Seventy-one percent of Medicare beneficiaries in 2018 did not take advantage of open enrollment to compare and select the plan coverage that best suits their needs, according to new research from the Kaiser Family Foundation (KFF)—causing many beneficiaries to incur "unexpected and avoidable costs."

Why health care consumers don’t have a savvy shopping habit

KFF study findings

For the study, KFF analyzed the 2019 Medicare Current Beneficiary Survey to determine the number of beneficiaries who compared plans during the 2018 open enrollment period, the number who compared drug coverage in Medicare Advantage and stand-alone drug plans, and to identify variations between different demographics.

How to engage Medicaid members in closing care gaps

Overall, KFF found that 71% of all Medicare beneficiaries did not compare their plan to other available plans during the 2018 open enrollment period. For those enrolled in Medicare Advantage plans, 68% did not compare plans during the same time period. The number among traditional Medicare beneficiaries was even higher—with 73% saying they did not compare plans.

Notably, the number of all Medicare beneficiaries who did not compare plans in 2018 was higher among certain demographics—with 74% of Black and 79% of Hispanic beneficiaries not comparing plans. Several other demographic groups also did not compare plans, including 84% of beneficiaries ages 85 and older, 77% of beneficiaries under 65 with disabilities, as well as 85% of beneficiaries with lower incomes, 82% of individuals with less than a high school education, 73% living in rural areas, 74% of those in relatively poor health, and 87% of dual-eligibles enrolled in both Medicare and Medicaid.

In addition, KFF found that the resources available to Medicare beneficiaries were not widely used. For example, the survey showed 47% of all beneficiaries said they never visited Medicare's website for information. More than half of all Medicare beneficiaries said they had never called Medicare's helpline for information, and 16% said they were not aware the helpline even existed. Fifty-one percent of beneficiaries said they had read at least some of the "Medicare & You" handbook—but 31% said they hadn't read it at all, and 18% said they didn't receive the handbook.

Why don't people compare plans?

While some beneficiaries choose not to compare plans because they are satisfied with their current coverage, many become overwhelmed or confused by all the different options available to them, the New York Times reports.

For example, in 2022, beneficiaries on average can select their coverage from among 33 Medicare Advantage plans and 30 Part D stand-alone prescription drug plans (PDPs), according to the Times. In some areas of the country, that number increases to 56 or 63 Medicare Advantage plans.

"It is hopelessly, needlessly complicated and it continues to get more complicated," said David Lipschutz, associate director of the Center for Medicare Advocacy. "The entire system relies on savvy actors maximizing their choices, and that just does not happen." (Koma et al., Kaiser Family Foundation study, 10/13; Span, New York Times, 11/1)