As America's Seniors Continue to Age, Medicare Insurance Market Becomes More Intricate
The number of Americans 85 and older will increase sharply between now and 2040. Will Medicare be able to keep up with their services and needs? Ensurem's Dave Rich explains how these seniors will need to navigate and deal with the ever-increasing complexities of this health care system.
CLEARWATER, Fla., Aug. 4, 2021 /PRNewswire-PRWeb/ -- The overall population of Medicare recipients will grow by 37% between 2020 and 2040 as the baby boom generation reaches retirement age.(1) In addition to increasing in size, says Dave Rich, CEO of Ensurem, Florida-based insurance technology and product distribution firm, the Medicare enrollee population's age demographics will change significantly. Currently, he notes, just under 11% of Medicare enrollees are 85 or older (or non-baby boomers);(2) however, that number is projected to more than double, from 6.5 million in 2018 to 14.4 million in 2040—a fact with serious implications for the entire senior healthcare delivery system.(3) "As the Medicare enrollee population skews older," says Rich, "the need for additional services will increase the complexity of an already very complex market."
A major factor in this increased complexity, says Rich, will be continued growth in the popularity of Medicare Advantage. Currently, 42% of all Medicare enrollees opt for coverage under a private Medicare Advantage plan,(4) a share that is all but certain to grow as seniors seek services not covered by traditional Medicare. This in turn will drive an increase in the complexity of the choices seniors are required to make—which is already, he notes, considerable. Already in 2021, the average Medicare beneficiary is being asked to choose from among 33 different Medicare Advantage plans.(4)
The situation is made more confusing still, Rich points out, by the government's rules surrounding Medicare Part A and Part B sign-up periods. Adding to the confusion are Medicare Supplement plans, also known as Medigap.(5)
The largest factor driving complexity in the market, Rich notes, healthcare cost is a major element in essentially all older peoples' financial considerations. On average, healthcare spending in the United States for the 45 to 64-year-old age group is $6,406 per year; for the 65+ age group, it is $11,316, or more than $900 per month.(6)
The need for assisted living and long-term care, which often arises with beneficiaries in the 85+ age cohort, can dramatically increase month-to-month medical expenses, notes Rich, adding that this is an area in which seniors and their advisors need to pay particular attention to the details of specific plan offerings. Traditional Medicare does not cover costs for most types of long-term care, including Alzheimer's and dementia care. When it does pay, it is only in a very limited capacity.(7) Medicaid, a joint federal and state program, may cover some or all nursing home costs based on need. In the event of a terminal illness with a life expectancy of six months or less, traditional Medicare covers virtually all the cost of hospice care.(8)
Ensurem, says Rich, essentially exists as a way for seniors to understand their options in the increasingly complex industry of Medicare insurance, particularly Medicare Advantage coverage. Acting as a consultant to insurance shoppers, it seeks to identify a given client's specific coverage needs and match them to the lowest available premium. As a wave of increasingly elderly beneficiaries approaches, Rich points out, it is time to prepare for it by making the most of recently available technology, and by addressing cost and efficiency issues on an industry-wide basis.
"As the Medicare enrollee population grows older and their needs increase," says Rich, "seniors will need to understand their options and make the best possible choice. It is incumbent upon all of us in the senior healthcare delivery system to make certain that they understand their choices, and that their needs are being met."
About Ensurem
Ensurem, headquartered in Clearwater, FL, is a leading technology and product distribution company serving carriers and consumers within the massive U.S. senior market. The company provides end-to-end solutions for carriers, including product development, digital marketing, and consumer-centric front ends and back end. For more information, please visit Ensurem.com.
1. "Projected Change in Medicare Enrollment, 2000-2050." KFF, 12 Mar. 2013, kff.org/projected-change-in-enrollment-2000-2050-medicare/.
2. Elflein, John. "Distribution of Medicare Beneficiaries by AGE 2019." Statista, 23 June 2021, statista.com/statistics/248035/distribution-of-medicare-beneficiaries-by-age/.
3. "Profile of Older Americans." ACL Administration for Community Living, acl.gov/aging-and-disability-in-america/data-and-research/profile-older-americans.
4. Freed, Meredith and Biniek, Jeannie Fuglesten. "Medicare Advantage IN 2021: Enrollment Update and Key Trends." KFF, 24 June 2021, kff.org/medicare/issue-brief/medicare-advantage-in-2021-enrollment-update-and-key-trends/.
5. "Part a & Part b Sign up Periods." Medicare, medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/part-a-part-b-sign-up-periods.
6. Androus, Amanda Bucceri. "Healthcare Costs & SPEND: Rising by Age, Gender, and Race." Healthcare Costs & Spend: Rising by Age, Gender, and Race, RegisteredNursing.org, 12 June 2021, registerednursing.org/articles/healthcare-costs-by-age/.
7. Cobb, Daniel. "Medicare Benefits for Assisted Living & Long Term Care." Payment Options & Financial Assistance for Senior Care, PayingforSeniorCare.com, 25 June 2021, payingforseniorcare.com/medicare.
8. "What Medicare Covers." Medicare, medicare.gov/what-medicare-covers.
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SOURCE Ensurem
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