The findings arrive as roughly 69 million people prepare to enter Open Enrollment for 2027 coverage, which runs from October 15 to December 7. The poll team gathered its data just after last year’s enrollment period by surveying Medicare enrollees aged 65 and older drawn from a nationally representative sample of older adults. The survey, conducted by NORC at the University of Chicago, was administered online and by phone in December 2025 and January 2026. The Medicare questions went to 1,796 community-dwelling U.S. adults aged 65 to 98 from the AmeriSpeak panel, with results weighted to reflect the population. A Michigan-focused analysis, funded by the Michigan Health Endowment Fund as part of the Michigan Poll on Healthy Aging, included 608 community-dwelling Michigan adults aged 65 to 93 and found no major differences from the national sample.

Perhaps the most telling number in the poll is this: 80 percent of respondents stuck with the same Medicare coverage they had the previous year. That pattern of inertia persists even though plan options, costs, and benefits often change from year to year, and even though the menu of available plans varies dramatically depending on where a person lives. Geoffrey Hoffman, an associate professor at the University of Michigan School of Nursing and an IHPI member who studies Medicare, said the data point to a strong need for older adults, particularly those dissatisfied with their current coverage, to take more time to thoroughly review their options. It is easy, he noted, to set coverage aside and forget about it, especially when someone likes their current plan and assumes it is the best available, but the number of choices and the tools for navigating them can be confusing, and there may be coverage that better suits a person’s needs and wallet.

Confidence, however, does not appear to be in short supply. Virtually all those surveyed, 92 percent, said they were somewhat or very confident about making decisions about their Medicare coverage. That self-assurance stands in contrast to how little time many devote to the decision and to the sources they rely on when they do look. Among those who did review what was available in their area, only 25 percent said the most important source they consulted was one offered by Medicare itself, either the plan-finding tool on the Medicare website or the Medicare hotline. Just 5 percent named a free local counselor, such as one from the federally funded State Health Insurance Assistance Program, known as SHIP, which operates in every state. By comparison, 26 percent said their most important source was an insurance broker, and 21 percent said it was a health plan website, sources that may carry commercial incentives.

Lianlian Lei, an assistant professor in the University of Michigan Medical School who also worked on the poll, has compared the decision to other major purchases. Just as someone would take time before buying a car or a major appliance, she noted, the same care should apply to Medicare options. The best choice depends on a person’s health conditions and goals, the doctors they want to see, the hospitals they prefer, and the medications their doctors have prescribed. She also pointed out that the best plan for one member of a couple may not be the best one for their partner, a reminder that household coverage decisions deserve individual scrutiny.

The poll also probed how many enrollees had heard about major policy changes that federal lawmakers and the Centers for Medicare and Medicaid Services had made for 2026. Awareness was modest across the board. The change generating the most recognition was lower prices for 10 high-cost drugs, a result of Medicare’s new authority to negotiate what it pays drugmakers for some prescription medications, but only 38 percent of all respondents had heard of it. The impact on any individual enrollee depends on the Part D prescription drug plan they choose, and fifteen more drugs added to the negotiation list for 2027 will be reflected in the drug coverage shown on the Medicare Plan Finder.

Even fewer enrollees knew about changes affecting their own wallets. Just 29 percent were aware of two 2026 changes that could increase their exposure to prescription drug costs: an increase in the deductible, the total amount they could be asked to pay before Medicare or their Medicare Advantage plan starts paying, and an increase in the cap on total annual drug costs. Only 15 percent had heard of a feature added during the 2026 enrollment cycle that lets users of the Medicare Plan Finder see which doctors and other health care professionals would be considered in network by a chosen Medicare Advantage plan. That information had been difficult to find in previous years, even though going to an out-of-network provider or hospital can be very costly.

When poll respondents were asked to choose from a list of factors that mattered most in their Medicare decisions, out-of-pocket costs topped the list, selected by 69 percent, followed closely by medication coverage at 63 percent and network coverage of health care providers at 62 percent. Jeffrey Kullgren, the poll’s director, who has studied how out-of-pocket costs influence health decisions, especially among people with chronic conditions, added a caution: just because a plan was available one year does not mean it will be available the next. Medicare Advantage and prescription drug plan options are changing across the country as insurance companies make business decisions about what they offer and where, which makes it especially important, he said, to check all options carefully every year.

The technical landscape of Medicare itself helps explain why the decision is so complex. Depending on where someone lives, options always include traditional Medicare, which is accepted by nearly all doctors and hospitals, and may include as many as 80 Medicare Advantage plans, each with its own networks. In some areas, a program called PACE is available to Medicare-eligible people who need nursing home-level care but want to remain at home. Optional Medigap plans can supplement traditional Medicare, although states vary in whether enrollees with major health issues can be charged more or denied outright if they want to buy a Medigap plan after moving from Medicare Advantage back to traditional Medicare. Medicare Advantage plans can offer benefits traditional Medicare cannot, such as transportation, food programs, and caregiver support, though some plans have trimmed these offerings in recent years. Part D prescription plans each carry their own formulary, deductible, and per-fill copay, and in 2027 Part D deductibles can range from zero to as high as 700 dollars.

One structural protection has changed the calculus for drug costs. Since 2025, a cap has limited the total amount any Medicare enrollee must pay out of pocket for prescriptions covered by Part D or Medicare Advantage, closing the so-called donut hole that formerly left some enrollees paying thousands more. That cap rises to 2,400 dollars in 2027, up from 2,100 dollars in 2026 and 2,000 dollars in 2025. Meanwhile, older adults face a barrage of marketing mail, phone calls, advertisements, and even free dinner information sessions every fall from insurance companies and from brokers who earn commissions based on how many people they sign up. Against that noise, free resources exist: the Medicare website and toll-free hotline offer information in multiple languages with interpreter and deaf and hard-of-hearing services, the Plan Finder lets users compare Medicare Advantage, Part D, and Medigap plans down to specific drugs and doctors, and SHIP counselors and programs such as Michigan’s MI Options call center, launched in summer 2025, provide help with no financial stake in the outcome. Yet NPHA data from 2024 showed that only 25 percent of people over 50 were familiar with SHIPs. For those who do switch to a Medicare Advantage plan and regret it, a second chance exists: they can change plans, or move to traditional Medicare, before March 31 after coverage begins, and other special enrollment periods may also apply.

Subject of Research: Medicare plan selection behavior and decision-making among older adults during Open Enrollment

Article Title: Many older adults make Medicare decisions quickly and most don’t change plans, poll finds

Article References: Many older adults make Medicare decisions quickly and most don’t change plans, poll finds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: Medicare, Open Enrollment, Medicare Advantage, National Poll on Healthy Aging, University of Michigan, prescription drug costs, SHIP counselors, health insurance, older adults, Plan Finder, Part D, health policy