As you prepare for the Medicare Annual Enrollment Period, how well do you understand your plan and what changes you may want to make?
Assurance IQ conducted a survey of 1,000 people who say they have Medicare and found that many do not fully understand the program’s terminology or their coverage, which could leave them underinsured after enrollment. The survey also touched on key factors driving people to consider shopping for a new plan.
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Medicare Terminology Is Confusing
Do you know what Medicare Parts A, B, C and D are? Understand the differences between Original Medicare and Medicare Advantage? A majority of our survey respondents indicated that terminology related to Medicare was a significant source of confusion. When asked to describe their understanding of certain words or abbreviations, many respondents indicated they didn’t recognize terms they are likely to encounter during the Annual Enrollment Period or when they use their plans.
A significant portion of respondents selected, “Don’t understand, would need help” or “somewhat understand, familiar but couldn’t define” when asked to best describe their understanding of these words or abbreviations:
- CMS (88% of respondents said they did not fully understand) is an acronym for Centers for Medicare & Medicaid Services. This is a federal agency that administers the Medicare program and works with states to administer Medicaid.
- PACE (92% did not fully understand) stands for Program of All-Inclusive Care for the Elderly. It’s a special type of health plan that serves older adults who need nursing home services but are capable of living in the community.
- TTY (76% did not fully understand) stands for teletypewriters, which are devices used to communicate by people who have impaired ability to hear or speak. TTYs enable people who cannot speak on the phone to enroll in Medicare.
Top Most Confusing Terms
Many respondents also said they did not fully understand these additional common terms and concepts.
- Medicare Part C (59% did not fully understand) represents Medicare Advantage plans, a type of Medicare-approved health plan from a private company. You can choose a Medicare Advantage plan to cover your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D).
- Medicare Part D (45% did not fully understand) represents drug coverage. Part D coverage is optional, but available to everyone with Medicare. Most Medicare Advantage plans include Part D coverage.
- Formulary (67% did not fully understand)means a list of drugs covered by an insurance plan. Sometimes, these are also referred to as preferred drug lists (PDLs).
- The Low Income Subsidy (LIS) (80% did not fully understand) helps people with Medicare pay for prescription drugs, and lowers the cost of Medicare prescription drug coverage.
- State Pharmaceutical Assistance Programs (88% did not fully understand) are state-run programs that can help certain populations cover the cost of prescription drugs.
Other Considerations When Shopping For a Medicare Advantage Plan
In addition to understanding the language when shopping for a plan, it is important to consider your unique needs. Understanding what is important to you as an individual is an important first step before enrolling in a Medicare plan. This will help you choose a plan that serves you well.
For example, how important is your primary care physician to you? In our survey, 43% of respondents said they would not be open to changing to a new plan, even if they would save money, if they had to change their primary care doctor. However, most people said they were open to considering the possibility, with more than 32% of respondents saying they would consider it if it led to “significant” cost savings.
Additionally, how often do you travel? Nearly a quarter of our survey respondents thought Medicare covers health needs while traveling internationally. However, Medicare coverage is very limited outside the U.S., though some Medicare Supplement plans cover foreign travel emergency care and some Medicare Advantage plans may have international coverage benefits too. It is important to review your plan closely to determine where you are covered before you travel.
If you feel overwhelmed by the process of shopping for a new plan, you are not alone. Our survey shows that many people find the terminology associated with Medicare confusing. However, there are resources available to help guide you. Medicare.gov has a glossary of Medicare terms that can help you decipher terminology that you see in Medicare Advantage marketing materials, or your plan. Speaking with a licensed insurance agent can also be helpful in understanding how these terms are relevant to you.
Assurance IQ surveyed 1,000 adults who self-reported they had Medicare and were decision makers about their plan on June 28, 2023.