Exclusive National Opinion Poll

Retirees share likes and dislikes about their health insurance

As you get closer to retirement, you may wonder how transitioning to Medicare coverage will affect you.

We surveyed people ages 55 and older who are already retired (either fully or partially). We asked them about their satisfaction with many aspects of their primary health insurance coverage – whether that’s through traditional Medicare, Medicare Advantage, or private insurance.

Some of their answers may surprise you.

What they like

Most respondents express satisfaction with various aspects of their current health insurance coverage.

Access to preferred providers, 87%

Access to specialists, 87%

Range of covered services, 87%

Reliability of claims approvals, 80%

Insurer’s responsiveness to questions/complaints, 78%

Affordability of deductibles, 73%

Affordability of co-insurance, 72%

Affordability of premiums, 71%

Percent of respondents rating their current health as excellent or good, 59%

Of those, percent who are confident they can maintain their health throughout retirement, 86%

Not surprisingly, respondents who rate their health as excellent or good are happier with their coverage across several measures.

Chart:

Access to specialists, 89% Excellent/good health, 84% Fair/poor health

Reliability of claims approvals, 82% Excellent/good health, 77% Fair/poor health

Insurer's responsiveness to questions/complaints 81% Excellent/good health, 73% Fair/poor health

Affordability of co-insurance, 75% Excellent/good health, 68% Fair/poor health

High satisfaction for Medigap and RX coverage

A third of those currently enrolled in traditional Medicare, also have a supplemental policy for Medicare (often called Medigap) that provides extra coverage for deductibles and co-insurance. And almost a third have an add-on Part D prescription drug policy as well.

93% report being satisfied with their current Medigap plan

And only 1 in 5 have ever switched plans

Top reason they switched plans?

Lower premiums

79% Are happy with their current RX plan

What they dislike

8 in 10 Are concerned that Congress will reduce Medicare benefits at some point in the future

1 in 5 Worry about paying a future medical bill under their current coverage

What they spend

More than half of all respondents (58%) report spending $199 or less each month on their own health insurance premium.

And nearly a third believe that their out-of-pocket spending on healthcare (including all premiums, co-pays, deductibles and co-insurance) adds up to more than they spent before retiring.

$315,000 is how much a 65-year-old couple retiring in 2022 will spend on average for healthcare expenses during their retirement, according to Fidelity Investments.

5 things to know about Medicare Advantage

1. Medicare Advantage plans are another way for retirees to get Medicare Part A and Part B coverage.

2. Sometimes called “Part C” coverage, these plans are offered by insurance companies. Although these companies are private, for-profit firms, they are supposed to follow rules set by Medicare.

3. Many of these plans include prescription drug coverage (Part D).

4. You may be limited to in-network providers. Some plans offer non-emergency coverage out of network, but typically at a higher cost.

5. The average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available in more than a decade.

Sources: Medicare.gov; “Enrollment Updates in Medicare Advantage,” KFF.org.

Our respondents and Medicare Advantage

Among our respondents ages 65 and older, enrollment is almost split between the two primary Medicare options.

Traditional Medicare, 47.5%

Medicare Advantage, 52.5%

This tracks with national trends showing increasing enrollment in private Medicare Advantage plans.

Medicare Advantage Enrollment (in millions)

2008, 9 million

2010, 11 million

2012, 13 million

2014, 15 million

2016, 17 million

2018, 20 million

2020, 24 million

2022, 28 million (which equates to 48% of those eligible)

Source: Kaiser Family Foundation (KFF) analysis of CMS Medicare Advantage Enrollment Files, 2010-2022; Medicare Chronic Conditions (CCW) Data Warehouse from 5 percent of beneficiaries, 2010-2017; CCW data from 20 percent of beneficiaries, 2018-2020; and Medicare Enrollment Dashboard 2021-2022.

Do they like it?

Pro

Retirees enrolled in Medicare Advantage report slightly higher satisfaction levels with the cost of their plans.

Percent of respondents who are satisfied with the cost of their plans

Affordability of deductibles, 81% Medicare Advantage, 76% Traditional Medicine

Affordability of premiums, 82% Medicare Advantage, 72% Traditional Medicine

Con

Overall, respondents enrolled in Medicare Advantage express slightly less satisfaction with the range of covered services (90% versus 94%). What's more, 1 in 5 of these respondents report having experienced difficulty receiving care for a covered service, compared to only 1 in 10 of those enrolled in traditional Medicare.

The U.S. Department of Health and Human Services recently released a report accusing Medicare Advantage plans of denying legitimate claims for tens of thousands of enrollees each year (footnote: “Some Medicare Advantage Organization Denials of Prior Authorization Requests,” HHS, April 2022.)

A follow-up survey by online insurance broker eHealth found that although a majority of Medicare Advantage enrollees are satisfied with their plans, 13% have had a medical claim or prior authorization denied (footnote: “Spotlight on Medicare Advantage,” eHealth, June 2022).

Methodology: The poll, conducted in August 2022, surveyed 608 respondents, ages 55 or older, who have already retired (either partially or fully). The respondents were roughly divided between men and women (47% vs 53%). *Some response rates may exceed 100% due to the option to select more than one answer.

Kiplinger, copyright November 2022, Future US LLC