Complexities in Medicare Advantage Options may Discourage Seniors from Comparing Plans

Jan 28, 2020 at 10:56 pm by pj

CLEARWATER - Medicare Advantage Open Enrollment Period (MAOEP) is from January 1 – March 31. It’s a time when seniors can potentially save money and gain benefits. Unfortunately, many seniors will do neither. But why is the Open Enrollment Period ignored by seniors? 


As Dave RichCEO, Ensurem LLC, puts it, “The Medicare Advantage market is constantly changing making better plans available to seniors every year during the fall Annual Election Period. This is crunch time for most seniors, but what they don’t usually realize is they also have a chance to make one additional change to their MA coverage for the year during the OEP. Additionally, insurance companies and brokers aren’t legally allowed to market this period or its benefits to consumers. So oftentimes, they’re left feeling stuck with the choices they made during a hectic AEP season.”


The MAOEP is the time when a beneficiary with Medicare Advantage can either:

  1. Change from one Medicare Advantage plan to a different Medicare Advantage plan.
  2. Drop their Medicare Advantage plan and return to Original Medicare, Part A and Part B (and subsequently apply for Medigap or Part D, if they choose.) 

For those who do decide to drop their Medicare Advantage policy and return to Original Medicare they often don’t understand that there is an increase in patient medical costs for Original Medicare holders, while Medicare Advantage costs are on the decline. 


Medicare Part A and Part B comprise Original Medicare. This covers the basic hospital and medical expenses that the government provides at age 65. It does not cover all healthcare expenses however (such as Prescription Drug Plans) and it leaves the senior with out-of-pocket expenses that can sometimes be crippling.


The difference between Original Medicare and Medicare Advantage

Medicare Advantage, or Medicare Part C, replaces Original Medicare. This coverage is provided by private insurance companies that contract with Medicare. These plans will sometimes include additional coverage for things like dental and vision care, prescription drugs, rehabilitation services, diagnostic services or even fitness programs.


If a senior has Medicare Advantage (MA) they may want to shop during the MAOEP because the MA markets are getting more competitive as more entrants continue to break in. To stay competitive, insurance companies are always adding new services and benefits. For example, hundreds of Medicare Advantage companies are rolling out new homecare benefits in 2020. This is because the Centers for Medicare & Medicaid Services (CMS) is giving Medicare Advantage plans the most flexibility they’ve ever had in terms of covering non-medical, in-home supplemental benefits. 


Additionally, the steps the Trump Administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits, and lower costs for seniors. Nevertheless, many seniors will likely not take advantage of these benefits.


Only 6-11% of seniors voluntarily switched from Original Medicare to Medicare Advantage during the 2006 to 2017 enrollment periods. In addition, more than one in three Medicare beneficiaries reported difficulty comparing the Medicare Advantage plan options. 


Seniors find it easier to confront a colonoscopy

Another survey indicated that 23% of seniors said they found reviewing their Medicare plan to be one of the most unpleasant tasks they do among a list provided to them by pollsters. Other choices they said they’d rather confront before Medicaid included "getting a colonoscopy" and "going to the dentist." 


According to Rich of Ensurem, neither reviewing your Medicare program or shopping for a new Medicare Advantage program has to be confusing or painful. After years dealing in international insurance Rich became a passionate believer in the use of technology and the need to fundamentally change how insurance is sold so that more Americans can enjoy the benefits of these products. 


“What is needed,” claims Rich, “is a user-friendly online platform serving as an insurance broker on one side and a provider of tailored Medicare solutions information and purchasing opportunities on the other.”


Ensurem has designed such a platform. It has carrier relationships with Aetna, Humana, Ameritas, and other major health insurers where the senior can go and fill out a few forms and get straight, non-complicated answers as to which Medicare Advantage plan will work best for him or her.


Medicare Advantage beneficiaries still have a chance to make changes to their 2020 coverage during the Medicare Advantage Open Enrollment Period (January 1 – March 31.) According to Rich an investment of a few minutes of time to do so may be worth it for any senior. “The Ensurem solution provides an online consumer marketplace that educates visitors and rapidly matches them to MA programs through a simple application backed by a fully licensed Contact Center staffed with Medicare experts.”


Ensurem, headquartered in Clearwater, FL, is a leading technology and product distribution company serving carriers and consumers within the massive U.S. senior market. The company provides end-to-end solutions for carriers, including product development, digital marketing, and consumer-centric front ends and back end. For more information, please visit