Despite 13% of claims being denied, most Medicare Advantage members satisfied with coverage, survey finds

An overwhelming majority of Medicare Advantage members are satisfied with their health coverage, but 13 percent say they have had a claim or prior authorization request denied, according to an eHealth survey published June 13.

The voluntary survey was conducted in late May and included responses from 2,848 Medicare Advantage members who purchased plans through eHealth's website.

Six key takeaways:

1. Among Medicare Advantage members, 88 percent were satisfied with their coverage.
   
   
2. Among those who expressed dissatisfaction with their plan, 29 percent cited lack of coverage for their preferred provider, 25 percent cited dissatisfaction with out-of-pocket costs and 22 percent were dissatisfied with their prescription drug coverage.
   
   
3. Thirteen percent of Medicare Advantage members say they have had a claim or pre-authorization request denied. Among those, 43 percent say they were told the service was excluded from coverage under their plan, 15 percent say their coverage was denied because the service was not medically necessary and 15 percent say their claim was eventually covered.
   
   
4. Among Medicare Advantage members previously enrolled in Medigap, 59 percent say they are "more satisfied" with their Medicare Advantage plan and 23 percent were "equally satisfied." 
   
   
5. Sixty-one percent of members say Medicare Advantage is a good example of public-private cooperation.
   
   
6. Seventy-three percent of beneficiaries can only afford monthly premiums of $50 or less, and 48 percent cannot afford to pay any monthly premiums for similar coverage if Medicare Advantage was not available. Seventy-four percent say they could only pay annual out-of-pocket costs of $1,000 or less.