A new survey found that four out of 10 Medicare Advantage (MA) customers mistakenly believe they don’t have to stay in-network for care, which is a key difference between the program and traditional Medicare.
The survey was released Tuesday by MedicareGuide.com, which helps with Medicare enrollment and contains responses from 1,148 seniors. It comes as the MA market has increased in size and become a lucrative option for insurers.
A key difference between MA and traditional Medicare plans is that MA plans require customers to only get care from physicians in the plan’s network whereas traditional Medicare covers any physician. The findings appeared to contradict a similar response rate where eight out of 10 said their understanding of MA medical coverage was good or very good, while 14% said it was fair.
Seniors in the survey listed why they decided to choose an MA plan, which can offer additional benefits besides traditional Medicare.
A majority (57%) listed access to vision benefits as the top reason, with other benefits scoring high including dental (48%) and drug coverage at 46%.
“Asked if they find Medicare Advantage coverage and benefits as advertised, the largest number (81%) answered yes, in an overwhelmingly positive assessment,” the survey said.
But some MA members are switching back to traditional Medicare due to issues such as claims refusals.
It found that 11% of respondents left MA because a plan didn’t authorize a procedure while another 11% said they were billed for an out-of-network charge. Another 10% said it was due to skipping a procedure and 8% because a claim was refused.
The survey results come as MA continues to grow in popularity. A recent study from the Chartis Group found that enrollment grew by 2.3 million for 2022, making up 45% of all Medicare enrollment thanks to 1.3 million people transitioning from traditional Medicare to MA.
The Chartis study showed a continued migration in enrollment from nonprofit plans to for-profit entities such as Anthem and UnitedHealthcare.