About 6 million Medicare Advantage beneficiaries are estimated to be affected by plan degradation, while about 2 million more to see plan exits – a first in Medicare Advantage history
CHICAGO, October 15, 2024 – As the Medicare Annual Enrollment Period (AEP) begins, GoHealth, Inc. (NASDAQ: GOCO), a leading health insurance marketplace and Medicare-focused digital health company, today announced the launch of AI and proprietary technology tools dedicated to increasing efficiency and improving consumer experience. This new technology is designed to ensure ‘peace of mind’ for consumers with their healthcare decisions, amidst new data from GoHealth suggesting that millions of Medicare Advantage beneficiaries are expected to experience an unprecedented period of disruption this AEP.
In an analysis of more than 5,000 Medicare Advantage plans from top health insurers, GoHealth found that an estimated 6 million Medicare Advantage beneficiaries are expected to face plan degradation, an erosion of benefits offered within their specific plan. Furthermore, according to Deft Research, an estimated 2 million are expected to be affected by plan exits, which means carriers will no longer be offering that plan within a specific county.
“Medicare Advantage beneficiaries are staring down a truly unprecedented enrollment period. This AEP will present unique industry and market dynamics, including a reduction in marketing capacity across the broker industry, combined with strong demand for Medicare Advantage shopping and appropriate switching,” said GoHealth CEO Vijay Kotte. “Individuals are going to see fewer options, higher costs, and diminished benefits. GoHealth has thousands of licensed, trusted agents with the tools necessary to provide clear personalized advice to help beneficiaries make the best decision that benefits their future.”
Additional GoHealth research reveals the significance of choosing the right Medicare plan.
- Most beneficiaries likened purchasing a plan to that of buying a house or a new car. Like those higher-stakes purchases, 44% of beneficiaries preferred to be presented with 2-3 options before making a decision, while an additional 40% said they preferred to review all options.
- Moreover, 46% of those surveyed said that the availability of better plans was the top reason they would consider changing their Medicare plans. An additional 40% cited prescription drug coverage, annual changes to plan coverage, benefits or costs as reasons they would consider switching their plan.
- Furthermore, beneficiaries who were surveyed said the most common emotion they experienced before choosing a plan was nervousness.
“Our research underscores the importance of choosing the right Medicare plan as beneficiaries often view this decision with the gravity of their physical and financial health in mind. Now more than ever, it is imperative that consumers shop around and compare plans. Building on our PlanFit technology, we are proud to offer a data-driven, unbiased solution that addresses their concerns to help them select a plan that best fits their needs while also delivering excellent consumer experience,” Kotte added.
Last year, GoHealth introduced PlanFit Checkup, a seamless offering designed to remove stress and enhance the experience for consumers shopping for a Medicare Advantage plan. Backed by analytics from nearly 30 million consumer touch points and by machine learning technology, GoHealth’s proprietary PlanFit technology reduced stress and improved the shopping experience by matching every consumer with the best plan based on their profile and priorities. This technology further distinguished GoHealth’s industry-leading model by investing in the long-term consumer relationship, aligning consumer healthcare needs with agent compensation to create a pressure-free Medicare shopping experience. Specifically, GoHealth agents who complete a PlanFit CheckUp continue to be compensated regardless of whether the assessment results in an enrollment – for example, if the consumer is already on the best plan to suit their needs.
This year, GoHealth is building upon its PlanFit technology to enhance the consumer-agent experience, leveraging AI to tackle the unprecedented challenges of this year’s AEP by making plan selection more informed and efficient.
- Utilizing an AI-powered coach, GoHealth provides agents with training and scenarios simulations, in advance of the busy AEP season with complex plan questions they may encounter. This tool helps agents by ensuring they’re fully prepared to deliver the most accurate and comprehensive counsel to individuals navigating challenging and potentially life-changing decisions.
- GoHealth has also built PlanGPT, a large-language model to streamline the plan comparison process by retrieving key information from thousands of pages of plan documentation. Implementing this tool allows licensed insurance agents to provide more personalized guidance by answering detailed questions for consumers in real time to help them make educated decisions when comparing benefits across multiple plans.
“With streamlined processes for agent onboarding and precise, data-driven insights, we will continue to build lasting relationships and improve the Medicare consumer journey,” Kotte said. “Our consumer-centric approach is purpose-built to deliver peace of mind to beneficiaries and provide clarity in a landscape often marked by confusion and uncertainty.”
This year’s AEP runs from October 15 through December 7. GoHealth encourages Medicare beneficiaries to keep their ‘NOTES’ handy and offers the following tips:
- NEEDS – Know your prioritized healthcare/benefit NEEDS.
- OPTIONS – Understand the different types of OPTIONS available to you and understand what you might be giving up to get the new things.
- TRUST – Find someone you can TRUST who can do a personalized assessment of which option is best for you.
- ENGAGE – Connect with a licensed, experienced professional who can provide expert guidance throughout AEP.
- SHOP – SHOP every year to give you peace of mind you are either on the best plan for you or enrolling in the best plan for you.
Learn more at www.GoHealth.com
About GoHealth Inc.
As a leading health insurance marketplace, GoHealth believes every Medicare consumer should have personalized guidance so they can find a plan that fits their needs and budget. For customers, enrolling in a health insurance plan is confusing and difficult, and seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth uses their technology, agents, and expertise to cut through the confusion and get customers enrolled in a plan with the right coverage and benefits.
