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Survey Finds People in MA Plans Experienced Delays in Accessing Care


High costs and prior authorization impact beneficiaries’ ability to access care. Some said they had to wait more than a month to see a doctor.

About two thirds of older Americans enrolled in Medicare Advantage or traditional plans say their coverage met expectations, finds a new survey from The Commonwealth Fund. But people in Medicare Advantage plans are more likely to say they experienced delays in getting care because of the need for prior authorization or they couldn’t afford the cost of copays or deductibles.

The Commonwealth Fund 2024 Value of Medicare Survey surveyed 3,280 Medicare beneficiaries about access to benefits, services, providers, care coordination, and satisfaction. The survey was conducted by SSRS for the Commonwealth Fund between Nov. 6, 2023, and Jan. 4, 2024. They also conducted interviews with beneficiaries.

The survey found that among beneficiaries reporting a challenge in getting care, 33% in Medicare Advantage plans and 32% in traditional Medicare said the problem occurred when trying to access primary care. About one in six of these beneficiaries said they were told to go to urgent care because their provider had no appointments available.

About half of those in Medicare Advantage said the plan helped them to schedule visits and screenings. “Some visits and screenings, such as for flu vaccines and eye exams, are tied directly to the quality-bonus payments that MA plans can receive. Wellness exams and primary care visits, meanwhile, can help ensure that beneficiaries receive many of the other tests that are linked to plan payments,” the authors said.

Additionally, 69% of those Medicare Advantage plans said their used any of the supplement benefits that are offered. Dental care, vision care, and an allowance for over-the-counter medications were the benefits most often used supplemental benefits.

The majority of beneficiaries said that high-quality care, access to providers and low out-of-pocket costs were important.

A previous survey by the Commonwealth Fund in September 2023, found that the affordability of healthcare is an issue for many people over the age of 65. This survey found that 19% of older adults with Medicare reported high costs and were underinsured. One-third of older adults in traditional Medicare who did not have supplemental coverage reported being underinsured.

Additionally, more than a quarter of older adults with Medicare reported not getting dental care, and more than one in 10 reported not filling a prescription because of the cost. About 18% of older adults with Medicare reported they had medical bill or debt problems. This was more likely to be the case for those in Medicare Advantage plans

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