making. When choosing their coverage, participants said they valued a variety of factors, including premiums and other costs, access to preferred providers, availability of extra benefits, and coverage of prescription drugs.

Participants in the focus groups – whether in traditional Medicare or Medicare Advantage – emphasized that they are generally satisfied with their Medicare coverage. Participants in Medicare Advantage plans were pleased with their coverage due to the low or no premium costs, as well as the availability of extra benefits, such as dental, vision, hearing, and debit cards. Participants with traditional Medicare and a Medigap policy were happy with their coverage due to the low or no cost-sharing requirements, no network restrictions on seeing their preferred providers, and the ability to control their own health care.

However, some participants, particularly in Medicare Advantage plans, also noted that there are elements of their coverage that caused them frustration, including delays receiving care due to prior authorization and referral requirements as well as facing limitations in seeing their preferred doctors due to limited networks. In recent months, CMS and policymakers have sought to address some of these issues through both legislation and rulemaking, including rules that would streamline the prior authorization process and place additional limitations on Medicare marketing.

Most dual-eligible participants who have both Medicare and Medicaid said they are satisfied with their coverage, whether in Medicare Advantage or traditional Medicare, though some in Medicare Advantage encountered problems finding a provider in their plan’s network. Further, some participants with Medicaid were uniquely concerned about maintaining their Medicaid eligibility and were anxious about losing Medicaid during the annual redetermination process. With Medicaid redeterminations having restarted April 1, states may have begun disenrollments, which could lead to some losing their coverage, though it is unclear how much that would impact focus group participants who generally had not experienced a loss of coverage prior to the pandemic.

In making coverage decisions, participants say they were annoyed by marketing calls and the number of ads marketing Medicare plans on TV, and generally ignored them. Few participants said they intend to review or switch their coverage. While focus group participants were generally satisfied with their Medicare coverage, most were also confused and frustrated by the complexity of the program and lacked confidence in their own ability to compare and choose a source of coverage to best meet their individual needs.

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