Document Type
Article
Publication Date
2026
Publisher
BioMed Central (BMC)
Source Publication
BMC Health Services Research
Source ISSN
1472-6963
Original Item ID
DOI: 10.1186/s12913-026-14198-7
Abstract
Background
In 2025, the US Medicare program is expected to spend over $1.1 trillion taxpayer dollars. A growing trend in the US Medicare program is more beneficiaries electing a private insurer, referred to as Medicare Advantage (MA), to manage their care. Since 2023, a slight majority of Medicare beneficiaries have elected to enroll in MA, yet little is understood about the mechanisms that drive beneficiaries toward their choices.
Methods
Our objective was to examine the association between comparing coverage options and ‘switching’ or ‘sticking’ with Fee-for-Service (FFS) Medicare or Medicare Advantage (MA). We conducted a panel study, using data from the 2019–2020 Medicare Current Beneficiary Survey within the Medicare community setting in the United States. Our sample was comprised of 6,214 Medicare beneficiaries.
Results
Less than 3% of our sample switched coverage in 2020. 92% of switchers moved from FFS into MA. Comparing coverage (69.2%), having FFS (157.7%), and both having FFS and comparing coverage (242.3%) were associated with an increased probability of switching between programs. Potential mechanisms associated with comparing coverage and switching may be related to beneficiary examination of total out-of-pocket costs and access to supplemental benefits, such as supplemental financial protections, Part D prescription drug coverage, and other benefits.
Conclusion
Our findings suggest that when studies on Medicare switchers are used to extrapolate payment policy recommendations, comparing coverage should be addressed, as it is an important predictor on whether a beneficiary considers switching.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Grabert, Lisa M.; Miller, Brian J.; and Wagner, Kathryn L., "Comparing US Medicare Coverage Options as a Contributing Mechanism to Sticking or Switching to an Insurance Plan" (2026). College of Nursing Faculty Research and Publications. 1075.
https://epublications.marquette.edu/nursing_fac/1075
Comments
Published version. BMC Health Services Research, Vol. 26 (2026). DOI. © 2026 The Authors. Used with permission.
This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.