ArticleJournal of general internal medicine2026
Associations of Medicare Advantage Enrollment Duration with Health Insurance Literacy and Access to and Affordability of Health Care.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealth insurance literacy is crucial for making informed decisions about insurance plans, particularly in the context of the complex structure of Medicare Advantage (MA). Longer MA enrollment has the potential to improve health insurance literacy, which may, in turn, enhance access to and affordability of care. However, the extent of this relationship remains poorly understood.
objectiveTo examine the association of the duration of MA enrollment with health insurance literacy as well as access to and affordability of care.
designCross-sectional study within the MA setting.
participants13,103 Medicare Advantage enrollees from the 2017-2020 Medicare Current Beneficiary Survey. MAIN MEASURES: Health insurance literacy, access to care, and affordability of care. KEY
resultsCompared to those enrolled in MA for 1-2 years, those with 3-5, 6-10, and ≥11 years of enrollment were more likely to report better understanding and knowledge of Medicare (adjusted differences ranging from 3.44 [p=0.011] to 6.53 [p<0.001] percentage points). Additionally, they were less likely to report trouble getting needed care (1.85 [p=0.007], 2.68 [p < 0.001], 2.08 [p=0.01] percentage points for 3-5, 6-10, and ≥11 years of enrollment). More pronounced differences were observed in care affordability: delaying care due to cost decreased by -1.36 (p=0.13), 2.59 (p=0.003), 2.39 (p=0.04) percentage points while having problems paying medical bills decreased by 3.48 (p<0.001), 2.76 (p<0.001), 2.93 (p=0.003) percentage points. However, these associations did not necessarily increase with enrollment beyond 3-5 years.
conclusionsOur findings indicate that longer MA enrollment is associated with higher health insurance literacy and better access to and affordability of care. However, this association appears to plateau after the first few years of enrollment. These results underscore the importance of implementing targeted programs to enhance health insurance literacy among those newly enrolled in MA, with the goal of improving access to and affordability of care.
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