If you are choosing a Medicare Advantage plan, keep in mind that you are taking a big gamble: You can’t know whether it will cover the care you need when you need it. The star-rating system is a farce. And, paying more is likely a waste. It’s not a proxy for better quality, according to a new study in JAMA Health Forum.
The authors find that quality of care in Medicare Advantage does not differ in a meaningful way across premium levels. In fact, they find that there is tremendous variability in quality at each premium level. That said, the authors do report slightly higher quality of care and patient experience in higher-premium plans.
The takeaway: If you can’t afford the supplemental coverage you need for traditional Medicare and you are choosing among Medicare Advantage plans, you should not choose the Medicare Advantage plan with the higher premium on the theory that it will provide you with better quality care.
A second takeaway: The additional premium you choose to pay for a Medicare Advantage plan might not bear any relation to significant copays you might face should you need costly care. Those out-of-pocket costs are unknown. Because they can be high, many people end up skipping or delaying needed care in order to avoid paying these costs.
The bottom line: With Medicare Advantage, what you think is more could very well be less. Higher premiums and “additional benefits” may end up delivering far less than you might think. The problem is that you likely won’t find out the financial and administrative barriers to care you face until it’s too late to disenroll.
Here’s more from Just Care:
- Medicare ratings of Medicare Advantage plans a farce
- New study finds Medicare Advantage plan enrollees end up in lower quality nursing homes than people in traditional Medicare
- If you want easy health care access and good quality care, you probably want traditional Medicare
- Ten ways to improve Medicare Advantage
- Costs in Medicare Advantage present barrier to care
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