Medicare Advantage Disenrollment
Medicare insurance agents have their beneficiaries best intentions at heart. For most, their desire to help is the reason they entered the field in the first place. Being able to help clients choose which level of coverage and plan is best for them and their families is an honor. However, sometimes, for a variety of reasons, beneficiaries do not renew their insurance plans or even disenroll from them. These are types of Medicare Advantage Disenrollment. Beneficiaries that are enrolled in Medicare Advantage health insurance plans have the opportunity to disenroll from their plan and return to Original Medicare or switch to a different Medicare Advantage plan.
Most of the time, disenrollment is the beneficiary’s choice. However, there are instances when a person is forced to disenroll. Some of the reasons that a beneficiary would no longer be eligible for a Medicare Advantage plan and be forced to disenroll would be if they changed living locations and are no longer covered under their previous plan, if they lose Medicare eligibility, or if they do not pay their premiums. Some of the reasons that a beneficiary may choose to disenroll are if they are dissatisfied with their coverage, if their medical needs change, or if the out-of-pocket costs are too high for them to pay.
Why This Matters To Agents
This is important to know for a variety of reasons. Voluntary disenrollment statistics may shed light on things like beneficiary satisfaction, quality of plans and providers, and likelihood of renewal. A conscientious Medicare agent or broker should be aware of all of these factors when recommending plans to their clients. High, voluntary rates of disenrollment may be cause for hesitancy recommending that particular plan or carrier, especially if the agent is looking to maintain a good relationship with the beneficiary. In 2021, 17% of enrollees voluntarily disenrolled from their Medicare Advantage plans. This is a significant increase from 2010, in which only 10% of enrollees voluntarily disenrolled.
The two most cited reasons for disenrolling were plan coverage issues and financial concerns. In fact, on average, across Medicare Advantage contracts, nearly a quarter of those who disenrolled reported that it was coverage problems with physicians and hospitals that made their decision. The ratio was nearly the same for financial concerns, with nearly 24% reporting that as the main cause of their disenrollment.
These kinds of statistics are vital for agents to be aware of, particularly before enrollment periods. It would be foolish to recommend Medicare Advantage coverage for beneficiaries that have a high rate of disenrollment. This is beneficial for the agent’s sake and the beneficiary’s sake. Knowledge can help both agents and beneficiaries make informed decisions about their care and coverage moving forward.
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