For nearly every state, November 1st marked the start of open enrollment season. This was met with mixed responses from some since many subscribers are still adjusting to the news of upcoming Medicare changes. In September, Medicare recipients learned their premiums would be rising in the new year, but they will see some savings in prescription medications with a new out-of-pocket maximum and caps on some of the priciest drugs.
Who is impacted?
It appears that Medicare Advantage (MA) members will have perhaps the most decisions to make, as data predicts that almost 2 million MA subscribers need to select new plans for 2025. Many older adults are having difficulty choosing the plan that is best for them due to uncertainty surrounding how the cost of their medications will change.
Age isn’t the only factor
Seniors are not the only group faced with decisions during this open enrollment period. Experts are also seeing that 47% of adults ages 18 to 43 have asked their parents for help choosing employer-sponsored health plans. This group has cited difficulties, including not knowing the official contact person to ask questions about their health plan and “blindly” choosing their health insurance plan in the past due to a lack of understanding.
Payers are feeling the strain
According to the InstaMed Consumer Healthcare Payments Survey, 71% of payers have reported a high volume of member calls for confusion about payment-related matters. While finding staff to handle these calls has become difficult, premium payments as a whole are also causing concerns. Almost half (45%) of health plans are reporting late or absent premium payments as an ongoing concern. Many members have also expressed a preference for electronic payments on their health plan’s website.
How can health plans respond effectively?
- Providing more outreach to assist all age groups in understanding the details of each plan in layman’s terms can help the plan selection process.
- Highlighting the best person to contact with questions about their plan can avoid incorrectly routed calls and limit hold times while improving member satisfaction. Health plans should create clear website directories with this information as well as various print materials. Instead of simply listing phone numbers and email addresses, payers should also include job titles so members understand who they are connecting with.
- Addressing member resources and overall brand strategy can improve member knowledge, satisfaction rates, and retention. This may involve revamping overall messaging, learning what members value the most, and developing programming that suits their needs.