Poll Shows Many Older Michigan Residents Spend Little Time on Medicare Choices, Raising the Stakes

This story was originally published by BridgeMichigan, a nonprofit and nonpartisan news organization. Visit the newsroom online: bridgemi.com.

• Michiganders have fewer Medicare Advantage options this year as insurers leave the market
• People who do not replace those plans may be left paying 20% of medical costs if they are moved into pared-down Original Medicare without Medigap coverage
• Medicare open enrollment continues through Dec. 7

For 2.3 million Michiganders, choosing a Medicare plan is one of the most important health care decisions they will make. Yet a new poll found that 3 in 5 spend less than an hour, or no time at all, comparing their options.

Experts say that limited attention could be especially dangerous this year because insurers are pulling back from the Michigan market, leaving many residents without the plans they have relied on to help pay for routine doctor visits, hospital stays and prescription drugs.

For people whose Medicare Advantage plans have been discontinued, the open enrollment period offers fewer choices, and it runs through Dec. 7.

There is also a potential upside.

Because their plan is ending, they get a narrow but valuable chance to leave Medicare Advantage and return to Original Medicare, also known as Parts A and B, together with a Medigap policy that helps fill in the gaps in Original Medicare coverage.

Even so, they have only 63 days after their plan ends to secure a Medigap plan with pricing that is not tied to their medical history.

Original Medicare generally pays about 80% of hospital and medical costs, while Medigap plans help cover much of the remainder.

Putting Medicare decisions off until the last minute can lead to a plan that leaves money or benefits unused, said Geoffrey Hoffman, an associate professor at the University of Michigan School of Nursing.

Hoffman studies how Medicare enrollees make decisions and worked with the team at the National Poll on Healthy Aging at the University of Michigan’s Institute for Healthcare Policy and Innovation.

He said the Medicare system can be overwhelming.

Unlike younger adults who may receive coverage through an employer, older Michiganders often face a confusing range of plan choices at the same time their health becomes less predictable. At the same time, groceries, gas and other necessities continue to squeeze many people living on fixed incomes.

Make the wrong choice, Hoffman said, and someone could end up overpaying by hundreds or even thousands of dollars.

LOSING ADVANTAGE

Insurers are offering 181 Medicare Advantage plans in Michigan this year, down from 192 last year, according to the U.S. Centers for Medicare and Medicaid Services.

Also known as Part C, Advantage plans cover the medically necessary services included in Original Medicare, but they may also include extra benefits such as vision, hearing and dental care.

It is not yet clear how many Michiganders were enrolled in the Advantage plans that are leaving the state. Across the country last year, about 3 million Medicare Advantage enrollees were in plans that were discontinued, and experts say that number is expected to rise this year.

People whose plans are ending have several choices to make.

They can switch to another Advantage plan.

This year, the average monthly premium for an Advantage plan in Michigan is $16.21, according to the Centers for Medicare and Medicaid Services. That cost comes on top of Part B medical insurance, which typically costs $202.90 a month.

They can also move back to Original Medicare, which generally leaves beneficiaries responsible for 20% of their medical bills.

And they can pair it with a Medigap plan to help pay those bills.

That is a rare opportunity for Michiganders who did not buy Medigap earlier. In most cases, Medicare beneficiaries must choose Medigap coverage during their first year of Medicare enrollment.

After that, Medigap plans are usually subject to underwriting, meaning insurers can raise premiums based on a person’s health and make coverage more expensive or harder to obtain.

But people whose Advantage plans are discontinued get another chance to enroll in Original Medicare with a Medigap policy. They have 63 days after their Medicare plan ends to pick a Medigap plan without underwriting.

Like Advantage plans, Medigap prices vary by county. Last year in Michigan, they averaged $235, according to the health research nonprofit KFF in San Francisco.

AND FINALLY?

Original Medicare does not include prescription drug coverage, so experts say people with only Original Medicare should also consider a Part D plan, often called a drug plan.

The plans differ not only in price but also in the medications they cover.

Michigan has 11 standalone drug plans this year.

FREE ASSISTANCE

Beneficiaries can use the Medicare Plan Finder to compare Medicare Advantage, Part D prescription drug and Medigap plans in their area, including the specific medicines they take and the doctors they see.

Medicare also offers help through its hotline at 1-800-MEDICARE, or 800-633-4227.

Free counseling is available through the federally funded State Health Insurance Assistance Program in every state. In Michigan, the program is called MI Options and can provide help in person or by phone at 800-803-7174.

Insurance brokers can also help, though they may receive commissions from insurance companies based on the number of people they enroll.