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As more employees continue working past age 65, HR teams are increasingly pulled into conversations about Medicare鈥攈ow it works, what it covers, and how workers should navigate their choices alongside employer-sponsored benefits. Understanding what truly drives Medicare decisions can help employers better support aging employees, improve pre-retirement education, and offer a more confident, seamless transition off the employer plan when the time comes.

A recent episode of Benefits Buzz surfaced powerful new insights into , based on nearly 3,100 real conversations with members across the country. We explored real-world perspectives gathered from people who use Medicare every day, with the goal of uncovering the 鈥渨hy鈥� behind their decisions鈥攍ooking beyond premiums to understand what truly drives enrollment, retention, and satisfaction. Check out our episode with Rod Kersch, vice president of health plan sales at WEX, who shared exclusive findings collected through thousands of conversations with Medicare members nationwide.

Inspiration for a new Medicare research methodology

Kersch explained that the inspiration for his research dates back to 2015鈥�2016, when it became clear to him that most new ideas in Medicare were generated internally by plans or vendors鈥攏ot by the members they were meant to serve.

So in 2021, he took a bold new approach. He traveled the country in a camper, gathering 鈥渦ninhibited, real-world data鈥� by talking with people around campfires. The informal setting encouraged honest conversation, offering what he believes is the 鈥減urest way to get people to talk freely.鈥�

Challenging assumptions: Price vs. cost and member education

One of the industry鈥檚 biggest assumptions is that affordability is the primary driver of Medicare plan selection. But Kersch鈥檚 conversations revealed something different: members often confuse price (their premium) with true cost (the financial risk they carry). A low-premium plan can quickly become extremely expensive if the wrong healthcare event occurs.

Compounding the issue is a significant education gap. Kersch shared more than 80% of members rely on a broker, agent, or friend for advice鈥攁nd many make decisions after answering fewer than 10 questions. This lack of engagement in their own decision-making underscores the importance of better Medicare education.

Member coverage and the need for segmentation

Another key insight: seniors are not one single group.

Many people around retirement age don鈥檛 see themselves as 鈥渞etirees.鈥� Many are still active, prioritizing benefits such as vision. Meanwhile, older members typically value dental, hearing, and OTC coverage more highly.

Kersch emphasized that plans should segment seniors based on their 鈥渓ife formula鈥� and personalize benefits accordingly.

The importance of transformative experiences and social connection

One of the most powerful takeaways involved the emotional and social needs of older adults. Kersch shared the story of a WWII veteran who became energized and joyful after two evenings of social interaction at the campsite.

The experience highlighted the profound impact of social isolation鈥攁nd the importance of creating opportunities for seniors to connect.

Turning data into action for Medicare decision-makers

Most of the members interviewed described Medicare as 鈥渙kay at best.鈥� To improve member satisfaction and financial stability, Kersch suggests focusing on reducing members鈥� overall cost of living, especially as inflation strains fixed incomes.

糖心Vlogis partnering with him to explore programs that offer rebates or discounts on everyday goods to help seniors stretch their dollars further鈥攁llowing more room to manage healthcare costs.

Innovation and the future of Medicare

Despite assumptions that seniors crave digital-first or cutting-edge benefits, the research found the opposite: members overwhelmingly want stronger, more affordable versions of the 鈥渂ig four鈥� supplemental benefits:

• Vision
  
• Dental
  
• Hearing
  
• OTC allowances
  

Kersch challenges plans to collaborate with retailers and manufacturers to deliver more offerings at lower costs, helping members maximize their dollars.

He also predicts that the next 24鈥�36 months could be unusually turbulent, with millions of seniors potentially displaced as Medicare plans rebalance their markets.

The role of brokers and jey takeaways

The research revealed exceptionally high trust in brokers鈥攐ver 82% of members rated theirs an eight or higher on a 10-point scale. The trust bridge is already built; the challenge is ensuring brokers have the right education and incentives to guide members through a more thorough, personalized enrollment process.

For Kersch, the most important takeaway from the 3,100 conversations is simple: members need to feel informed and involved. And he plans to continue these conversations for the next several years to ensure health plans have access to current, authentic, member-driven data.

Don鈥檛 forget to with Rod Kersch to learn even more from his conversations with Medicare members!

The information in this blog post is for educational purposes only. It is not legal or tax advice. For legal or tax advice, you should consult your own legal counsel, tax and investment advisers. 

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