Do More Medicare Beneficiaries Enroll in Traditional Medicare Their First Year?

While enrollment in Medicare Advantage has grown rapidly over the past decade, the majority of Medicare beneficiaries choose to enroll in traditional Medicare during their first year on Medicare, according to the Kaiser Family Foundation (KFF).

A KFF Issue Brief found that older adults and younger beneficiaries with disabilities have said that they make this choice based on premiums and out-of-pocket costs, access to desired providers, the reputation of the company offering the plan, ads and other marketing materials, and the advice of brokers, family members, and friends.

Medicare Advantage offers one-stop shopping, with all Medicare benefits in one combined package, and enrollees may have lower out-of-pocket costs than those in traditional Medicare, with an out-of-pocket cap and coverage of some additional benefits, such as eyeglasses. Beneficiaries in traditional Medicare have open access to providers and fewer administrative hassles, such as prior authorization and referral requirements.

“We found that less than one-third (29%) of Medicare beneficiaries enrolled in Medicare Advantage plans during their first year on Medicare,” says Gretchen Jacobson, an associate director of the KFF’s Program on Medicare Policy. Most new beneficiaries (71%) were covered under traditional Medicare for their first year on Medicare.

“Enrollment rates among new Medicare beneficiaries were much higher in areas with high Medicare Advantage penetration rates and much lower in areas with low Medicare Advantage penetration rates,” Jacobson says. “In essence, new Medicare beneficiaries seem to be making care choices that are similar to other beneficiaries in their area.”