Medicare Advantage satisfaction declines; advisors should review

Customer satisfaction with Medicare Advantage fell for a second consecutive year, according to JD Power’s U.S. Medicare Advantage Study released Aug. 18. The survey covered 14,559 Medicare Advantage members across 12 states. The largest two-year declines were in perceptions that plans help save time and money (down 51 points), level of trust (down 49 points) and that product and coverage offerings meet members’ needs (down 47 points). High-performing plans scored better on communication and new-member onboarding.

State-level results in the study varied. New York recorded the lowest average overall satisfaction index at 593, followed by Kentucky at 606 and Illinois at 607. Tennessee and Pennsylvania had the highest averages, at 647 and 646, respectively. Among new members who reported they understood their coverage, 34% said they felt prepared by their insurer for unexpected events and 29% said their insurer anticipated their needs; both figures were lower among members who reported they did not understand their coverage.

The study notes a decline in trust and perceived value across the sampled markets. Heather Schreiber, founder of HLS Retirement Consulting, wrote in an email that trust is built through plan interactions and clear understanding of coverage. She urged advisors to include Medicare choices in ongoing retirement planning conversations and to ask whether coverage has been reviewed, whether healthcare needs or costs have changed, and whether those costs still fit a client’s long-term income plan.

Market shifts cited in the study and by industry advisers include private insurers exiting or shrinking Medicare Advantage offerings for some products after finding certain plans unprofitable. That change has moved higher-cost enrollees into Medicare supplement plans, where early claim activity has increased premiums for supplement policies. Rising supplement premiums have, in some cases, led beneficiaries to return to Medicare Advantage plans.

Matthew Collins, founder of Truce Benefits, described a feedback loop in which insurer exits raise supplement plan premiums, and higher premiums prompt some beneficiaries to switch back to Medicare Advantage. He recommended that advisors remain involved in clients’ coverage decisions to avoid irreversible choices and suggested advisors learn enough about Medicare options to guide clients.

The study and advisers point to practical actions: confirm clients understand their benefits and network rules; review whether out-of-pocket cost exposure matches a client’s cash-flow plan; check for changes in provider networks and prior authorization rules; and coordinate Medicare coverage decisions with Social Security timing to avoid enrollment penalties. The findings highlight falling satisfaction, lower trust and shifting enrollment patterns between Medicare Advantage and Medigap that are affecting premiums and plan availability.