Medicare Advantage (MA) plans are popular with the American public, with 32.8 million people enrolled in a health insurance plan. That figure comprises 54 percent of the entire Medicare population, according to the health care policy and research firm KFF.
Additionally, Medicare Advantage enrollment has risen from 19 percent in 2007 to 54 percent in 2024, KFF adds.
However, new research shows Medicare Advantage consumers aren't getting the added benefits as expected.
Data from a new study titled “The Use and Costs of Supplemental Benefits in Medicare Advantage” from Mass General Brigham shows MA participants aren’t receiving benefits they should be getting—and are already covering out-of-pocket expenses.
“As the privatized form of Medicare, Medicare Advantage plans advertise dental, vision, and hearing benefits not covered by traditional Medicare, but a recent analysis found that Medicare Advantage beneficiaries do not typically receive more of these supplemental services than traditional Medicare beneficiaries,” the study noted. “Additionally, out-of-pocket spending was similar for most supplemental services.”
A big part of the problem is that some MA recipients seem unaware they can receive benefits they already pay for each month.
For example, just 54.2 percent of Medicare Advantage beneficiaries were aware of having Medicare Advantage dental coverage. Meanwhile, 54.3 percent of MA payers were aware they had vision coverage. Consequently, over half of all Medicare Advantage enrollees “were no more likely” to get eye examinations, hearing aids, or other health services than traditional Medicare enrollees, the Brigham study noted.
“Medicare Advantage plans receive more money per beneficiary than traditional Medicare plans, but our findings add to the evidence that this increased cost is not justified,” said study co-author Dr. Christopher L. Cai in a press release. He is also a resident in the Department of Internal Medicine at Brigham and Women’s Hospital, where he and his team conducted the study research.
Study co-author Dr. Lisa Simon, assistant professor in the Division of General and Internal Medicine at Brigham and Women’s Hospital, added that Medicare Advantage recipients carry extra healthcare costs they shouldn’t be paying.
“Supplemental benefits are a major draw to Medicare Advantage,” Simon said in the press release. “However, our findings show that people enrolled in Medicare Advantage have no better access to extra services than people in traditional Medicare and that much of the cost comes out of their own pockets.”
The study focused on 76,000 Medicare beneficiaries active between 2017 and 2021. Researchers used healthcare industry studies such as the Medical Expenditure Panel Survey and the Medicare Current Beneficiary Survey to conclude what supplemental health services MA recipients aren’t getting and what they are paying monthly.
The Brigham study also noted some expanding and concerning cash outlay implications of Medicare Advantage plans on the healthcare system. On an annual basis, Medicare Advantage plans spend approximately $3.9 billion on vision and dental services. Yet Medicare Advantage recipients pay $9.2 billion in out-of-pocket costs for those same services.
“This raises substantial concerns about the sustainability of such a model, especially considering that Medicare Advantage plans receive $37.2 billion more from taxpayers than traditional Medicare would spend on the same beneficiaries,” the study noted.
NTD reached out to Medicare for comment but did not receive a response by publication time.