Increasing the Probability of Comparing Between Traditional Medicare and Medicare Advantage

Having knowledge of out-of-pocket cost and access to services constitutes an advanced level of health literacy within the Medicare population. The cost and services offered within Medicare change annually, yet less than 30% of beneficiaries compare their coverage options (between traditional or fee-for-service Medicare and Medicare Advantage)-an important application of health care knowledge. Failure to compare can expose the financing of the Medicare program and the beneficiary to financial risk if a beneficiary has not elected a coverage option that best suits their individual needs. The factors driving beneficiaries to compare are poorly understood.

Our objective was to examine the association between different levels of information reviewed (exposure) and comparing coverage (outcome).

This pooled cross-sectional study included 28,924 Medicare beneficiaries using data from the 2019-2021 Medicare Current Beneficiary Survey. Multivariable probit regressions were performed using Stata version 18.

Reviewing both cost and service information increased the probability of comparing coverage by 159% (44.4 percentage points). Exposure to service-only information increased the probability of comparing coverage by 97% (27.2 percentage points) and 68% (19.1 percentage points) for cost-only information, relative to those who reviewed neither cost nor service information. Forty-seven percent of beneficiaries did not review cost nor service information, followed by 39% who reviewed both, 8% cost-only, and 6% service-only. The probability of comparing coverage increased by 8.2% (2.3 percentage points) for beneficiaries who reviewed both cost and service information and those who had an education greater than high school.

A targeted outreach and education campaign geared toward increasing the type of information reviewed could result in an increase in comparing Medicare coverage options.