Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
J Am Geriatr Soc. 2020 Oct;68(10):2343-2347. doi: 10.1111/jgs.16656. Epub 2020 Jun 20.
BACKGROUND/OBJECTIVES: The Medicare Advantage (MA) program insures a rapidly growing proportion of older adults, and may be more appealing due to lower cost sharing. However, the extent to which older adults are informed of their plan benefits and how plan knowledge has changed over time is unclear. We evaluated temporal trends and characteristics associated with not knowing MA coverage for dental, vision, and nursing home (NH) services.
Longitudinal cohort study.
Medicare Current Beneficiary Survey (MCBS), 2010 to 2016.
Adults aged 65 years or older enrolled in MA plans and not in Medicaid.
Insurance knowledge was determined from separate items asking if individuals had coverage through their MA plan for dental, vision, and NH care. Responses were dichotomized between responding yes/no and not knowing. Demographic, clinical, and functional characteristics were assessed from the MCBS.
The proportion of older adults in MA who did not know if their plan covered NH care increased from 38.0% in 2010 to 45.5% in 2016. However, proportions of not knowing dental benefits decreased from 6.4% in 2010 to 3.4% in 2016 and not knowing vision benefits decreased from 8.2% in 2010 to 5.9% in 2016. We found significant associations of race, education, income, region, and disability with knowledge of MA benefits.
As enrollment in MA plans has grown, older adults in MA plans increasingly report that they know their plan's vision and dental benefits, although they decreasingly know about NH care. Older adults from racial and ethnic minority groups, with lower levels of education and income and who reside in certain regions or have functional disability, are less likely to know their plan benefits. This may imply decreasing preparedness for future long-term care needs. J Am Geriatr Soc 68:2343-2347, 2020.
背景/目的：医疗保险优势（MA）计划承保了越来越多的老年人，由于分担成本较低，该计划可能更具吸引力。然而，老年人对其计划福利的了解程度以及这些知识随时间的变化情况尚不清楚。我们评估了不知道 MA 计划对牙科、视力和疗养院（NH）服务覆盖情况的时间趋势和相关特征。
纵向队列研究。
医疗保险当前受保人调查（MCBS），2010 年至 2016 年。
年龄在 65 岁或以上，参加 MA 计划但未参加医疗补助的成年人。
通过单独的项目询问个人是否通过 MA 计划获得牙科、视力和 NH 护理的保险，根据是否回答“是”或“否”以及不知道来确定保险知识。从 MCBS 评估人口统计学、临床和功能特征。
在 MA 计划中不知道其计划是否覆盖 NH 护理的老年人比例从 2010 年的 38.0%增加到 2016 年的 45.5%。然而，不知道牙科福利的比例从 2010 年的 6.4%下降到 2016 年的 3.4%，不知道视力福利的比例从 2010 年的 8.2%下降到 2016 年的 5.9%。我们发现种族、教育、收入、地区和残疾与 MA 福利知识显著相关。
随着 MA 计划的参保人数增加，MA 计划中的老年人越来越多地报告他们知道自己计划的视力和牙科福利，但他们对 NH 护理的了解却越来越少。来自种族和少数民族群体、教育程度和收入较低、居住在某些地区或有功能残疾的老年人，不太可能了解他们的计划福利。这可能意味着他们对未来的长期护理需求准备不足。美国老年学会杂志 68:2343-2347, 2020.
