Older Americans enrolled in Medicare are substantially happier with their health insurance than people who insure themselves or receive coverage through their employers, a new Commonwealth Fund report finds.

That's because those enrolled in Medicare say they have better access to care and are less likely to have problems paying their medical bills.

Just 8 percent of Medicare beneficiaries 65 or over rated their coverage “fair” or “poor.” By comparison, 20 percent of those with employer-based coverage gave their insurance plan low marks. And 33 percent of people who bought insurance on their own reported unhappiness with their coverage.

As the federal government weighs proposals to cut Medicare spending, researchers at the Commonwealth Fund, a private health-policy advocacy foundation, warn that shifting Medicare beneficiaries into private plans could put the elderly at greater risk for not getting needed health care and being less satisfied with their insurance.

“Policies designed to move the elderly out of Medicare and into private plans need to be carefully designed, so as not to expose beneficiaries to the poorer access to care currently experienced by many working-age adults with private insurance,” says Commonwealth Fund senior researcher Kristof Stremikis.

The study finds that Medicare beneficiaries have better access to care and greater financial protection than adults with private coverage. In 2010, about one-fourth of Medicare beneficiaries went without needed health care because of costs, compared with 37 percent of those with employer coverage. Adults with employer-based insurance (39 percent) and individual insurance (39 percent) reported medical bill problems at almost double the rate of Medicare beneficiaries (21 percent).

But researchers found mixed results comparing seniors' attitudes on traditional Medicare with those on Medicare Advantage. Only 6 percent of those in traditional Medicare rated their insurance “fair” or “poor,” while 15 percent gave their Medicare Advantage plan that assessment, complaining of more problems.

Instant Insights /

Medicare trumps private plans in patient satisfaction

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