Published Feb. 25, 2020

What is the biggest fear facing most Medicare beneficiaries?

According to one recent study, it’s surprise medical bills. 

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Medicare beneficiaries were asked about their biggest fears concerning their Original Medicare coverage (Medicare Part A and Part B), which is the nation’s largest health care plan. Receiving a surprise medical bill topped the list, with 63 percent of responses.²

Other fears near the top of the list for Medicare beneficiaries included:

• Their health care provider not being in-network (38 percent)
• Not being able to pay their deductible (35 percent)
• Not being able to pay their copayment or coinsurance costs (29 percent)

Beneficiaries of private Medicare plans express less fear of surprise bills

The survey distinguished some of the data for beneficiaries who are enrolled in private Medicare plans such as Medicare Advantage (Medicare Part C) plans and Medicare Supplement Insurance (Medigap). 

• Among Medicare Advantage plan enrollees, 38 percent worried about paying their deductibles, while only 29 percent of Medigap beneficiaries shared the same concern.
  
  
• 34 percent of Medicare Advantage enrollees and 22 percent of Medigap beneficiaries cited a fear of being able to pay coinsurance or copayment costs.

Each type of standardized Medigap plan provides full coverage of Medicare Part A coinsurance costs and (except for Medigap Plan A) partial or full coverage of the Medicare Part A deductible.

• 18 percent of Medicare Advantage beneficiaries and 23 percent of Medigap plan holders who were questioned in the study expressed a fear of being able to pay their monthly plan premiums.

Medigap plans and Medicare Advantage plans both include monthly premiums. Medicare Advantage plan premiums, however, continue to decrease in recent years, and you may be able to find $0 premium Medicare Advantage plans where you live, if they’re available in your area. 

• 31 percent of Medicare Advantage respondents reported that being able to visit a preferred health care provider was the most important consideration for picking a plan.

Many Medicare Advantage plans typically feature a network of participating providers and are structured as Health Maintenance Organization (HMO) plans or Preferred Provider Organization (PPO) plans. The types of plans that are available where you live may vary. 

Medicare Supplement Insurance plans are accepted by any provider or hospital that also accepts Original Medicare. 

Medicare Advantage plans are sold by private insurers and provide all of the same basic benefits as Original Medicare. Some Medicare Advantage plans may also cover benefits that Original Medicare doesn’t cover such as routine vision, dental, and hearing care.

Most Medicare Advantage plans also offer prescription drug coverage. 

Medicare Supplement Insurance (Medigap) works in conjunction with Original Medicare to help pay for certain Medicare out-of-pocket costs like deductibles, coinsurance and copayments. Medigap plans can help reduce the number of or amount of surprise medical bills for Medicare beneficiaries.

Medicare Advantage plans include an annual out-of-pocket spending limit. For Medicare Advantage beneficiaries, this feature can help prevent large surprise medical bills.

Medicare Advantage plans and Medicare Supplement plans are not the same thing. You cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.

Licensed insurance agents can help beneficiaries compare plans

When it comes to shopping for a plan, 55 percent of beneficiaries said they prefer to use a combination of online tools and a licensed insurance agent to help them choose a policy.

You can call to speak with a licensed agent who can help you compare Medicare Advantage plans that may be available where you live. You can also compare plans online for free, with no obligation to enroll. 

Or call 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!