Most patients spend less than an hour picking a Medicare plan. Their physicians live with the choice all year.

A patient comes in for a January follow-up and hands over a medication list that hasn't changed in three years. The prescriptions haven't changed either. The plan has. The patient's Part D formulary moved a key drug to a higher tier, the deductible went up, and the cardiologist the patient has seen for a decade is no longer in network. The patient had no idea. The patient didn't look.

That scenario is more common than many physicians might assume. Medicare open enrollment for 2027 coverage opened Oct. 15 and runs through Dec. 7. New data suggest most patients will give the decision less time than they'd spend comparing streaming services.

According to the University of Michigan's National Poll on Healthy Aging, 60% of Medicare enrollees aged 65 and older spent less than an hour choosing coverage during last year's open enrollment. That includes 27% who didn't review their options at all and 33% who looked but spent less than an hour. Eight in 10 kept the same coverage they had the year before.

The poll was conducted by the university's Institute for Healthcare Policy and Innovation shortly after the last open enrollment period. It surveyed Medicare enrollees drawn from a nationally representative sample of older adults. Separate funding from the Michigan Health Endowment Fund supported a parallel Michigan sample, which tracked closely with the national results.

For physicians, the findings expose a gap. Patients make a coverage decision quickly and often passively. That decision then shapes which doctors they can see, which drugs they can afford and how much they will owe at the front desk for the next 12 months.

Confident, but not informed

The most striking contradiction in the poll is between confidence and knowledge. Nearly all respondents, 92%, said they were somewhat or very confident about making Medicare coverage decisions. Yet awareness of major changes affecting their coverage was low.

The best-known change for 2026 was lower prices on 10 high-cost drugs, a product of Medicare's new authority to negotiate with drugmakers. Only 38% of respondents had heard of it. Fifteen more drugs join that list for 2027.

Only 29% knew about two changes that raise patients' exposure to drug costs: a higher Part D deductible and a higher annual out-of-pocket cap. The cap rises to $2,400 in 2027, up from $2,100 this year and $2,000 in 2025. Part D plans can set deductibles as high as $700 for 2027.

Just 15% knew that Medicare's Plan Finder tool can now show which physicians and other clinicians a given Medicare Advantage plan considers in network. Before, that information was difficult to find, and going out of network can be very costly.

Poll director Jeffrey Kullgren, M.D., M.P.H., M.S., said the factors respondents ranked most important were out-of-pocket costs (69%), medication coverage (63%) and whether their providers were in network (62%). In other words, patients care most about the things they are least likely to check.

Kullgren also warned that a plan available one year may not be offered the next, because insurers keep changing which Medicare Advantage and drug plans they sell and where.

Where the cost of a bad match lands

That warning echoes what Medical Economics has been reporting all year. Scott Woods, founder of Patient Coverage Connect, wrote in Medical Economics in August that patients enrolled in the wrong Medicare Advantage plan are a practice problem as much as a patient problem. Woods's company flags Medicare coverage mismatches for practices and connects patients with licensed advisors.

"We think of coverage problems as patient problems, but some of the cost lands on practices like Brenda's," Woods wrote, describing a composite primary care physician. "Medicare Advantage in general may always have higher delays, denials and administrative work, but educated patients in plans that fit them reduce friction for everyone."

Woods cited IQVIA data showing that nearly a quarter of prescriptions written for Medicare beneficiaries go unfilled because of payer rejections or high copays. He also noted that the average Medicare Advantage drug plan deductible nearly quadrupled in a single year, according to the USC Schaeffer Center.

"Unfilled medications can lead to worsening conditions, emergency department visits and increased overall cost," he wrote. "Drug adherence affects quality scores and downstream costs, both of which affect Brenda's bottom line."

Plan exits make it worse. Woods noted that at least 25 health systems had cut ties with certain Medicare Advantage plans so far in 2026. He added that up to 1 in 10 Medicare Advantage enrollees face forced disenrollment as insurers discontinue plans.

"Not only might Brenda's patients not have coverage for their doctors and/or their drugs, they could miss their best opportunity to fix the problem," he wrote. "Many of her patients could switch before January; they just don't know it."

The Michigan poll suggests why. A patient who spends no time reviewing options won't notice that a plan is leaving the market, that a formulary changed or that their physician dropped out of the network. And 80% are simply staying put.

Who patients turn to

The poll also asked respondents who reviewed their options which information source mattered most. Insurance brokers topped the list at 26%. Medicare's own resources, the Plan Finder website or the 1-800-MEDICARE hotline, came in at 25%. Health plan websites followed at 21%.

Only 5% named their most important source as a State Health Insurance Assistance Program counselor. SHIPs are federally funded, operate in every state, and have no financial stake in which plan a patient chooses. Earlier poll data from 2024 found that only a quarter of adults over 50 were even familiar with SHIPs.

Geoffrey Hoffman, Ph.D., an associate professor at the U-M School of Nursing who worked with the poll team, said older adults can easily "set it and forget it" with Medicare. He encouraged patients to seek help and pointed to SHIP counselors as an underused, unbiased option.

Brokers have become a fixture in the decision, and some see a role alongside physicians. Cristin Hopkin Bishop, chief operating officer of The Brokerage Inc., a field marketing organization that supports independent insurance agents, told Medical Economics in April that agents often work directly in physician offices.

"There are a lot of clinics that our agents sit in at the local level, and they ask questions," Bishop said. "They are that resource that the doctor or the staff there can help guide the patient to work with them."

The poll notes that brokers earn commissions from insurers based on how many people they enroll. That is a meaningful distinction when physicians decide where to send patients who ask for help.

Bishop also described a market in which plans are under growing financial strain, and that strain is now reaching benefit design and networks. In her conversation about Medicare Advantage belt-tightening, she said plans face higher utilization and rising specialty drug costs.

"Utilization is up, cost is up, enrollment is still up as well, but the margin is down," Bishop said. "And so I think plans are having to reassess, especially going into their 2027 bids this year. What do their benefits look like? What's their doctor network? What doctors and physicians are they going to be working with?"

Those reassessments are the changes patients are least likely to notice if they skip their annual review.

Trust is falling, and understanding is the difference

Patients' passivity is also happening as their trust in coverage weakens. Medical Economics reported in August on declining trust among Medicare Advantage members, citing the JD Power 2026 U.S. Medicare Advantage Study. Overall member satisfaction fell 12 points this year, the second consecutive annual decline and a 41-point drop since 2024. Only 43% of members strongly agreed that their plan is a trusted partner in their health.

The same study pointed to one lever that works: understanding. New members who said they understood their coverage very well were roughly twice as likely to feel their insurer prepared them for the unexpected as members who didn't understand their coverage.

That finding lines up with the Michigan researchers' advice. Lianlian Lei, Ph.D., an assistant professor at the U-M Medical School, compared the Medicare decision to buying a car or a major appliance. She said the right plan depends on a person's health conditions, preferred physicians and hospitals, and current prescriptions. She also noted that the best plan for one spouse may not be the best for the other.

What practices can do before Dec. 7

Physicians don't sell insurance, and most don't want to steer patients toward a particular plan. But the Michigan data suggest there is room for practices to nudge patients toward a better-informed decision without taking sides.

Some practical options during the open enrollment window:

• Prompt the review. A simple reminder at check-in or in a patient portal message can help, noting that plans, formularies and networks change every year and that open enrollment closes Dec. 7. That alone could reach the 27% who don't look at all.
• Hand patients the inputs. Out-of-pocket costs, drugs and network status are what patients say matter most. An up-to-date medication list and a list of the practice's current Medicare Advantage contracts give patients what they need to use the Plan Finder well.
• Point to unbiased help. Including the local SHIP's contact information in after-visit summaries or waiting-room materials costs little. It addresses the poll's finding that few patients know SHIPs exist.
• Flag the second chance. Patients who choose a Medicare Advantage plan and later regret it can switch to another MA plan or to traditional Medicare between Jan. 1 and March 31. Staff who hear about coverage surprises in January can point patients to that window. Patients considering a move back to traditional Medicare should know that Medigap underwriting rules vary by state.

The stakes run both ways. A patient in a poorly matched plan may skip prescriptions, lose access to a trusted physician or end up with a balance they can't pay. The practice inherits the missed visits, the prior authorization rework and the bad debt.

As Woods put it in his August commentary: "It's possible to head off these problems before the first missed dose or unpaid balance, and the importance of doing so is increasingly evident."