More on Medicare Choice Confusion: Help Your Senior Friends, Relatives Get Some Help

September 12, 2011 in Health Insurance, Medicare, News

Back on August 18 I wrote about the study by Harvard professor Dr. Michael McWilliams and others concerning the complexity of choosing among Medicare Part C options.  Medicare Part C was once known as Medicare +Choice and is now known as Medicare Advantage. Over the Labor Day holiday I had a chance to read the entire report and Dr. McWilliams answered some follow-up questions.  

My takeaway from the research: Get some independent help to understand your Medicare Advantage options.  Even if you are not Medicare age yourself, if you know or are related to someone that is turning 65 or anyone that is already on Medicare, help them to get some help.  Senior centers can help you get that independent help.

The Harvard study finds that Part C complexity is especially a problem for a person with cognitive issues (which some would argue — only half jokingly — includes all of us over 65). Dr. McWilliams says: 

“…the most important finding of our study was that seniors with poorer cognition were less responsive to increases in benefit generosity in Medicare Advantage (MA) than seniors with higher cognitive functioning, who were more likely to switch into MA during the study period when benefits improved. (emphasis added by Byron)”

The report only covered the complexity of one type of Medicare. But Dr. McWilliams explained to me in an email that he thinks it is the most confusing type because — unlike with “Original Medicare” (formally called Parts A and B) and so-called Medigap plans — MA-plan benefits can vary from insurer to insurer. He is referring to the fact that some MA plans have high co-pays and deductibles (but never worse than Original Medicare); some have co-pays but not deductibles. Some cover prescriptions; some don’t. Some cover vision; some don’t. Some pay health club dues…  Etc.

The research found that the more MA plan choices there are in your county (particularly if more than 15), the less likely a person with poorer cognition is to choose the best plan for that person’s particular situation.

And as explained elsewhere on Healthcare Savvy (see Medicare is not simple) even a good decision one year is not the best plan for the next year because the details change every year. That’s why I put the emphasis on “when benefits improved” in Dr. McWilliams quote.  Or — of course — they could get worse.

That’s why seniors need to check their coverage every year. Do a senior you know a favor and at least remind them.

Leave a reply

You must be logged in to post a comment.