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When Americans are asked what they think about Medicare, they generally rate the program highly. But how do people 65 and older who are actually in<\/em> Traditional Medicare or the alternative Medicare Advantage (MA) plans<\/a> from health insurers really feel about it?<\/p>\n That\u2019s a somewhat different story, as recent surveys from health researchers at The Commonwealth Fund, KFF, Brigham & Women\u2019s Hospital and Retirement Living revealed.<\/p>\n While beneficiaries in Traditional Medicare and Medicare Advantage plans say they\u2019re largely happy with each program, they also report challenges and frustrations.<\/p>\n Some Medicare Advantage beneficiaries were disappointed by the realities of major reasons they enrolled in the plans.<\/p>\n One of the surveys\u2019 biggest surprises: Although Medicare Advantage plans heavily promote the supplemental benefits they offer and that Traditional Medicare can\u2019t\u2014dental<\/a>, hearing<\/a>, and vision<\/a>\u2014a sizable percentage of MA members don\u2019t use them.<\/p>\n Here\u2019s a dive into the survey findings:<\/p>\n Medicare beneficiaries are mostly happy with their health insurance and happier than people with employer-sponsored health coverage<\/strong>. In KFF\u2019s 2023 Survey of Consumer Experiences with Health Insurance<\/a>, 92% people aged 65+ rated as \u201cexcellent\u201d or \u201cgood\u201d the overall performance of Medicare\u2019s health insurance and the availability and quality of medical providers. By contrast, only 80% of people with employer-sponsored health insurance graded it \u201cexcellent\u201d or \u201cgood.\u201d<\/p>\n \u201cWhen we asked people to rate their health insurance, overall, people were generally pretty happy. But people with Medicare really stood out as overwhelmingly happy,\u201d says Lunna Lopez, senior survey analyst at KFF.\u00a0 \u201cPeople with employer-sponsored insurance have more challenges with cost and insurance not paying for something they thought was going to be covered.\u201d<\/p>\n Although Medicare beneficiaries told KFF they were generally pleased with their health insurance, \u201cthat doesn\u2019t mean they don\u2019t have issues with it,\u201d says Lopez. She believes many people on Medicare are \u201ckind of grateful and feeling at least more secure in having health coverage to begin with.\u201d<\/p>\n KFF\u2019s survey found that people in Medicare were more likely to report problems with coverage of their prescription drugs than those with employer-sponsored insurance<\/strong>. Some 27% said Medicare either didn\u2019t cover their medications<\/a> or required a very high co-pay for them.<\/p>\n Overall, people in Medicare Advantage plans are as likely to say their coverage met their expectations as people in Traditional Medicare<\/strong>. The Commonwealth Fund\u2019s 2024 Value of Medicare Survey<\/a> found that about two in three beneficiaries in MA plans and in Traditional Medicare said their coverage fully met their expectations.<\/p>\n The high marks from Medicare Advantage members might seem surprising considering that, unlike Traditional Medicare, their plans often have limited networks of doctors and hospitals and typically require prior authorization approval to see specialists.<\/p>\n But The Commonwealth Fund\u2019s Vice President for Medicare, Gretchen Jacobson, noted that Medicare Advantage enrollment in PPOs\u2014preferred provider organizations that let members get care covered if they go outside their network\u2014has been growing. Medicare Advantage HMOs (health maintenance organizations) require beneficiaries stay in network for care.<\/p>\n Medicare Advantage beneficiaries were, however, almost twice as likely to report delays getting care than people with Traditional Medicare<\/strong>. In The Commonwealth Fund survey, 22% of MA beneficiaries said they experienced delays due to prior approval vs. 13% of those with Traditional Medicare.<\/p>\n But 65% of people with Medicare Advantage and Traditional Medicare whose health care was delayed said they eventually did receive the care.<\/strong><\/p>\n \u00a0Whether the delays were a nuisance or worsened patients\u2019 health is unknown. However, Jacobson says, \u201cif you have a significant delay in care, depending on your condition, that can really result in poorer health outcomes.\u201d<\/p>\n The biggest challenges reported by those in Traditional Medicare and Medicare Advantage: Out-of-pocket medical costs and health services they needed but weren\u2019t covered.<\/strong><\/p>\n \u201cThe gaps in Medicare coverage can really be notable,\u201d says Jacobson. \u201cIt\u2019s not only the cost-sharing requirements, deductibles and premiums, but also the services that aren\u2019t covered at all, which includes long-care.\u201d<\/p>\n For people with Traditional Medicare, those services include dental, vision and hearing as well. \u201cMany people over the age of 65 really need those benefits,\u201d Jacobson says.<\/p>\n Medicare Advantage members were more likely to run into health care affordability issues than people with Traditional Medicare, The Commonwealth Fund found.<\/strong><\/p>\n Although MA plans <\/strong>often tout themselves as being \u201c$0 premiums,\u201d that doesn\u2019t mean $0 co-pays or deductibles. In the new Commonwealth Fund survey, 12% of people with Medicare Advantage said they couldn\u2019t afford care because of co-payments or deductibles vs. just 7% of people with Traditional Medicare.<\/p>\n This difference is especially striking because The Commonwealth Fund\u2019s 2022 Biennial Health Insurance Survey<\/a> and Retirement Living\u2019s 2023 Medicare Advantage Satisfaction Index<\/a> found that a limit on out-of-pocket costs was a chief reason people gave for enrolling in Medicare Advantage plans.<\/p>\n Medicare Advantage plans\u2019 claimed advantage over Traditional Medicare for coordinating health care for members didn\u2019t ring true.<\/strong> \u201cMost Medicare beneficiaries [in our survey] said they coordinated their own care regardless of whether they were in Medicare Advantage or Traditional Medicare,\u201d says Jacobson.<\/p>\n But Medicare Advantage members said their plans were helpful for scheduling doctor\u2019s appointments and wellness exams.<\/p>\n The much-touted supplemental benefits of Medicare Advantage are often going unused. <\/strong>Although people with Medicare Advantage have told The Commonwealth Fund that supplemental benefits were a main reason they chose the private insurers\u2019 program over Traditional Medicare, the group\u2019s new survey revealed that three in 10 members didn\u2019t use any <\/em>of those benefits in the past year.<\/p>\n \u201cIt could be that the supplemental benefits may not be the benefits people really need or value,\u201d says Jacobson. Indeed, 63% who didn\u2019t use their supplemental benefits said they hadn\u2019t needed them. Another 24% didn\u2019t know what benefits their plan offered and 13% said those benefits were hard to use or cost too much.<\/p>\n\n