Survey: Half of Medicare Beneficiaries Have Skipped Medical Care in the Past Year Due to Confusion Over Their Coverage

54% of Medicare Supplement enrollees are considering moving to Medicare Advantage this fall, citing high premiums.

Rhea-AI Summary

eHealth (EHTH) published Medicare survey research finding that 48% of beneficiaries skipped or delayed care because of coverage confusion in the past year. Another 54% skipped or delayed care or filling a prescription because of out-of-pocket cost concerns during that period.

For 2027 coverage, 71% intend to review their plan options during the Annual Enrollment Period. Among beneficiaries planning a review this fall, 62% intend to use artificial intelligence tools to compare plans, and 75% express confidence in finding suitable coverage. However, 71% of all beneficiaries find Medicare shopping confusing, and 61% would trust a person over an AI tool when advice conflicts.

Among those intending to review plans this fall, 71% consider coverage of GLP-1 drugs for weight loss important, although most plans will not cover them for that purpose.

Key Figures

Skipped or delayed care due to coverage confusion: 48% Skipped or delayed care or prescriptions due to cost concerns: 54% Plan to use AI tools to compare plans: 62% +4 more

Skipped or delayed care due to coverage confusion

48%

Medicare beneficiaries; past year

Skipped or delayed care or prescriptions due to cost concerns

54%

Medicare beneficiaries; past year

Plan to use AI tools to compare plans

62%

Beneficiaries planning to review coverage options this fall

Plan to review coverage options

71%

All Medicare beneficiaries; this Annual Enrollment Period

Suspect they have been targeted by Medicare-related scams

58%

Medicare beneficiaries; in the past

Survey sample size

Over 1,000 beneficiaries

eHealth report survey

Margin of error

+/- 3%

Survey

Key Terms

medigap, glp-1, c-snp, a1c

4 terms

medigap regulatory

"Medicare Supplement (Medigap) enrollees"

Medigap is private Medicare Supplement insurance sold by non-government insurers to cover gaps in Original Medicare (Part A and Part B), such as coinsurance, copayments, and some deductibles that Medicare does not fully pay. Medigap plans are standardized into lettered options (A, B, C, etc.) that offer defined benefit packages in most states, require enrollment in Medicare Parts A and B, and are regulated at the state level; they are separate from Medicare Advantage (Part C) and generally cannot be used alongside an active Medicare Advantage plan. Benefits, availability to people under 65, and pricing rules vary by state and by the specific lettered plan.

glp-1 medical

"finding GLP-1 coverage for weight loss important"

GLP-1 (glucagon-like peptide-1) is a natural hormone in the body that helps regulate blood sugar levels and appetite. Its significance to investors lies in its role as the basis for a class of medications that address conditions like type 2 diabetes and obesity, which are large and growing markets. Advances or investments in GLP-1-based treatments can signal opportunities in healthcare innovation and potentially impact pharmaceutical companies’ growth.

c-snp regulatory

"enrolled in a C-SNP plan say it has helped them lower their A1C levels"

A C‑SNP (Chronic Condition Special Needs Plan) is a type of Medicare Advantage plan that is limited to enrollees who have one or more specific chronic health conditions (for example, diabetes or heart failure). These plans tailor benefits, provider networks, and care management services to the needs of that patient group and must meet Medicare rules for eligibility, benefits and coordination of care; beneficiaries must both be eligible for Medicare and meet the plan’s clinical criteria to enroll.

a1c medical

"helped them lower their A1C levels"

A1C is a blood test that reports average blood sugar over about three months by measuring how much glucose sticks to hemoglobin, a protein in red blood cells. For investors, A1C acts like a long-term scorecard for diabetes treatments, devices and diagnostics: meaningful changes in A1C in clinical studies can affect regulatory approval, insurance coverage and commercial prospects, and thus influence a company's market value.

AI-generated analysis. How Rhea-AI works. Not financial advice.

See more from StockTitan in Google Search and AI answers. Adds StockTitan as a preferred source · opens Google

Add on Google Not now

Six in 10 intend to use AI tools this fall to help them review Medicare plan options

58% of beneficiaries believe they have been targeted by Medicare-related scams

Seven in 10 plan to prioritize GLP-1 drug coverage when considering Medicare choices

INDIANAPOLIS, Oct. 8, 2026 /PRNewswire/ -- With a record number of Medicare beneficiaries making coverage decisions during the upcoming Annual Enrollment Period (AEP), eHealth (Nasdaq: EHTH) today published new original research showing that many have skipped medical care recently due to confusion about their coverage, while a growing number are turning to AI to help them compare their plan options.

Based on a survey of over 1,000 Medicare beneficiaries, the new report from eHealth, a leading private online health insurance marketplace, highlights how cost pressures and benefit confusion are pushing many to reconsider their coverage options for 2027:

• 48% of Medicare beneficiaries have skipped or delayed medical care in the past year due to confusion over their coverage.
• 54% of Medicare beneficiaries have skipped or delayed medical care or filling a prescription in the past year due to concerns about out-of-pocket costs.
• 62% of Medicare beneficiaries who plan to review their coverage options this fall intend to use AI tools to help them compare plans.
• 56% of Medicare beneficiaries either don't know or mistakenly believe that Medicare may proactively contact them by phone to discuss their coverage, potentially leaving them vulnerable to scams.

"With tens of millions of Medicare beneficiaries reconsidering their plan options during this year's Annual Enrollment Period, this new research shows many are delaying accessing care due to cost and coverage confusion, highlighting the need for additional support and educational resources," said Derrick Duke, CEO of eHealth. "The new data show that many Medicare beneficiaries intend to turn to AI tools this year for help reviewing their plan options, yet most beneficiaries say they are more likely to trust advice from a real person."

Additional highlights from the report include:

Most Medicare beneficiaries plan to review their coverage options for 2027

• 71% of all Medicare beneficiaries intend to review their plan options this Annual Enrollment Period.
• 54% of Medicare Supplement (Medigap) enrollees are considering moving to Medicare Advantage this fall, citing high premiums.

High confidence despite confusion and inadequate resources

• 75% of Medicare beneficiaries planning to review their options this fall express confidence in their ability to find the right plan for their needs and budget.
• Yet 71% of all Medicare beneficiaries say that shopping for Medicare coverage is confusing.
• 46% of Medicare beneficiaries are unsure or don't think that government resources are enough to help them effectively review and compare their options.

Leveraging AI tools to review Medicare plans

• 48% of all Medicare beneficiaries say they have used AI tools in the past to review their Medicare plan options.
• 61% of Medicare beneficiaries say that, given conflicting advice, they would trust a real person rather than an AI tool when comparing plan options.

Prioritizing GLP-1 drug coverage

• 71% of Medicare beneficiaries who intend to review their plan options this fall call finding GLP-1 coverage for weight loss important, even though most plans won't cover it for that purpose.
• 57% of all Medicare beneficiaries are now familiar with the federal GLP-1 Bridge program, up significantly from 27% earlier this year.

Potential vulnerability to Medicare-related scams

• 56% of Medicare beneficiaries either don't know or mistakenly believe that Medicare may proactively contact them by phone to discuss their coverage.
• 58% of Medicare beneficiaries suspect they have been targeted by Medicare-related scams in the past.
• 46% of Medicare beneficiaries say they or someone they know has been a victim of a Medicare-related scam.

The value of Chronic Special Needs Plans (C-SNPs)

• 78% of Medicare beneficiaries with diabetes and enrolled in a C-SNP plan say it has helped them lower their A1C levels.
• 57% say it helped them save money on diabetes medications and supplies.

Read the full report.

eHealth's report is based on a survey of more than 1,000 Medicare beneficiaries drawn from the general population. The survey was conducted in September 2026 through a third-party survey tool. The margin of error is +/- 3%.

About eHealth
For nearly 30 years, eHealth, Inc. (Nasdaq: EHTH) has helped millions of Americans find the healthcare coverage that fits their needs at a price they can afford, using data, artificial intelligence and a consumer-first approach to help people quickly and effectively compare insurance options. As a leading independent licensed insurance agency and advisor, eHealth offers access to plans from more than 180 health insurers, including national and regional companies, supporting consumers during their working years and retirement. eHealth's licensed insurance agents help match consumers with the insurance plans, services, and support they need to live healthier, more financially secure lives. For more information, visit eHealth or follow us on LinkedIn, Facebook, Instagram, and X.

eHealth media inquiries: pr@ehealth.com

View original content to download multimedia:https://www.prnewswire.com/news-releases/survey-half-of-medicare-beneficiaries-have-skipped-medical-care-in-the-past-year-due-to-confusion-over-their-coverage-302901933.html

SOURCE eHealth, Inc.

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What did eHealth's Medicare survey find about delayed medical care?

48% of Medicare beneficiaries skipped or delayed medical care in the past year because of confusion about coverage. Separately, 54% skipped or delayed medical care or filling a prescription during that period because of concerns about out-of-pocket costs.

How was eHealth's 2026 Medicare beneficiary survey conducted?

The survey was conducted in September 2026 through a third-party survey tool, with more than 1,000 Medicare beneficiaries drawn from the general population. Its margin of error is +/- 3%.

What did eHealth's survey find about diabetes patients enrolled in Chronic Special Needs Plans?

Among Medicare beneficiaries with diabetes enrolled in a Chronic Special Needs Plan, 78% said the plan helped lower their A1C levels, a blood sugar measure. Another 57% said it helped them save money on diabetes medications and supplies.