Understanding What Medicare Recipients Want From Health Plan Benefits 

Updated on June 2, 2023
Medicare Benefits

With more than 900 healthcare insurance companies in the United States, it has become increasingly critical – and more difficult – for health plans to stand out from their competitors. Most Medicare plans focus on STAR Ratings, which indicate the quality of their member experience, medical care management and plan administration. As health plans work to maintain high ratings, supplemental benefits have become a key area where they can differentiate themselves. The challenge is determining what benefits matter most to members and how they should be administered to positively impact plan satisfaction. 

These may be simple questions, but it can be difficult for insurance providers to decide what benefits to prioritize. The unique needs of individual members often complicate matters. For example, some members may prefer benefits they can redeem for dental or vision care appointments, while others want help purchasing healthy foods and other everyday items to improve their quality of life. 

On top of that is the redemption process, where plan and member preferences may not align. Traditionally, plans have reimbursed members after they buy eligible products or services with their own funds. This gives plans more control over costs, but members bear the burden of keeping track of receipts and itemizing purchases. Modern commerce presents additional considerations – some members may want to use benefit funds at a physical store, while others prefer delivery services. 

Health plan benefit managers may believe it is best to focus on a specific category; however, research shows being expansive rather than selective is more impactful. A recent survey conducted by InComm Healthcare suggests offering a wide range of supplemental benefits, coupled with a streamlined means of managing them, can empower health plans to maintain an engaging member experience, which ultimately better positions them to strengthen their STAR Ratings, attract new members and retain current ones. 

What benefits do Medicare recipients seek?

InComm Healthcare surveyed more than 1,500 Medicare recipients to shed light on the factors influencing their plan sections, including what benefits matter most to them. Nearly half (49%) of participants said they are likely to leave a plan that doesn’t have their preferred benefits, making this an essential area for plans to address. 

The top five benefits health plan members want, according to InComm Healthcare’s survey, are:

  • Dental and Vision
  • Hearing
  • Money Towards Over-The-Counter (OTC) Purchases
  • In-Home Support Services 
  • Personal Emergency Response System

In addition to these sought-after benefits, 70% of surveyed Medicare plan members said they would be more likely to complete an annual physical or dental cleaning if they received an incentive, such as a gift card or additional supplemental benefit funds. This is an important finding for health plans because preventive care and screenings can help reduce costs in the long term. Understanding what benefits Medicare recipients seek, however, is only part of the equation. Health plans must also understand how their members prefer to manage and use their benefits.

What factors are important for supplemental benefits management?

In short, convenience is the most important element to Medicare recipients when using their plan benefits. InComm Healthcare’s survey found that: 

  • 69% of members would prefer a lump sum versus splitting their benefit dollars into various categories
  • 78% want their benefits all in one place (e.g., managed on one card and/or website)
  • 69% of surveyed recipients want to be able to use benefits cards at retailers within a mile of their location 

All three of these preferences point towards a desire for convenience. While this may seem like an obvious conclusion, there are a surprising number of plans that fail to deliver that experience – 64% of surveyed Medicare recipients say they currently have more than one card for managing multiple benefits, while 49% say they must use more than one website or mobile app to manage their benefits. This presents a considerable opportunity for health plans seeking to stand out from the competition: create and maintain a convenient, easy way for members to manage and use multiple types of supplemental benefits.

What can Medicare plans do to enhance their supplemental benefits? 

Health plans should begin streamlining their supplemental benefits by reviewing how members can redeem them. If each benefit offering is disbursed on a separate debit or prepaid card, aim to merge them all onto one card that members can use online or at brick-and-mortar stores and healthcare providers in their communities. This is where finding the right payments and technology partner is essential. 

Health plans should collaborate with a payments technology provider that understands the complexities of both retail and payment systems, as well as the healthcare industry’s security, privacy and compliance requirements. A reliable payments partner can help increase member satisfaction by consolidating health benefits and how they are managed, providing greater flexibility and functionality. As an example, InComm Healthcare’s Dual Network Benefit Card enables health plans to mix and match the type of benefits they wish to offer on just one flex card, which can be tailored for use only on eligible products that encourage healthy habits. Tapping into a flexible solution such as Dual Network Benefit Card provides health plans the freedom to connect members with expansive benefit offerings, from over-the-counter products to meal delivery services.

With the right supplemental benefit experience, health plans can significantly impact member satisfaction and other key areas that determine their STAR Ratings. As plans look to improve upon their offerings, finding a partner who can provide simple and easy access to a wide variety of benefits and incentives will be an essential step forward to success.

Dave Etling is Senior Vice President and General Manager of InComm Healthcare
Dave Etling

Dave Etling is Senior Vice President and General Manager of InComm Healthcare. To learn more about the company’s award-winning work enhancing health plan supplemental benefits, visit: www.incomm.com/products/healthcare-solutions/.