Don't Punish 60 Million Medicare Beneficiaries Because of Joe Namath

Commentary April 11, 2023 at 03:18 PM
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We all see the TV commercials every day with Joe Namath, Jimmy "Dynomite!" JJ Walker, William Shatner and many others encouraging seniors to call a 1-800 number to learn more about the many benefits of enrolling in a Medicare Advantage plan.

Celebrity endorsement of products and services is nothing new in this country and is as American as baseball and apple pie.

But what is new is the government reacting to TV advertising by cutting off the consumer from information, freedom to choose, and advisors to answer their questions and help them enroll in Medicare plans when they are ready.

A 48-Hour Wait

Imagine a world where a person is mandated to wait 48 hours from the time they request information about buying a vehicle, a computer or a TV, or about looking for a doctor or a lawyer until they are allowed to speak with anyone and move forward.

Well, that is exactly what the recently proposed changes to Medicare by the Centers for Medicare and Medicaid Services (CMS) will do by forcing a person seeking more information about enrolling in a Medicare Advantage plan to wait 48 hours before they could speak with anyone.

CMS has proposed several new changes related to the marketing of Medicare Advantage plans that will harm the consumer by creating confusion, frustration and delays during the enrollment process, reduce competition and impede access to health care options for seniors attempting to enroll in Medicare plans.

A forced 48-hour waiting period takes away a senior's right to decide when to meet with an agent to discuss enrollment and puts them at risk of missing their eligibility period for enrollment through the annual enrollment period, the open enrollment period and special enrollment periods.

CMS should take seriously the impact of unintended negative consequences that these proposed new rules will cause:

  • Limited options for seniors to compare Medicare Advantage plans from multiple companies.
  • Restricted access to independent agents to provide multiple plan options instead of captive agents that can sell products from only one carrier.
  • Reduced awareness among seniors of the choices they may have when it comes to their Medicare coverage and options.

Because of this mandated wait period for Medicare enrollees, a significant number of seniors will delay, forget or give up on getting expert assistance for their enrollment needs leaving them with inadequate or no coverage at all (there are limited windows of eligibility to enroll that can't be missed).

As is the case with most things, people have a tendency to procrastinate when enrolling in Medicare plans and often find themselves within the 48-hour window before the deadline to act.

Studies have shown a large percentage of seniors wait until they are within 48 hours of their enrollment deadline to make a plan selection.

The Impact

This mandatory embargo from access to advisors will cause potentially millions of seniors to unintentionally and unexpectedly miss their enrollment deadlines suffering both financial and health-related consequences.

Today, nearly half of eligible Medicare beneficiaries — 30 million people out of 65 million Medicare beneficiaries overall — are enrolled in Medicare Advantage plans.

There are 3,998 Medicare Advantage plan options available in the United States in which people can enroll.

Restricting the ability for consumers to access an insurance agent to help guide them through such a large array of options and then guide them through the enrollment process will only serve to confuse and frustrate consumers and will ultimately undermine their ability to access the care they need — and deserve.

High Satisfaction Levels

Numerous expert sources cite high consumer satisfaction with Medicare Advantage plans, growth in enrollments, and little to no influence on their decision-making based on TV commercials:

  • BCBS.com reports that 98% of beneficiaries say they are satisfied with their Medicare Advantage plan, and 97% express satisfaction with their network of physicians, hospitals and specialists.
  • The J.D. Power 2022 Medicare Advantage Study measures enrollee satisfaction based on six factors (in order of importance): coverage and benefits; provider choice; cost; customer service; information and communication; and billing and payment. The study received responses from 3,094 members of Medicare Advantage plans across the United States showing customer satisfaction has been on the rise for the last eight years with Medicare Advantage plans rated 809 on a 1,000-point scale.
  • According to Medigap.com's Medicare Advantage Survey, beneficiaries report overall satisfaction with their plan enrollment, but those dissatisfied often cite difficulty finding providers and confusion over the cost of their copays or other related expenses, and they would be more satisfied if they understood the terms and conditions of the Medicare Advantage plan before signing up for it.

Placing an information embargo on consumers and making it more difficult for them to access expert advice and help with enrollment would only make matters worse.

Also, the vast majority of enrollees said TV advertising had little to no effect on their decision-making and enrollment process.

Comparatively, only 12.96% said they joined because of marketing and advertising campaigns about added benefits, and advertising campaigns don't influence the majority of Medicare beneficiaries.

It is clear that Medicare Advantage enrollees are overwhelmingly satisfied, but impeding consumers from getting timely information about plan types, features, and then help with enrollment when needed would cause confusion, frustration and widespread dissatisfaction among millions of Medicare beneficiaries.

Information is power and a well-informed consumer will be able to make better decisions than one who is restricted from accessing information and advisors at the time that they are needed.

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CMS implementing a 48-hour "blackout" rule would be an unprecedented trampling of consumers' rights to speak with an expert at exactly the time they want and need them most.

That is the opposite of baseball and apple pie, and I'm sure Joe Namath would agree that it just doesn't make any sense!

(Image: Adobe Stock)


Chris Orestis, Life Care Funding LLC Photos by Brian Fitzgerald.Chris Orestis is president of Retirement Genius. He is a former lobbyist who has worked in both the White House and for the Senate majority leader on Capitol Hill.

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