Industry Voices—The Shifting Needs of Seniors Health Plan Design Beyond Age 65

Marketing for Medicare Advantage plans often presents an idealized image of seniors—active, independent, and vibrant. Ads typically feature 65-year-olds who seem to need little more from their healthcare plans than they did at 45 or 55. However, this image does not reflect the reality of aging, where significant changes in health occur as people grow older.

Shara Cohen, Heidi Syropoulos

February 24, 2025

Currently, there are 22 million Americans aged 75 and above, and with aging, sensory and cognitive changes are common. Chronic diseases become more prevalent, while mobility and immune-system functions decline. As a result, activities of daily living become more challenging, and the need for long-term care increases. With the number of Americans aged 85 and older expected to triple by 2050, the associated healthcare costs are expected to soar.

As the senior population continues to grow, it’s clear that the U.S. healthcare system, including health plans, must adapt to address these evolving needs. One critical adaptation involves supporting family caregivers, who often play a pivotal role in the care of older adults. Women

The Shift in Care Needs

Older seniors face distinct healthcare needs compared to their younger counterparts. For example, they are more likely to be diagnosed with dementia, and those over age 75 visit emergency departments at higher rates than their younger peers. Additionally, individuals over 75 are more than five times as likely to need assistance with personal care compared to those aged 65-74. Often, the caregiver is a spouse managing their own health issues.

A significant number of older Americans prefer to age in place. A 2022 survey found that 88% of individuals between ages 50-80 want to remain in their homes as long as possible. This preference necessitates changes in clinical care and social support, calling for stronger infrastructure and engagement at home.

Although projections show 25% growth in home health employment between 2021 and 2031, this increase won’t be sufficient to meet the rising demand for home health workers. If unfilled job openings persist, older adults may face care gaps at home.

Medicare Advantage plans can play a crucial role by fostering connections between health plans and family caregivers, providing them with the necessary support. By designing age-friendly health plans, seniors and their caregivers can continue to access critical benefits as their care needs evolve.

The Importance of Caregivers in Age-Friendly Health Systems

Organizations like the Institute for Healthcare Improvement have already started addressing the rising need for age-friendly care by implementing frameworks that consider the “4 Ms” of high-quality care: Mentation, Medication, Mobility, and What Matters to older adults and their caregivers.

Caregivers have a significant impact on each of these four areas. They often oversee What Matters to their loved ones and manage Medication, Mentation, and Mobility. In essence, they are the primary communication channel between health plans and members who receive care at home.

To promote age-friendly care, Medicare Advantage organizations must prioritize caregiver support. By investing in human-led, technology-enabled caregiver assistance, health plans can help keep beneficiaries in the most cost-effective, high-quality care setting—their homes. Supporting caregivers is not just an investment in care, but also in the future success of Medicare Advantage plans as the aging population continues to grow.


Conetcare offers personalized healthcare solutions to support both caregivers and seniors in maintaining a healthy, independent lifestyle. If you or your loved ones are looking for care that promotes well-being and independence at home, contact Conetcare for tailored services that meet your needs