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September 13, 2023
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David Burda
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Medicare Advantage Bait and Switch

I have one quid pro quo in my life: I won’t tell you what to do if you don’t tell me what to do. I won’t tell you what to do, how to do it and when to do it, and I will extend you the same courtesy.

The only exception is anything really stupid that could kill me or you or both of us at the same time.

That’s why, 19 months from now, when I turn 65, I’m going to sign up for traditional Medicare. That’s assuming I’ll still be around in 19 months. Same with traditional Medicare. I’ll enroll in Medicare Part A and Part B and select and pay for Part D separately. No Part C or Medicare Advantage (MA) for me.

Statistically, I should live at least another 17.5 years after that. According to the latest life expectancy projections from the CDC, the average life expectancy of a male born in 1960 is 82.5 years in 2023. I’m not going to spend that time having an MA plan run by a private health insurance company telling me what physician I have to go to, what hospital I have to go to, what pharmacy I have to go to and what paperwork I have to fill out in triplicate to prove that I’m really sick and need to see someone.

It will be more expensive. But I’m willing to spend less on other things to preserve my medical liberty.

But I seem very much alone in my corner, at least according to a new study in Health Affairs on enrollment “switching” patterns between traditional Medicare and MA by beneficiaries.

Five researchers from U.S. Department of Health and Human Services (HHS) analyzed Medicare enrollment data from 2006 through 2022 to come up with the following results:

  • Total beneficiary enrollment in MA plans reached 30.3 million in December 2022, representing about half of all Medicare beneficiaries.
  • 7.4% of beneficiaries switched from traditional Medicare to an MA plan in 2022 compared with 1.2% of beneficiaries who switched from an MA plan to traditional Medicare.
  • 80% or more of the annual MA enrollment growth in 2020, 2021 and 2022 came from beneficiaries who switched from traditional Medicare to an MA plan.
  • 65.5% — nearly two-thirds of beneficiaries who switched to an MA plan in 2022 — did so in January.

The researchers also found some notable demographic characteristics of the beneficiaries who switched from traditional Medicare to an MA plan in 2022. Switchers generally were more likely to be:

  • Male
  • People of color
  • Healthier
  • Younger

What’s most interesting to me is what the HHS researchers picked up on as the most revealing of all the results in their analysis. And that’s when most beneficiaries made their switch from traditional Medicare to MA plans in 2022 — January. Open enrollment. The same timeframe MA plans operated by private insurers bombard beneficiaries with advertisements, touting their plan’s advantages, especially how cheap their monthly premiums are. If you know anything about old people, the word “zero” is music to their ears.

“We found that most switching between MA and fee-for-service Medicare happened during the open enrollment period, which suggests the importance of advertising during the annual open enrollment period, and most new MA enrollees gained their eligibility by turning 65,” the researchers said. “There are allegations that some MA plans may have engaged in misleading marketing and aggressive sales tactics, which may have fueled the rapid growth of MA market share.”

Boom. MA plan propaganda lures seniors into benefit packages that limit their choice of providers in exchange for low or no premiums, co-pays or deductibles.

Not me, brother. As long as I can afford it, I’ll pay more to see whomever I want. Don’t tell this soon-to-be senior what to do.

Thanks for reading.

To learn more about this topic, please read, “Where Medicare Advantage Members Come From,” on 4sighthealth.com.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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