While all insurers offering Medicare Advantage (MA) profit more the less care they deliver, every Medicare Advantage plan is different; we should not generalize about them. We know that access to care can be a serious issue in MA, with some insurers using artificial intelligence to deny care, others relying on prior authorization requirements to delay and deny care and others offering provider networks that do not meet enrollees’ needs. A new Commonwealth Fund survey confirms that access to care continues to be a far more serious concern for MA enrollees than for Traditional Medicare (TM) enrollees.
The Commonwealth Fund survey of more than 3,200 people with Medicare found that more than one in five people (22 percent) enrolled in Medicare Advantage reported delays in receiving care, as compared with one in eight (13 percent) enrolled in Traditional Medicare.
Wait times to see physicians did not vary between people in Traditional Medicare and people in Medicare Advantage. But, one in three people polled said they waited more than a month to see a physician.
People in MA reported significantly higher financial barriers to care than people in Traditional Medicare. Twelve percent of people in MA faced cost barriers to care, in the form of either a deductible or a copay, as compared with seven percent of people in Traditional Medicare. The five percent difference is especially telling, given people in MA overall are healthier than people in TM.
Satisfaction was relatively the same for people with Traditional Medicare and Medicare Advantage.
Here’s more from Just Care:
- Medicare should increase physician pay to ensure good access to care
- People in Medicare Advantage trade away access to care
- 2024: Access to Medicare mental health services is expanding
- Government watchdog agencies tell Congress Medicare Advantage inappropriately restricts access to care and needs fixing
- Do Medicare Advantage plans give you appropriate access to doctors?
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