Celebrating 60 Years of Medicare: Increasing Support Needed for Annual Enrollment

This week marks the 60th anniversary of Medicare, a milestone in American healthcare history. Signed into law by President Lyndon Johnson, Medicare initially provided health coverage for Americans over 65. Today, nearly 69 million Americans depend on this federal program, which now includes those with significant disabilities as well.

The program is divided mainly into traditional Medicare, managed directly by the government, and Medicare Advantage plans offered through private insurance companies with federal funding. This diversity of options creates a complex decision-making landscape for beneficiaries.

Recent studies from the University of Michigan highlight a crucial need for more comprehensive guidance during Medicare enrollment. One study published in the Journal of the American Geriatrics Society reveals that only about 38% of seniors who switch Medicare plans receive any assistance, with even fewer among those without family caregivers. Overall, only 13% of enrollees change plans each year. Furthermore, only one-third of Medicare beneficiaries utilize the internet to research plans and coverage options, and this usage is significantly lower among those with lower income or educational attainment. The COVID-19 pandemic further reduced the assistance received, although online usage has seen a sharp increase in recent years.

Another study published in Alzheimer's & Dementia: Behavior & Socioeconomics of Aging shows that seniors with dementia tend to choose similar Medicare Advantage plans as those without dementia, indicating a lack of tailored support for their specific healthcare needs. Interestingly, individuals with dementia who qualify for both Medicare and Medicaid are more likely to select specialized plans with more extensive care management features.

The decision-making process is further complicated by the multitude of available plans, including add-on options for prescription drug coverage and other benefits. With open enrollment occurring annually from mid-October to early December, older adults face a critical challenge in making informed choices.

Fortunately, free, unbiased resources like the State Health Insurance Assistance Program (SHIP) provide counseling to help beneficiaries navigate their options. The Medicare Plan Compare tool is another valuable resource, offering plan ratings and reviews based on quality and satisfaction. However, many beneficiaries rely on mailed advertisements and word of mouth, which often lack detailed information about plan benefits, provider networks, and costs.

Experts emphasize the importance of understanding not just premiums, but also copays, deductibles, and drug prices, which significantly influence the total cost of coverage. Current research underscores the need for increased awareness and use of available support programs to ensure seniors and disabled individuals make the best choices for their health needs.

Looking ahead, ongoing research by Lei and colleagues aims to further understand the factors influencing Medicare plan decisions, seeking to improve support systems and decision-making tools for vulnerable populations.

For more details, refer to the studies published in the Journal of the American Geriatrics Society and Alzheimer's & Dementia: Behavior & Socioeconomics of Aging. Source: https://medicalxpress.com/news/2025-07-medicare-annual-enrollment.html