Medicare Advantage (Private) Tempts with Lower Out-of-Pocket Costs than Traditional Medicare, But Problems Accessing Healthcare are Significant

“Meanwhile, differences in insurance plan ratings between traditional Medicare and Medicare Advantage groups were significant ( Exhibit 3 ). Only 6 percent of respondents age sixty-five or older with traditional Medicare gave their insurance a fair or poor rating, but 15 percent of those with a private Medicare Advantage plan did…

…Within the population of Medicare beneficiaries age sixty-five or older, those with private Medicare Advantage coverage were less likely to have premiums and out-of-pocket costs exceed 10 percent of their income, compared to people with traditional Medicare coverage ( Exhibit 3 ). The difference between 25 percent and 36 percent, respectively, is significant.

…Among Medicare beneficiaries age sixty-five or older, those with traditional Medicare coverage reported access problems at lower rates than respondents in the Medicare Advantage program: 23 percent compared to 32 percent ( Exhibit 3 ). This difference is significant.

Notably, adults with Medicare Advantage and nonelderly adults with individual or nongroup private plans reported similar rates of problems with medical bills and accessing care because of cost (Appendices 1 and 2).

Medicare Beneficiaries Less Likely To Experience Cost- And Access-Related Problems Than Adults With Private Coverage, Karen Davis, Kristof Stremikis, Michelle M. Doty, and Mark A. Zezza. Health Affairs 2012 31:8, 1866-1875

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