Issue Brief Finds that Medicare Complexity Outpaces Counseling Resources

Last week, the Center on Aging at the American Institute for Research (AIR) released a set of issue briefs detailing the complexities of enrolling in Medicare. One of the briefs, Medicare Complexity Taxes Counseling Resources Available to Beneficiaries, highlights Medicare choices and the personalized counseling available to beneficiaries and their families.

During Medicare’s fall open enrollment period, which runs from October 15th to December 7th, people with Medicare can make changes to the way they receive their Medicare benefits, including by changing their Medicare Advantage and Part D, prescription drug coverage. The report draws on a qualitative study of professional and volunteer counselors, State Health Insurance Assistance Programs (SHIPs), plan brokers, and employers to identify particular areas of confusion and trouble as well as the challenges of meeting the growing demand for assistance.

The report finds that the most common problems beneficiaries have when making decisions during fall open enrollment are: Medicare’s complexity in general, higher than expected Medicare Advantage out-of-pocket costs; limitations on changing Medigap plans and switching from Medicare Advantage back to original Medicare; unexpected and disruptive Part D formulary changes; and losing Marketplace low-income subsidies when they become Medicare eligible.

According to AIR, the free counseling resources provided by the SHIPs are “a highly cost-effective way to provide one-on-one support to help lower income beneficiaries make more informed choices about their coverage options. There are about 15,000 SHIP counselors available across the country, and about 57 percent are trained volunteers. In 2013, $51.9 million was spent on the SHIP, which provided one-on-one counseling to more than 2.6 million of the 52.5 million Medicare beneficiaries at a cost of less than $20 per beneficiary served.” The report encourages policy makers to expand SHIP funding and to better utilize these highly trained counselors to help people make better enrollment decisions as they transition from marketplace or employer-based coverage to Medicare.

Read the AIR blog post about the issue brief here.