From Call Center to Self-Service: How Digital Confidence Can Reshape Plan Economics

If you ask a Medicare Advantage operations leader where costs are growing fastest, “member services” and “customer support” are usually near the top of the list.

It’s not hard to see why. As benefits become more complex and digital options multiply, members turn to the channel they trust most: the phone.

But here’s the twist: a large share of those calls could be prevented—not by adding more features, but by growing digital confidence.

The Real Cost of “How Do I…?”

Every day, call centers handle thousands of questions that sound like:

• “How do I log in to my account?”
• “Where do I find my ID card?”
• “How do I see what’s covered?”
• “Can someone help me schedule a visit through the app?”

Individually, these calls may cost $8–$12 in staff time. At scale, they become a significant drag on administrative budgets.

Deloitte estimates that 20–60% of calls could be automated or deflected through better digital experiences and training.

J.D. Power reports that moving a customer service conversation from phone to digital can cut the cost to serve by half or more.

But none of that works if members never get comfortable with digital in the first place.

Why Self-Service Isn’t “Set It and Forget It”

Many plans assume that once a portal or app exists, members will naturally migrate to self-service over time. In reality, older adults often need:

• Guided onboarding
• Hands-on practice
• Reassurance that they won’t “break something”

Without that, self-service stays theoretical, and the phone remains the default.

GetSetUp’s survey underscores this:

• Many older adults have portals and apps, but they don’t feel confident using them regularly.
• A majority want more support understanding benefits and wellness offerings.

They aren’t refusing digital—they’re waiting for someone to show them how.

Turning Confidence into Cost Savings

When members gain digital confidence, several things happen:

• They answer their own questions more often.
• They become comfortable completing tasks like refills, appointment requests, or benefit lookups online.
• They learn to use chat or secure messaging instead of calling for routine issues.

These shifts may seem small at the individual level, but at scale they can contribute to:

• Double-digit reductions in call volume.
• Lower need for outsourced call-center support.
• More consistent use of digital workflows, which are easier to measure and optimize.

Research on digital health engagement has shown that members who use digital tools frequently tend to:

• Generate 5–6% lower basic healthcare costs.
• Have fewer avoidable admissions and emergency visits.
• Engage more in preventive and chronic care programs.

Digital activation therefore pulls on multiple levers at once: admin savings, medical cost reduction, and experience.

How GetSetUp Supports This Shift

GetSetUp is designed to be the activation layer that most plans don’t have:

• We teach older adults how to use plan tools step-by-step, with live instructors they relate to.
• We run recurring classes and 1-on-1 sessions, so members can come back as often as they need.
• We focus on building sustainable habits, not one-time explanations.

When you combine this peer-led education with your existing tech investments, you give members a clear path off the phone and into self-service—without sacrificing support.

The result isn’t just a friendlier experience. It’s a different cost curve.