Abstract
Medicare beneficiaries with cardiovascular disease are increasingly enrolling in Medicare Advantage and other managed care plans, raising concern for plan choice complexity and subsequent detrimental plan selection. In this repeated cross-sectional observational study, between 2016 and 2022, plan choice complexity for Medicare beneficiaries with cardiovascular disease has worsened substantially, especially for the medically complex and socially vulnerable beneficiaries dual-eligible for Medicare and Medicaid. These findings raise substantial concern for the health and well-being of Medicare beneficiaries given that plan choice complexity has previously been shown to negatively impact decision-making and outcomes for people with cardiovascular disease.