Medicare Decisions Often Made in Tandem by Couples

While there is no such thing as a family plan for Medicare — everyone eligible signs up individually regardless of marriage or relationship status — a study of 1,812 couples enrolled in Medicare Advantage (MA) plans found most stick together when it comes to choosing health coverage.

University of Michigan researchers who conducted the study published in JAMA: The Journal of the American Medical Association on March 20 say it suggests more efforts are needed to help these couples weigh and choose the options best suited to each person.

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“Being a member of a couple and sticking to the partner’s enrollment decisions was more important than any other factor in predicting whether a person with Medicare Advantage would change insurance coverage for the next year,” Lianlian Lei, the lead author of the study and an assistant professor of psychiatry at the U-M Medical School, said in a statement.

For the study, the researchers identified 1,812 couples age 65 or older enrolled in Medicare Advantage plans, the private alternative to traditional Medicare, who were interviewed as part of a broader national Health and Retirement Study between 2010 and 2018. They found that 84 percent of the couples began with both partners enrolled in the same MA plan.

The researchers then looked for changes, if any, made the following year. For the analysis, they identified individuals as either Partner A or Partner B within the pairs.

What they found:

1. 79.7 percent of Partner A individuals remained in the same Medicare Advantage plan for the next year. Among those who stayed, so did 95.5 percent of their partners.
2. 17.9 percent of Partner A individuals switched to another MA plan for the next year. Among those who changed plans, so did 85.6 percent of their partners.
3. 2.4 percent of Partner A individuals disenrolled from Medicare Advantage and turned to traditional Medicare. Among those, so did 69 percent of their partners.

The coverage offered by Medicare Advantage varies by individual plan — different premiums, deductibles and copays; different provider networks; different drug pricing tiers; different add-on services such as dental or vision — so plans may be better suited to the medical needs of some enrollees than others. The researchers contend that more decision-making tools and assistance may help couples decide if sticking together is best for both when choosing from among MA plans or traditional Medicare or if they’d be better off going their separate ways depending on individual health care needs.

How to get help picking a Medicare plan

Annual open enrollment for Medicare Advantage runs from Jan. 1 to March 31; the traditional Medicare open enrollment period is Oct. 15 to Dec. 7. Beneficiaries can compare plans at www.medicare.gov, which also offers live chat assistance during open enrollment. In addition, Medicare has a 24-hour toll-free hotline: 800-633-4227. Every state also has a State Health Insurance Assistance Program (SHIP) with counselors who can answer questions about coverage options. More information on Medicare enrollment can be found at AARP's Medicare Resource Center.