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Information and the Demand for Supplemental Medicare Insurance
Paul Gertler, Roland Sturm, Bruce Davidson
NBER Working Paper No.w4700
Issued in April 1994
---- Abstract -----
While the critical role of imperfect information has become axiomatic in explaining health care market failure, the theory is backed by little empirical evidence. In this paper we use a unique panel data set with explicit measures of information and an educational intervention to investigate the role of imperfect information about health insurance benefits on the demand for supplemental Medicare insurance. We estimate a structural discrete choice model of the demand for supplemental Medicare insurance that allows imperfect information to affect both the mean and the variance of the expected benefits distribution. The empirical specification is a structural panel multinomial probit with an unrestricted variance- covariance, including heteroskedasticity and random effects to control for unobserved heterogeneity. The model is computationally complex and is estimated by simulated maximum likelihood. The empirical results indicate that imperfect information affects the demand for supplemental Medicare insurance by increasing the variance of the expected benefits distribution rather than by systematically shifting the mean of the distribution. We find that the increase in variance due to imperfect information increases the probability of choosing not to purchase supplemental insurance by about 23%. We also found that controlling for unobserved heterogeneity is important. The goodness of fit increased by about 25% and the precision of the estimated effect of information on the variance of the expected benefits distribution improved dramatically.
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Information and the Demand for Supplemental Medicare Insurance Paul Gertler
Roland Sturm
Bruce Davidson
While the critical role of imperfect information has become axiomatic in explaining health care market failure, the theory is backed by little empirical evidence. In this paper we use a unique panel data set with explicit measures of information and an educational intervention to investigate the role of imperfect information about health insurance benefits on the demand for supplemental Medicare insurance. We estimate a structural discrete choice model of the demand for supplemental Medicare insurance that allows imperfect information to affect both the mean and the variance of the expected benefits distribution. The empirical specification is a structural panel multinomial probit with an unrestricted variance- covariance, including heteroskedasticity and random effects to control for unobserved heterogeneity. The model is computationally complex and is estimated by simulated maximum likelihood. The empirical results indicate that imperfect information affects the demand for supplemental Medicare insurance by increasing the variance of the expected benefits distribution rather than by systematically shifting the mean of the distribution. We find that the increase in variance due to imperfect information increases the probability of choosing not to purchase supplemental insurance by about 23%. We also found that controlling for unobserved heterogeneity is important. The goodness of fit increased by about 25% and the precision of the estimated effect of information on the variance of the expected benefits distribution improved dramatically.
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Home >> Working Papers Series >> NBER Working Papers >> Information and the Demand for Supplemental Medicare Insurance
Information and the Demand for Supplemental Medicare Insurance
Paul Gertler
Roland Sturm
Bruce Davidson
NBER Working Papers 4700 / National Bureau of Economic Research, Inc (
web site ) (RePEc:nbr:nberwo:4700)
Related papers by JEL classification: D8: Information and Uncertainty I1: Health Abstract: While the critical role of imperfect information has become axiomatic in explaining health care market failure, the theory is backed by little empirical evidence. In this paper we use a unique panel data set with explicit measures of information and an educational intervention to investigate the role of imperfect information about health insurance benefits on the demand for supplemental Medicare insurance. We estimate a structural discrete choice model of the demand for supplemental Medicare insurance that allows imperfect information to affect both the mean and the variance of the expected benefits distribution. The empirical specification is a structural panel multinomial probit with an unrestricted variance- covariance, including heteroskedasticity and random effects to control for unobserved heterogeneity. The model is computationally complex and is estimated by simulated maximum likelihood. The empirical results indicate that imperfect information affects the demand for supplemental Medicare insurance by increasing the variance of the expected benefits distribution rather than by systematically shifting the mean of the distribution. We find that the increase in variance due to imperfect information increases the probability of choosing not to purchase supplemental insurance by about 23%. We also found that controlling for unobserved heterogeneity is important. The goodness of fit increased by about 25% and the precision of the estimated effect of information on the variance of the expected benefits distribution improved dramatically.
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Assisted Living - Medicare and Supplemental Insurance
Medicare Insurance - Part A and Part B
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Americans who reach 65 years of age are usually eligible to
participate in Medicare. Medicare also covers people younger than 65 if they are disabled.
There are two parts to Medicare coverage. They are known as Medicare
Part A and Medicare Part B. Medicare Part A is provided at no charge to the insured
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Medicare Part A (no premium) covers:
Up to 90 days of hospital care (in-patient) per benefit period. (A
benefit period ends when a patient has been pout of the hospital for 60 consecutive days.)
There is no limit to how many benefit periods a person can have, as long as the
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There is a deductible for hospital care. The deductible is the
patient's responsibility and is either paid by the patient or through supplemental
insurance:
For the first 60 days of hospital care, the deductible is $764 per
day.
For the next 30 days (day 61 through day 90) there is a co-pay of
$191 per day.
Part A covers inpatient care in a participating skilled nursing
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Part A provides coverage for home health care
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Medical devices & equipment (with certain restrictions)
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Medicare is a federal insurance program for people age 65 and older and certain disabled people. It is run by the Health Care Financing Administration (HCFA), which is part of the United States Department of Health and Human services. Medicare is the nations's largest health insurance program and covers 39 million Americans. The Medicare supplemental insurance program consists of: Medicare Part A - Hospital Insurance for hospital, skilled nursing facility, home health and hospice care. Medicare Part B - Supplemental medical insurance for doctor services, outpatient hospital services, durable medical equipment and a number of other medical services and supplies. A third availability is limited coverage for preventative services. Not "ALL" medical charges are paid for by Medicare. Some services are not covered at all. Medicare supplements, also known as Medigap insurance policies, fill in the "gaps" left by Medicare. Medigap policies are offered by private insurance companies. Insurance Advisors is here to assist you in sorting it all out. We will assist in your understanding of all the Medicare and Medigap choices and match you with the very best package for you. You will be able to make a sound decision and feel secure about your future care.
Medigap Policies Medigap policies are sold in 10 standardized plans. This list gives you a quick and easy look at all the Medigap insurance plans and what benefits are in each plan. Basic Benefits Included in All 10 Plans Inpatient Hospital Care: Covers the Part A coinsurance and the cost of 365 extra days of hospital care during your lifetime after Medicare insurance coverage ends. Medical Costs: Covers the Part B coinsurance (generally 20%of the Medicare-approved payment amount) Blood: Covers the first 3 pints of blood each year. The Ten Plans Plan A Policy Basic Benefits Plan B Policy Basic Benefits Medicare Part A Deductible Plan C Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Medicare Part B Deductible Foreign Travel Emergency Plan D Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Foreign Travel Emergency At-Home Recovery Plan E Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Foreign Travel Emergency Preventive Care Plan F Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Medicare Part B Deductible Medicare Part B Excess (100%) Foreign Travel Emergency Note: Plan F has a high deductible option. Plan G Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Medicare Part B Excess (80%) Foreign Travel Emergency At-Home Recovery Plan H Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Foreign Travel Emergency Basic Drug Benefit ($1,250 limit) Plan I Policy Basic Benefits Skilled Nursing Coinsurance Medicare Part A Deductible Medicare Part B Excess (100%) foreign Travel Emergency At-Home Recovery Basic Drug Benefit ($1,250 Limit) Plan J Policy Basic Benefits Medicare Part A Deductible Medicare Part B Deductible Medicare Part B Excess (100%) Foreign Travel Emergency At-Home Recovery Extended Drug Benefit ($3,000 Limit) Preventive Care Note: Plan J has a high deductible option. Request For Quote Download Applications Carriers We Often Recommend to California Residents
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Medicare Supplemental Insurance for Oregon
Medicare Supplements:
Although the benefits are identical for all Medicare Supplemental Insurance Plans of the same type, the premiums
may vary greatly from company to company and area to area.
In Oregon there are 25 companies that sell Medicare Supplement Plans. We represent many of them.
The U.S. Government Medicare site has a page of publications for further information
on Medicare and Insurance, and you can also check out our chart of basic types of medicare supplements.
Medicare Supplemental Insurance Options:
Medicare supplement coverage can be sold in only ten standard plans. We feel that the best care is
received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medicare
HMO plans (MCO) are also available. Medicare Supplements are available with no medical underwriting during
your open enrollment period. This is the 6 months before and 6 months after your 65th birthday. The only other
time for open enrollment is if you are disabled and put onto Medicare. Then the 6 months after going onto
Medicare is an open enrollment period. You may however, apply to a company and fill out the medical underwriting
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Medicare Supplemental Insurance (Medigap) is specifically designed to supplement Medicare's benefits
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and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance
may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.
Standard Medigap Plans: To make it easier for you to compare Medigap insurance policies, all states
(except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number
of different Medigap policies that can be sold in any of those jurisdictions to no more than 10 standard Medigap
plans. The plans were developed by the National Association of Insurance Commissioners and incorporated into
state and federal law. They have letter designations ranging from "A" through "J," with Plan A being the "basic"
benefit package. Each of the other 9 plans includes the basic package plus a different combination of additional
benefits. Plan J provides the most coverage of all the plans. The plans cover specific expenses either not
covered or not fully covered by Medicare. Insurance companies are not permitted to change the combination
of benefits or the letter designations of any of the plans.
What is Medicare?
Medicare is a national health insurance program for people 65 years of age and older, certain younger
disabled people and people with permanent kidney failure. Medicare is run by the Health Care Financing Administration.
The Social Security Administration helps HCFA by enrolling people in Medicare and by collecting Medicare premiums.
Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part
A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part
B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your
Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B),
or both--and the date your coverage started.
Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply.
If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically
enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you
are not receiving retirement benefits, you must apply by contacting a Social Security Administration office
or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday
to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social
Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.
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