With the Medicare Annual Enrollment Period (AEP) opening October 15, a new survey from eHealth, Inc., a private online health insurance marketplace, exposes a sharp disconnect. Nearly nine in 10 current Medicare beneficiaries say they are confident in their coverage knowledge. Yet only 13% can correctly define all four main Medicare coverage types, according to the August 2026 eHealth Medicare Knowledge Gaps report.
The survey was conducted between July 15 and 25, and covered more than 1,000 Americans drawn from a census-balanced sample, with a margin of error of plus or minus 3%. Respondents included current beneficiaries and pre-Medicare adults ages 55 to 64, the cohort benefits brokers are most actively counseling ahead of the AEP window.
The most consequential findings are not about what people don't know. They are about what people don't know they don't know.
Eighty-eight percent of pre-Medicare adults ages 55 to 64 are unaware of the 10% Part B penalty added for every 12-month period they were eligible but failed to enroll. According to Medicare.gov, that penalty is permanent. It stays with the beneficiary for as long as they hold Part B.
The blind spot extends across coverage types. Eighty percent of pre-Medicare adults don't know that delaying Medicare Part D enrollment beyond the initial window can trigger a separate permanent penalty. Seventy-one percent don't know they may be declined or charged more for a Medicare Supplement (Medigap) plan if they apply outside their initial enrollment period.
That window does not reopen in most states. The knowledge pattern is consistent with what brokers routinely encounter when clients misunderstand how Medicare decisions drive long-term costs.
"Enrolling in Medicare isn't just about selecting a health plan," said Derrick Duke, CEO of eHealth. "It's about understanding how different coverage options affect your access to healthcare and financial security. Our survey shows many Americans are making those decisions without fully understanding how their various Medicare coverage options work, or the potential tradeoffs of each one."
The data on out-of-pocket costs tells a similar story. Sixty-three percent of current Medicare beneficiaries don't understand they will typically pay 20% coinsurance for covered medical services under Original Medicare alone. Among pre-Medicare adults ages 55 to 64, that figure rises to 82%.
Eighty-eight percent of current beneficiaries either don't know or incorrectly believe there is an annual out-of-pocket cap under Original Medicare Parts A and B. There is none.
Thirty-five percent mistakenly believe annual costs are capped at $5,000 or less. Nine percent think they would pay nothing at all. A client who enters Original Medicare with those assumptions and faces a serious illness can encounter uncapped costs that supplemental coverage could have addressed.
Forty-five percent of pre-Medicare adults don't know whether Original Medicare covers dental, vision, and hearing, or mistakenly think it does. Twenty-four percent believe they can make prescription drug copayments under Original Medicare, which does not cover most drug costs. These are the baseline knowledge gaps of most clients a broker will see before October 15.
Only 24% of adults ages 55 to 64 who are not yet enrolled express confidence about their Medicare coverage options. That compares to 89% of current beneficiaries. Pre-Medicare adults are more receptive to guidance than those already enrolled, who believe they understand a program the data suggests they do not.
That receptiveness does not last. Once people enroll, confidence rises sharply even as actual knowledge does not. For benefits brokers, the pre-enrollment window is when guidance on penalties, cost-sharing, and coverage gaps is most likely to land.
With more than 4.1 million Americans expected to turn 65 in 2026, according to Kiplinger, the opportunity is substantial. Among the four coverage types tested, none was correctly defined by more than 45% of current beneficiaries. Confidence, the eHealth data shows, is a poor proxy for knowledge. The overconfidence pattern seen in Medicare decisions mirrors a broader challenge documented in Medicaid enrollment and employer benefits markets, where coverage literacy gaps shape outcomes across the board.
The 2027 AEP runs October 15 through December 7.
