Spy vs. Spy? More Like Medicare vs. Medicare Advantage

By David Burda, News Editor & Columnist, 4sight Health
LinkedIn: David R. Burda
X: @davidrburda
X: @4sighthealth_

If you follow my columns, blog posts and podcast 4sight Health Roundup, you know that I’m not much for the Medicare Advantage (MA) program. So much so that I’ve publicly declared that I’ll choose traditional Medicare when my time comes in 2025.

You’ve read or heard my many reasons. But let’s find out from Medicare beneficiaries themselves thanks to a new report from the Commonwealth Fund.

The report is based on a survey of 3,280 Medicare beneficiaries conducted by the Commonwealth Fund from November 2023 through January 2024. The report didn’t disclose — or more likely I couldn’t find — the breakdown of how many respondents were in Medicare versus Medicare Advantage. But I do trust that the Commonwealth Fund researchers know what they are doing, especially after politely acknowledging that many beneficiaries didn’t know what type of Medicare coverage they had.

“For many beneficiaries, the various types of coverage offered — including traditional Medicare, Medicare Advantage plans, Medigap and other supplemental coverage — can be confusing and may lead beneficiaries to inaccurately identify their coverage,” the report said.

Whose fault is that? But I digress.

I’m going to highlight some of the differences in opinion of the respondents that the Commonwealth Fund researchers identified as statistically significant:

• 22% of MA enrollees said their care was delayed because they needed their MA plan’s approval compared with 13% of enrollees in traditional Medicare.
• 12% of MA enrollees said they couldn’t afford the care they needed because of the copayment or deductible amount compared with 7% of enrollees in traditional Medicare.
• 49% of MA enrollees said their doctor discussed the results of their health assessments with them compared with 62% of enrollees in traditional Medicare.

Here are a few other survey results that I found significant, albeit not statistical:

• 36% of MA enrollees said they waited more than a month to see a doctor compared with 34% of enrollees in traditional Medicare.
• 28% of MA enrollees said they needed to find a new doctor within the past 12 months compared with 27% of enrollees in traditional Medicare.
• Of the beneficiaries who said their Medicare coverage didn’t meet their expectation, 36% of MA enrollees said it was because their MA plan benefits didn’t cover what they needed compared with 33% of enrollees in traditional Medicare.
• Of the beneficiaries who said their Medicare coverage didn’t meet their expectation, 33% of MA enrollees said it was because the costs were too high compared with 30% of enrollees in traditional Medicare.

Overall, in this survey, I’d give the edge to traditional Medicare for giving seniors what they want. And we all know that if you don’t give seniors exactly what they want, someone’s going to hear about it.

Thanks for reading.

To learn more about this topic, please listen to the Feb. 15, 2024, episode of our 4sight Health Roundup podcast, “Rethinking Medicare Advantage,” on 4sighthealth.com.

This article was originally published on 4sight Health and is republished here with permission.