Medicare Eligible Seniors Survey Findings: Technology, COVID-19, the 2020 Election and More...
Medicare Eligible Seniors Survey Results
One important takeaway from this survey is that seniors are embracing technology in new ways during the coronavirus pandemic. More than half of the respondents agreed that they have been using technology more during the pandemic.
Seniors are using technology for the following:
Healthcare: they are receiving virtual care through telemedicine, ordering prescriptions online and monitoring their health through wearables.
Information: they are using social media to stay informed on relevant news.
Communication: they are staying in touch with family and friends via texting, phone calls, video chat, and social media.
Entertainment: they are binge watching their favorite shows on smart TVs and streaming devices.
Technology Use Among Seniors in 2020
89% have a smartphone
83% use Facebook the most
75% have a smart TV or streaming device
73% use social media
68% have an iPad or other type of tablet
66% still have cable TV
61% feel they have embraced technology more during the COVID-19 pandemic
54% video chat with their kids and grandkids
50% have video chatted more since the start of COVID-19
47% binge watch shows
43% would wear a device that helped maintain appropriate social distance during the COVID-19 pandemic and alert others if they are too close
42% prefer talking on a cell phone as their method of communication
32% video chat with their friends
30% use social media to staying in touch with friends
29% prefer texting as their method of communication
28% monitor their health using a wearable (Apple Watch, Fitbit, etc.)
22% use social media to stay in touch with family
21% use social media for news
11% started using a smartphone or tablet during the pandemic
Life During COVID-19
64% have only left the house to go food shopping or to the pharmacy during COVID-19
62% have you seen their kids or grandkids in person since mid-March
54% have put off a dentist appointment because of COVID-19
27% have left their house whenever they wanted during COVID-19
2020 Medicare Usage and Preferences
97% say their doctor accepts Medicare
84% are not looking to switch doctors because they don’t accept medicare
69% with a Medicare Advantage plan are happy with it
51% think the age to be eligible for Medicare should be lowered to 60
39% look for a Medicare a plan that accepts their doctor
37% think seniors who have a Medicare Advantage plan and who contract COVID-19 are getting better care
26% look for a Medicare plan with low monthly premiums and copays
26% intend to switch from an Original Medicare to a Medicare Advantage plan in the next enrollment period
22% look for a medicare plan that has extra benefits (ie. dental, vision, hearing, fitness programs)
22% intend to change their prescription drug plan in the next enrollment period
20% plan to adjust their Medicare plan during the next annual enrollment period (Oct. 15 - Dec. 7)
12% used the special enrollment period to enroll in Medicare during COVID-19
89% think prescription drug prices are too high
36% spend more than $50 a month on prescription drugs
34% order prescriptions from an online pharmacy
66% are worried about out-of-pocket costs
62% are you worried about receiving an unexpected medical bill
50% have money set aside for their children or family to use for their health needs
36% have put off seeing a doctor because of cost
35% are worried about contracting COVD-19 because they may be hit with a surprise bill
68% of those who haven’t used telemedicine during COVID-19 say its because they haven’t needed to
58% have used telemedicine just once during COVID-19
44% have used telemedicine during COVID-19
43% intend on using telemedicine once COVID-19 passes
30% have used telemedicine once a month during COVID-19
10% used telemedicine before COVID-19
The 2020 Presidential Election
92% say lowering drug prices is an important topic in the upcoming election
84% haven’t seen the country more divided in their lifetime than it is now
68% say the economy and healthcare are the two most important issues to them in the 2020 election
58% will vote via mail-in ballot in November
42% will vote in person in November
The above results were gathered through an online poll of more than 1,000 Medicare eligible Americans ages 64+. The poll was conducted from July 20, 2020 to July 21, 2020, gleaning representative samples from each state based on population.
Trump Administration Issues Call to Action Based on New Data Detailing COVID-19 Impacts on Medicare Beneficiaries
Today, under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) is calling for a renewed national commitment to value-based care based on Medicare claims data that provides an early snapshot of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the Medicare population. The data shows that older Americans and those with chronic health conditions are at the highest risk for COVID-19 and confirms long-understood disparities in health outcomes for racial and ethnic minority groups and among low-income populations.
“The disparities in the data reflect longstanding challenges facing minority communities and low income older adults, many of whom face structural challenges to their health that go far beyond what is traditionally considered ‘medical’,” said CMS Administrator Seema Verma. “Now more than ever, it is clear that our fee-for-service system is insufficient for the most vulnerable Americans because it limits payment to what goes on inside a doctor’s office. The transition to a value-based system has never been so urgent. When implemented effectively, it encourages clinicians to care for the whole person and address the social risk factors that are so critical for our beneficiaries’ quality of life.”
The data released today includes the total number of reported COVID-19 cases and hospitalizations among Medicare beneficiaries between January 1 and May 16, 2020. The snapshot breaks down COVID-19 cases and hospitalizations for Medicare beneficiaries by state, race/ethnicity, age, gender, dual eligibility for Medicare and Medicaid, and urban/rural locations. The new data show that more than 325,000 Medicare beneficiaries had a diagnosis of COVID-19 between January 1 and May 16, 2020. This translates to 518 COVID-19 cases per 100,000 Medicare beneficiaries. The data also indicate that nearly 110,000 Medicare beneficiaries were hospitalized for COVID-19-releated treatment, which equals 175 COVID-19 hospitalizations per 100,000 Medicare beneficiaries.
Blacks were hospitalized with COVID-19 at a rate nearly four times higher than whites. The disparities presented in the snapshot go beyond race/ethnicity and suggest the impact of social determinants of health, particularly socio-economic status.
Other key data points:
End-stage renal disease (ESRD) patients (individuals with chronic kidney disease undergoing dialysis) had the highest rate of hospitalization among all Medicare beneficiaries, with 1,341 hospitalizations per 100,000 beneficiaries. Patients with ESRD are also more likely to have chronic comorbidities associated with increased COVID-19 complications and hospitalization, such as diabetes and heart failure.
The second highest rate was among beneficiaries enrolled in both Medicare and Medicaid (also known as “dual eligible”), with 473 hospitalizations per 100,000 beneficiaries.
Among racial/ethnic groups, Blacks had the highest hospitalization rate, with 465 per 100,000. Hispanics had 258 hospitalizations per 100,000. Asians had 187 per 100,000 and whites had 123 per 100,000.
Beneficiaries living in rural areas have fewer cases and were hospitalized at a lower rate than those living in urban/suburban areas (57 versus 205 hospitalizations per 100,000).
The snapshot also shows that besides higher hospitalization rates, beneficiaries enrolled in both Medicaid and Medicare have a higher infection rate of COVID-19, with 1,406 cases per 100,000 beneficiaries. By comparison, the coronavirus infection rate for beneficiaries enrolled only in Medicare is 325 cases per 100,000. The rate of COVID-19 cases for dual eligible individuals is higher across all age, sex, and race/ethnicity groups. Previous research has shown that these individuals experience high rates of chronic illness, with many having long-term care needs and social risk factors that can lead to poor health outcomes.
Given the complexity of these disparities, any solution requires a multi-sectoral approach that includes federal, state, and local governments, community based organizations, and private industry. One piece of this is the increased implementation of a value-based system that rewards providers for keeping patients healthy and gives consumers the information about disease prevention and outcomes needed to help make healthcare choices on the basis of quality. Additionally, CMS is encouraging states to double down on efforts to protect low income seniors and look at the data and determine what resources are available, both locally and federally, to improve this disparity of health outcomes. CMS has identified a range of operational opportunities for states to improve care for dually eligible individuals and a variety of models that states can participate in that focus on improving the quality and cost of care for individuals who are concurrently enrolled in Medicaid and Medicare.
The Center for Medicaid and Children’s Health Insurance Program (CHIP) Services is developing guidance for states on new opportunities to adopt innovative, value-based payment design and implement strategies to address social determinants of health for their beneficiaries, including those who are dually-eligible for Medicare and Medicaid. In addition to these ongoing efforts and programs, the CMS Office of Minority Health will be holding a series of listening sessions with key stakeholders responsible for providing care to racial and ethnic minorities. These listening sessions are intended to help refine the ongoing outreach and work by CMS to improve future efforts on this issue.
CMS typically releases Medicare claims information on an annual basis when there are more complete claims and encounter data. However, as part of the agency’s efforts to provide data transparency during the pandemic and ensure the public has this vital information as soon as it is available, CMS is releasing this preliminary data now. The data will be updated on a monthly basis as more claims and encounter records are received. CMS anticipates releasing similar information on Medicaid beneficiaries in the future.
Social Security Admin Expands Online Medicare Enrollment Process on SSA.gov
By Casey Schwarz - Medicare Rights - June 11, 2020
The Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) recently expanded the functionalityof the Medicare enrollment process to accommodate more online applications during the coronavirus pandemic.
Previously, only people applying for Medicare Parts A and B at the same time could use the online portal. People who were already enrolled in Part A and were using a Special Enrollment Period (SEP) or seeking Equitable Relief to enroll in Part B had to submit documentation to SSA in person or via fax—an option made available during the current public health emergency.
Advocates, including the Medicare Rights Center, have long called for a user-friendly online tool to allow for Part B enrollment. We applaud CMS and SSA for introducing this improvement and urge its permanent adoption.
4 in 10 Insurance Agents Say They'll Continue Working from Home Post-Pandemic
A Channel Harvest Research survey of U.S. independent insurance agencies reveals about half expect to make no permanent transition to working at home when the pandemic is over, and all staff would return to the office.
However, 27% said at least some staff would continue to work from home, and 10% said that all employees would work at home. About 13% said they weren't yet sure what they would do.
Each year, Channel Harvest conducts an extensive survey of thousands of independent agents around the U.S., and recently published its 2020 report. Its first pandemic-related instant poll was conducted April 15-16, with the latest May 20-21. Some 200 agents responded to each.
When combining those who say they're going back to the office along with those who aren't sure, the result is that 63% of agents say they have no firm plans to continue remote work once the pandemic is over, noted John Campbell, Channel Harvest principal. "And that's probably an underestimate, as people tend to overestimate their ability and willingness to change things," he said.
Morale Holding Up
In a follow-up to the April poll, agents were asked to rate the overall feeling and morale among their workforce on a scale of 0 (terrible) to 10 (wonderful).
Just 7% reported low morale (0-3 on the scale), down from 9% a month ago. And 38% said average (4-6), which is unchanged. Some 55% said morale is good (7-10), up slightly from last month. "Morale is holding, and agents generally are looking forward to a return to normal, rather than a new normal," said Campbell.
About half of respondents reported their agency revenue has dropped since the crisis started in early March, Channel Harvest found. This is an increase from the April survey, where 41% had reported a decrease.
On the other hand, 17% said they have posted increased revenue during the crisis, up from 10% in the April survey.
Life at Home
Many agents offered their opinions of working at home, and those who pre-planned for remote work were grateful they had prepared ahead of time with technology, phone systems and workflows. Here are some related comments:
"I had changed to a work-at-home status several years ago. We are able to perform all of our duties via phone, email, video conference or, meeting at their home/office just as well as in our own office."
"We have learned a lot -- will come through this with new skills."
"Working from home has been a dream! I have no desire to return to the office. I would prefer to continue working in the privacy and safety of my own home."
"Our agency did a test run on the virtual office concept in 2011. The best thing about this crisis is that 98% of all our mail is now received by email, whereas back in 2011 it was 75%. Now it's possible to not have a physical office to process the incoming mail. We can drop mail in the working folders and allow staff to pick out their clients to process."
"My agency embraces technology and supports their employees. We were very proactively sent home with our computers and phones, to start working at home. It was seamless -- I have worked at other agencies. This is by far the most impressive one, from leadership, management and our tech support. The clients do not even know we are working from home when they call in for something."
"I've been working from home full-time since our state stay-at-home order. We now have the possibility to work from home full time and our company can look for a smaller space when the lease is up. I have felt less stressed and my quality of life has improved. I miss my work family but we stay in touch and continue to keep our culture."
"Remote officing works! Agencies better get behind this or risk losing their employees to agencies that do!"
On the other hand, some respondents say they will be happy to return to the agency office:
"It has been hard to stay out of the office and not personally see our clients. We have a relationship with most of them and feel not being there personally is not right. We have two staff members who have been going into the office and only using the lobby for contact. No one is going back to the offices. We are a very friendly group and this has been a real change for us."
"Now that we are back in the office partially, we are seeing a better flow. People are happier now."
"It will be a fight to get everyone back to the office. My goal is to start with volunteers after Labor Day and have everyone here by 12/31. But I suspect some like being at home and do not want to return. Some will be afraid to return."
Some respondents also commented on revenue issues:
"The most difficult issue is generation of leads/new business opportunities. It has seemed insensitive to consider calling on owners who have had to deal with employee safety, devastating economic impact, and employee retention these past months."
"I feel sales will increase ... once clients feel somewhat comfortable with virus and another increase does not happen. If a second wave occurs it will be devastating for many people."
Biden’s ‘Medicare At 60’ Gains Momentum In Coronavirus Era
A proposal by Democrat Joe Biden to allow Americans between the ages of 60 and 64 the option of buying into Medicare is gaining more attention as more people lose employer-sponsored health coverage in the era of the coronavirus strain Covid-19.
And Medicare would be particularly attractive to Americans with employer-sponsored coverage who are looking to retire early or have recently lost their jobs as companies close their doors and lay off workers during the spread Covid-19.
“As the economy works to recover on the heels of the Covid-19 pandemic, guaranteeing coverage for the country’s oldest workers at a somewhat modest cost may have wide appeal,” Dr. Zirui Song, of the department of health care policy at Harvard Medical School in Boston wrote in Friday’s JAMA(companion article) about the potential implications of lowering the age for Medicare eligibility. “Lowering the Medicare eligibility age to 60 years would achieve meaningful coverage gains while disrupting commercial insurance less than would a broader public option or Medicare-for-All program.”
Biden’s Medicare proposal is part of his campaign’s pledge to build on the Affordable Care Act. Biden’s Republican opponent, Donald Trump, however, hasbeen working to uproot the ACA as well as its subsidized individual coverage known as Obamacare and also opposes expanded Medicaid. And the Justice Department under Trump appointees have been working with Republican attorneys generalto repeal the ACA.
The latest analysis of Biden’s proposal indicates it would be cost effective and less disruptive to the commercial insurance market than a single payer version of “Medicare for All” that would uproot the private health insurance industry and essentially bring an end to the role of private insurers.
“Evidence on the effect of entering Medicare from employer-sponsored coverage shows that, at age 65 years, Medicare enrollment leads to decreased health care spending by about 30% without changes in utilization; virtually all of this reduction is related to lower prices for services—that is, Medicare reimburses physicians and hospitals less than private insurance,” Songwrote in JAMA.“Therefore, the policy would increase public spending by replacing some of today’s private spending with federal dollars, although notably at lower prices.”
Details of Biden’s proposal have yet to emerge other than the brief description that emerged less than two months ago. Biden said the idea was to allow Americans to have more choices than they do now and allow them to keep their employer coverage if they so desired.
Biden’s proposal to introduce a public option and expand existing Medicare is in line with public sentiment heading into the heat of the summer and fall Presidential election campaign.The latest data from the Kaiser Family Foundation’s health tracking poll show nearly 70% of Americans favor a public option, which is a percentage that has largely held steady since January and “before coronavirus became a major concern in the U.S.”
The Kaiser poll also showedmore than half, or 51% of the American public “now holds favorable views toward” the ACA while 41% hold “unfavorable views.” The poll was conducted May 13-18, Kaiser said, from a sample of nearly 1,200 adults.
As an increasing number of Americans continue to work beyond the traditional retirement age of 65, many have delayed enrolling in Medicare as they continue to enjoy employer-subsidized health insurance. But now that more than a million older workers have lost their jobs — and their health insurance — many are finding that trying to enroll in Medicare during a pandemic is complicated.
The unemployment rate among people age 65 and older quadrupled between March and April,from 3.7% to 14.7%, according to the Kaiser Family Foundation. More than 1.2 million adults age 65 and older lost their jobs in March and April and in many cases, their health insurance, too.
Although this group of unemployed workers is eligible for Medicare, delayed enrollment after age 65 is normally handled by visiting one of the local Social Security field offices, which have been closed to the public since March 17 as a result of the pandemic. Medicare is managed by the Centers for Medicare and Medicaid Services, but the Social Security Administration processes the applications.
“We have seen an increase in calls from people who have lost their jobs and are looking to go on Medicare,” said Frederic Riccardi, president of the nonprofitMedicare Rights Center, which fields more than 20,000 questions a year through its free consumer helpline (800-333-4114).
“People are calling because they are confused about how to enroll in Medicare,” Riccardi said. “It is really important to sign up for Medicare as soon as possible to avoid any gaps in coverage and lifetime late enrollment penalties.”
Most people can use theonline application to apply for Medicare to enroll in Parts A and B during their initial enrollment period, which begins three months before their 65th birthday, includes their birthday month and extends three months after their 65th birthday.
Medicare Part A covers in-patient hospital costs and is premium-free to anyone who has earned the minimum of 40 quarters of coverage and paid FICA taxes during at least 10 years of covered employment. Spouses are also eligible for premium-free coverage. Medicare Part B covers outpatient services and has a monthly premium, currently $144.50 per month in 2020. High-income beneficiaries pay more.
Many people enroll in Part A at 65, even if they continue to work, because it is premium-free.
In most cases, people who miss enrolling in Medicare Part B during their initial enrollment period facelifelong delayed enrollment penaltiesof 10% per year for every year they were eligible to enroll but did not.
But there is one major exception to the Medicare Part B signup rule: continued group health insurance coverage through a current employer or through a spouse’s current employer. People who have “creditable” group health insurance can delay enrolling in Medicare penalty-free for up to eight months after that employer coverage ends by taking advantage of a special enrollment period.
The challenge is how to sign up for coverage during a special enrollment period when the Social Security offices that take the applications are closed.
The Social Security Administration offers the following guidance:
Normally if you are applying for Medicare Part B as part of a special enrollment period as a result of losing group health insurance, your employer has to attest that you had creditable health insurance during the previous eight months. Given the pandemic, federal officials are allowing applicants to fill out that form on behalf of their employer and submit proof that they had health insurance, such as income tax returns that show health insurance premiums paid, W-2s reflecting pretax medical contributions or pay stubs that list health insurance premium deductions.
The Medicare Rights Center recommends that you send your paperwork to your local Social security office by certified mail so you will have a receipt and confirmation that your form was delivered in case you encounter any problems with your enrollment. If you speak to anyone at your local office, record the name of the representative you speak to and the date and time of the conversation. And if you experience difficulties with your local Social Security office, such as being told your enrollment cannot be processed, ask to speak to a supervisor. If that doesn’t resolve the problem, contact your congressman for help.
There is another complicating factor when it comes to losing a job and employer-provided health insurance. In some cases, unemployed workers can continue their group health insurance for 18 months under COBRA, usually paying the entire cost of the premium, both the employer and the employee portion. But COBRA and retiree health plans aren’t considered coverage based on current employment. You must sign up for Medicare Part B within eight months of losing employer-provided health insurance — not eight months after your COBRA coverage ends — to avoid delayed enrollment penalties.
New Poll Highlights Impact of Coronavirus on Health, Economic, and Food Security
A new Kaiser Family Foundation (KFF)Health Tracking Polloffers insights into the impact of the coronavirus on American’s personal health, economic, and food security, as well as about the Medicaid program.
The findings expose some troubling trends. Nearly half of adults (48%) say they or someone in their household have postponed or skipped medical care due to the outbreak, and 11% say their or their family member’s condition worsened as a result.
At the same time, about four in ten adults report that coronavirus-related stress has negatively impacted their mental health, including 12% who say it has had a “major” impact. Income or job loss may exacerbate these harms. Among adults in such households (who make up one-third of adults overall), 46% say the pandemic has had a negative impact on their mental health.