Compared to people with employer-sponsored insurance, people with Medicare report fewer problems with medical bills and with accessing care because of costs. These findings were part of a Commonwealth Fund study that was recently published in Health Affairs. According to the article, “Medicare Beneficiaries Are Less Likely to Experience Cost and Access Related Problems than Adults with Private Coverage,” Medicare beneficiaries have lower out-of-pocket health care expenses as a share of income and fewer financial problems because of medical bills compared to people who are privately insured.
Researchers used the Commonwealth Fund 2010 Health Insurance Survey to compare the experiences of Medicare beneficiaries over the age of 65 to younger adults enrolled in private, employer-sponsored insurance. Researchers also compared the experiences of people with traditional fee-for-service Medicare to those with Medicare private health plans, also known as Medicare Advantage plans. Researchers found that while Medicare beneficiaries have more health problems and lower incomes than people with employer insurance, beneficiaries are less likely to pay 10 percent or more of their incomes on out-of-pocket health costs. Researchers attributed this difference to the fact that 83 percent of Medicare beneficiaries surveyed had additional coverage in the form of a retiree plan, a Medigap policy or Medicaid. However, just having insurance comes at a cost: other studies have shown that people with Medicare spend two-thirds of all their health care expenses on premiums. Paying to retain supplemental coverage allows beneficiaries to protect themselves against unexpected, catastrophic medical bills.
The study also found that Medicare beneficiaries are more satisfied with their health insurance compared to people with private insurance. According to the study, only eight percent of Medicare beneficiaries rated their insurance as fair or poor, compared to 20 percent of people with employer-sponsored insurance and 33 percent of people who purchased private insurance on the individual market. Researchers also found that Medicare beneficiaries are more likely to have regular access to a doctor or a place of care with knowledge of their health history, and access to a doctor who coordinates their care with other providers.
According to the article, policymakers looking for ways to reduce costs in the Medicare program should acknowledge that Medicare beneficiaries have more positive experiences with their health coverage than do people with private insurance. Recent premium support proposals would convert Medicare into a program under which beneficiaries would receive cash vouchers to purchase private health insurance. These plans could leave beneficiaries at increased risk for problems obtaining needed care and shift more costs to people with Medicare as plan premiums and out-of-pocket expenses rise.