There’s widespread gaps in Medicare knowledge among both current beneficiaries and adults approaching eligibility for the program, even as most enrollees express high confidence in their understanding of the program, according to a new eHealth survey.
The findings, released Aug. 20, were based on nationwide surveys of 1,000 adults conducted by a third-party vendor from July 15 to July 25. The margin of error is +/- 3%.
Seven things to know:
1. Nearly 9 in 10 Medicare beneficiaries say they are “very confident” (43%) or “confident” (46%) in their understanding of their coverage options, but only 13% could correctly identify the definitions of all four primary Medicare coverage types, including original Medicare, Medicare Advantage, Medicare Part D and Medicare supplement. Fewer than half could define any individual type correctly, with 45% identifying the correct definitions of Medicare Advantage and Medicare supplement plans, 44% correctly defining a Part D plan and 42% correctly identifying Parts A and B.
2. Eighty-eight percent of current Medicare beneficiaries either do not know or incorrectly believe there is an annual cap on out-of-pocket costs under Parts A and B. Thirty-five percent mistakenly believe annual out-of-pocket costs are capped at $5,000 or less per year.
3. Sixty-three percent of current beneficiaries do not understand they will typically pay 20% for covered medical charges if enrolled solely in original Medicare. Nine percent believe they would pay nothing toward covered care, and 16% think they would owe 5% or 10% of their bills.
4. Among pre-Medicare adults ages 55 to 64, the knowledge gaps are even wider. Eighty-two percent do not understand the 20% coinsurance rate for non-preventive care under original Medicare, and 51% either do not know what types of out-of-pocket costs they may face or think they won’t face any at all. Twenty-four percent mistakenly believe original Medicare will allow them to make copayments for prescription drugs.
5. Eighty-eight percent of pre-Medicare adults don’t know they may face a 10% penalty on their Part B premium for every 12-month period they were eligible to enroll but did not. Eighty percent are unaware of potential late enrollment penalties for Part D, and 71% don’t know they may be denied or charged more for Medicare supplement coverage if they apply beyond their initial enrollment period.
6. Sixty-one percent of pre-Medicare adults ages 55 to 64 don’t recognize the potential risks of delayed enrollment, with 22% mistakenly believing they can sign up for additional Medicare coverage at any time without risking late enrollment penalties or an underwriting review of their health history, and another 39% saying they didn’t know if those risks exist.
7. Forty-five percent of pre-Medicare adults ages 55 to 64 either don’t know whether original Medicare provides dental, vision and hearing coverage or mistakenly believe it does.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
