Table 3. Marginal Changes in Benefit-Specific Enrollment in Medicare Advantage (MA) Among MA Enrollees by Health Insurance Literacy.
| Characteristic | Marginal association, percentage pointa | |||||
|---|---|---|---|---|---|---|
| I have the information I need to make an informed comparison among different health insurance choices | How easy would you say it is for you to review and compare your Medicare coverage options? | How often do you review or compare your Medicare coverage options? | ||||
| Disagree | Agree | Difficult | Easy | Less than annually | Annually | |
| Change in star rating | ||||||
| From 2-2.5 to 3-3.5 | –0.01 | 0.00 | 0.01 | –0.01 | –0.16 | 0.12 |
| From 3-3.5 to 4-4.5 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| From 4-4.5 to 5 | 0.00 | 0.00 | –0.01 | 0.01 | 0.41 | –0.31 |
| $100 Increase in premium | –1.04 | –0.84 | –1.06 | –0.84 | –0.85b | –1.12b |
| $1000 Increase in in-network maximum out-of-pocket limit | –1.04 | –0.84 | –1.06 | –0.84 | –0.84 | –1.13 |
| Plan type | ||||||
| From HMO to local PPO | 0.00 | 0.00 | 0.01 | –0.01 | –0.09 | 0.07 |
| From HMO to regional PPO | 0.00 | 0.00 | –0.01 | 0.01 | 0.05 | –0.04 |
| From HMO to other | 0.00 | 0.00 | 0.01 | –0.01 | –0.02 | 0.02 |
| Supplemental benefits | ||||||
| From none to prescription gap coverage | 0.00 | 0.00 | –0.01 | 0.01 | –0.04 | 0.03 |
| From none to dental coverage | 0.00 | 0.00 | 0.00 | 0.00 | –0.01 | 0.01 |
| From none to vision coverage | 0.00 | 0.00 | 0.00 | 0.00 | 0.01 | –0.01 |
Abbreviations: HMO, health maintenance organization; PPO, preferred provider organization.
The marginal associations were estimated with conditional logit regression while controlling for plan characteristics (star rating, monthly premium, in-network maximum out-of-pocket limit, plan type, and supplemental benefits), as well as their interaction terms with each measure of health insurance literacy. Then, the differential associations were estimated between an MA plan’s characteristic and the probability that an enrollee would select that MA plan. These results were presented as the marginal association between a 1-unit change in a characteristic and the probability of selecting an MA plan. For example, an increase in plans’ rating from 4 to 4.5 stars to 5 stars was associated with an increase of 0.41 percentage point in the likelihood of enrolling in a given plan among MA enrollees who reviewed or compared Medicare coverage options less than annually and was associated with a decrease of 0.31 percentage point in the likelihood of enrolling in a given plan among MA enrollees who reviewed or compared Medicare coverage options annually.
P < .05.