Insurance knowledge and decision-making practices among Medicare beneficiaries and their caregivers

Abstract

Background: The complexity of health plans and the Medicare program may require some beneficiaries to seek help when making health insurance decisions. However, there has been little research examining the Medicare-related knowledge and information gathering of beneficiaries who receive decision-making help and those who assist them. Objectives: We sought to compare the Medicare knowledge and information-gathering of beneficiaries who receive help with insurance decisions or their proxy respondents with beneficiaries who make their own decisions. Research Design: Data were drawn from the 2000 Medicare Current Beneficiary Survey (MCBS), which includes a nationally representative sample of noninstitutionalized Medicare beneficiaries. Subjects: We included a total of 11,978 beneficiaries and 1401 proxies who completed the MCBS. Measures: Measures were items and indices from the MCBS measuring the Medicare education campaign goals of access, awareness, and use of information sources, understanding of Medicare, and confidence in decision-making. Results: Beneficiaries who receive help with health insurance decisions have lower knowledge of the Medicare program and are less likely to be aware of and use information sources than beneficiaries who make their own decisions. With few exceptions, proxy respondents had similar levels of access and knowledge as beneficiaries who make their own insurance decisions. Conclusions: Beneficiaries who receive help with their insurance decisions may be a particularly vulnerable population. They may have limited Medicare knowledge and not be aware of the resources that could help them