Seniors regularly find Medicare confusing. And no wonder. It is confusing, from the enrollment process to all the different plans.
In this article, we’ll examine the reasons why Medicare is so confusing. We’ll also discuss some of the plans to simplify Medicare and the reason why we believe more seniors aren’t enrolling online. Finally, for those who are already Medicare beneficiaries, we’ll close with a reminder that we’re always here to help explain your Medicare plan.
Without further ado, let’s jump in.
The Enrollment Process Is Outdated and Complicated
According to a recent survey of Medicare beneficiaries conducted by Hella Health, enrollment and plan selection are the most difficult parts of the process. Forty percent of respondents agreed that plan selection and enrollment are unnecessarily complicated and challenging. That’s more than the combined number of respondents who felt penalties or timelines were difficult to understand (19.7% and 16.4%, respectively).
Since Medicare enrollment doesn’t “roll over” to the following year, seniors must stay on their toes and be prepared to re-enroll when open enrollment starts. However, some don’t understand when to do that, and if they don’t do it within the correct time frame, that could have a negative impact on their finances or their coverage (and, following that, their overall health).
Here are some of the risks of neglecting to enroll during the enrollment period:
- High out-of-pocket healthcare costs
- Late enrollment penalties (which could take the rest of their lives to pay off)
- Gaps in healthcare coverage or access
Confusion About Choosing the Right Plan
Selecting the right plan is an even bigger struggle for many seniors. Because the features of the plans are so confusing, you may choose a plan that doesn’t suit your needs. This could mean paying greater out-of-pocket costs for treatment and medication, or simply not getting the care you deserve because the plan you chose doesn’t cover it.
The sheer number of available Medicare plans—from dozens, to hundreds, to thousands depending on the details—is staggering. For instance, as of 2022, the total number of Medicare Advantage plans was 3,834. The average Medicare beneficiary has access to 39 different Medicare Advantage plans, which is enough to give anyone a bad case of decision fatigue. No matter who you are—especially if you’re already sick or unwell—the thought of examining several dozen separate plans in an effort to choose the best one is beyond difficult, especially if there’s a timeline to meet.
In short, the difficulty choosing a Medicare plan is a major reason why over 70% of Medicare beneficiaries say that the enrollment process could be improved or simplified. If they can put a man on the moon, surely there’s got to be an easier way to get the right Medicare plan!
Enrollees Don’t Understand Their Plans
Even after a plan has been selected, many seniors struggle to understand the features of their plans. If this is you, you’re not alone. The survey showed that 72% of seniors didn’t fully or clearly understand their Medicare plan features.
The problem is obvious: if you don’t understand your plan’s features, how will you be able to benefit from it? How will you know if a less costly plan will serve you just as well, or whether you should choose a better plan that will save you money (and bolster your health) in the long run?
Although many of the respondents (56.2%) said they understood most of their plan’s features, a combined 16.5% said they don’t understand most of or any of their plan’s features. The startling fact that nearly 17% of seniors don’t understand most of their plans shows that there is much work to be done to help take the mystery out of Medicare.
Plans to Simplify Medicare Are in the Works
If you resonate with the respondents who don’t understand Medicare, we may have encouraging news: the Biden-Harris administration recently proposed a new rule to improve Medicare enrollment. The goal is to “make high-quality healthcare more accessible and affordable for all Americans,” said HHS Secretary Xavier Becerra.
If this rule is finalized, it will standardize eligibility and enrollment policies in the following ways:
- Limiting renewal to once every 12 months
- Giving applicants 30 days to respond to information requests
- Requiring pre-populated renewal forms
- Establishing consistent, clear renewal processes throughout the U.S.
- Standardizing record-keeping procedures across states
- Simplifying enrollment in Medicare Savings Programs
- Automatic enrollment in Medicare Savings Programs for certain SSI individuals
Although these changes could be helpful, Rafal Walkiewicz (founder of Hella Health, the company which conducted the survey) feels it may not be enough. “Everybody focuses on the initial transaction,” he argued. “And that’s usually the end of the relationship, which is actually the opposite of what should happen. There should always be ways to help people along the way, not just at point zero.” He feels that digital solutions are the answer to this problem.
Why Don’t More Seniors Enroll Online?
One of the questions asked during the survey was, “How comfortable are you with selecting Medicare using the internet?” While 63.5% of respondents said they were comfortable using the internet to select a plan, 62% of Medicare beneficiaries who enrolled used non-online means. This begs the question, “If so many seniors are comfortable using the internet, why don’t they enroll online?”
We believe it’s because, regardless of the level of tech savvy that seniors attain, they’re still looking for that expert, personal touch to help them make sense of Medicare. Essentially half of the polled seniors—45.7%—chose to enroll in Medicare over the phone or face to face with a broker.
However, that doesn’t solve the problem cited by Walkiewicz, which is that seniors are helped through the enrollment process and then left alone throughout the life of their enrollment plans. Why is this? Unfortunately, some seniors choose to enroll with the wrong people—people who aren’t willing to walk them through the features of their plans or aren’t available to help after enrollment.
Fortunately, we have the answer.
Let Us Take the Mystery Out of Medicare for You
At Susan Polk Insurance, finding the right insurance for you isn’t a one-and-done process. We are happy to talk with you about the benefits and drawbacks of each plan type, taking into consideration your unique needs and health concerns. We study every aspect of healthcare so you don’t have to struggle through trying to figure it out on your own—and we provide as much assistance as you need every step of the way.
If you have questions about your Medicare plan, contact us and let us give you the answers you’re looking for. As Medicare experts, we specialize in taking the mystery out of Medicare and making the process simple. We’re always available and we’re delighted to help.