Each fall, we are inudated with “Free” Medicare Advantage Plan advertisements. Post cards and commercials alike boast extra benefits like dental, vision, and even money back on your Medicare premiums. If you’re wondering whether these offers are legitimate or just slick advertising, you’re not alone.
AMAC’s Medicare Advisory Service is committed to helping American citizens navigate the often-confusing world of Medicare. Here’s what you need to know about those eye-catching ads—and how to separate fact from fiction.
What Is a Medicare Advantage Plan?
Medicare Advantage Plans, also known as Part C, are private insurance options that function as an alternative to Original Medicare (Parts A and B). Ads often call them “All-in-One,” “Bundle Plans,” or “All Inclusive” to make them sound more appealing. Some consumers refer to them as “Free” Medicare Advantage Plans, but we will explain later why this is problematic.
Medicare Advantage Plans can include extra benefits, but they all have different costs and rules.
Extra Benefits
Many Medicare Advantage Plans offer extra benefits that go beyond what Original Medicare covers. This can include:
- Dental and vision coverage
- Over-the-counter allowances
- Gym memberships
- Acupuncture and massage therapy
However, not every plan includes extra benefits. Coverage levels vary by provider and plan type. Extra benefits may also have limited availability depending on your area.
Bottom line: Always read the fine print and compare plans carefully.
Are Medicare Advantage Plans Really Free?
Commercials often highlight $0 premiums, hence the misnomer: “Free” Medicare Advantage Plan. While many have low or $0 premiums, you’re still responsible for paying your Medicare Part B premium, which is typically deducted from your Social Security check. So no, they are not “free” Medicare Advantage Plans.
Plus, you may still face:
- Deductibles
- Copayments
- Coinsurance
Costs can add up, depending on how often you use healthcare services. However, there is a spending cap—also known as the Maxium Out-of-Pocket (MOOP)—that offers enrollees some protection.
The MOOP limits your annual out-of-pocket expenses for hospital and medical services. Once you’ve met your MOOP the plan pays 100% of covered medical expenses for the rest of the year. In plan year 2025, the Maximum Out-of-Pocket is $9,350 for in-network services and $14,000 for in-network and out-of-network services combined. Nevertheless, plan providers can choose to offer a lower MOOP.
What About the Part B Give Back?
Some Medicare Advantage Plans advertise a Part B Give Back or Buy Back—a feature that reduces your monthly Part B premium. This benefit means more money in your Social Security check each month.
But be careful as not all plans offer it and the giveback amount varies. Eligibility also depends on your location and the insurance carrier. If you’re considering a plan with this feature, speak with a licensed insurance agent to understand exactly how much you might receive.
Network Plans
Here’s what the commercials leave out: enrolling in a Medicare Advantage Plan means you’re using a private insurer to manage your healthcare needs instead of Original Medicare. Medicare Advantage Plans do not cancel your Original Medicare coverage, but they take the place of it. This means that your insurer manages your coverage and you must follow their network rules.
Main Network Types:
- HMO (Health Maintenance Organization) – requires referrals to see specialists and you can only use in-network doctors (except in emergency situations)
- PPO (Preferred Provider Organization) – no referrals required and you have the flexibility to use out-of-network doctors (at higher costs)
- PFFS (Private Fee-for-Service) – you must confirm with your provider at each visit whether they will accept the plan
Each Medicare Advantage Plan operates differently. If your preferred doctor or hospital isn’t in the network, you could pay significantly more—or not be covered at all.
How to Choose the Right Plan
All Medicare Advantage Plans are not created equal.
That’s why it’s vital to:
- Compare coverage and extra benefits
- Check doctor and hospital networks
- Confirm prescription drug coverage
- Understand costs like premiums, copays, and deductibles
AMAC’s licensed Medicare Advisors will guide you every step of the way. We’ll research which plans your doctors accept, review drug coverage, and help you find a plan with extra benefits that suit your lifestyle.
Don’t Be Misled by Medicare Ads
Medicare Advantage Plans can be a smart choice, but only if you know what you’re signing up for. Remember that ads might leave out critical details—so always look beyond the headlines.
For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below.
There’s so much more to choosing to go traditional Medicare and pickup a Part D and a Supplement or go Medicare Advantage. Such as a MA plan company can drop their MA plan at open enrollment and you are scrambling to find one that aligns with those same benefits. Then the question of do your physicians and preferred hospital participate with the new one.
If you choose traditional Medicare, Part D and a supplement there is a cost but no pre-existing. If you go with a MA at anytime then decide to go with traditional and a supplement, you may be subject to pre-existing with the supplement and the cost is higher.
This is just an example of something that has to be considered. Also, traditional with D and G will cost more but…most physicians and hospitals participate with it. Makes traveling much easier.
It’s not just a matter of having to scramble around for a new plan if the company drops your Medicare Advantage plan at open enrollment. Your Medicare plan choices should be reviewed EVERY YEAR at Open Enrollment to determine which plan is the best for you and your requirements. Don’t assume the plan you currently have is not changing for the next year. Do some research at Medicare.gov to familiarize yourself with how Medicare works. Most folks newly eligible for Medicare don’t have a clue how it works. Even eligibility for coverage is complicated…
I know personally that Medicare Advantage is NG. It may be good for young healthy people but not for aging folks who need a lot of medical care. My husband at 80 became seriously ill and was in hospital for 30 days and then in a rehab facility. The financial office of the rehab place called me and said ‘are you crazy having your husband in Medicare Advantage’. She helped me move his coverage. He then went back to the hospital for another 30 days before his death. I had thousands of dollars for the first month and zero for the second. Co-pays, deductibles, etc. I am 1000% against Medicare Advantage
If you do decide on a Medicare Advantage plan. Please find out ahead of time what the deductible for ambulance, ER and hospital stay are ahead of time. My first year in Medicare I went with an Advantage plan. I ended up having to be hospitalized. The deductible back in 2023 was almost $700. I was lucky I got in on what they had back then a way to switch to a supplement without having to answer medical questions, yes a lot more money, but for me well worth it. Last year I landed in ER several times a few times by ambulance. In 2023 the ambulance deductible for the plan I had was $230, ER was $90. I was hospitalized 4 times last year. Thankfully with the supplement I meet a one time deductible of $257 and haven’t had to pay anything else. I started doing the math and I would have been close to $10,000 in debt with the hospital and specialist. That is whole lot less than I pay in premiums for the supplement.
Everyone’s situation is different so everyone has to do what is best for them.
I didn’t expect the problems I now had, was pretty healthy going into Medicare, but things changed quickly.
My husband and I are military retirees and have been very happy with our Advantage Plan. It’s a PPO with a $0 cost and a kickback to our SSA checks. The copays and extra costs are picked up by our secondary insurance from our military service. We’ve had surgeries and paid nothing more out-of-pocket other than our prescription copays.
Phishing phone calls that say they know all about my health drive me
nuts. i ask them to put me on a do not call list, but I get an average of
5 daily. They lie or at let mislead when they say they are calling from
medicare. These need to be outlawed. I am on both medicare and
tricare and I don’t need anything else. Please stop the elder abuse.
Nothing is ever free, you are paying for it one way or the other. Medicare Advantage Plan is nothing more than another HMO plan, meaning you have to get an authorization to seek medical care for an outside “contracted specialist/other provider” of services from the provider’s office you are getting treated by. If you choose to go to a different specialist, other than one that is contracted with the group, this may result in you paying for it out of your own pocket. Before choosing an Advantage Plan, take into account what your illnesses are, ask many questions of the provider (doctor), or office, you are thinking about signing up with. Don’t get stuck with bills you may have to pay. Talk with your friends or neighbors, get 2nd/3rd opinions, see how they feel about the Advantage Plan versus traditional Medicare.
Why is it so complicated? The obvious answer is to keep all of us confused and susceptible to any lie they want to tell us… I was trying to choose between two alternatives and each one of those two had a half dozen options… and each one of those options came with pages and pages of detailed “pay or not pay” information.
great article medicare and advantage ain,t FREE. bit it is worth
it, i use aetna and it works….. like your article states,its paid as a
deductionof ssa check. keep the TRUTH coming AMAC
I’ve had a Medicare Advantage plan for 6 years, and it’s worked very well for me. I live in what is considered a rural area, and the plans I can choose from are limited. Until this year, I had a $0 premium and low copays. But starting in 2025, there are no $0 premiums plans available to me. Now I have a $30 monthly premium. But I still pay much less overall than my friend with traditional Medicare. She pays hundreds for her monthly premium, plus another premium for a drug plan. When you add it up, I think I’ve come out ahead. And 99% of doctors in our area are part of the PPO, so I always pay in-network copays. You have to evaluate each option based on your needs.
I was NOT looking forward to navigating this system when I turned 65 two years ago. Went to an “agent”, choice was straight forward since my county in southern OR only has Atrio. She took care of everything and process was rather seamless. Whew.
I consider the Advantage ads fraudulent, in large part for the reasons given in the article. But an additional issue with these plans is that you are essentially putting all of your healthcare decisions in the hands of an insurance company that makes more money the less healthcare they provide! Advantage insurers often can and do ration healthcare more strictly than Basic Medicare and a Supplement which must pay the 20% Medicare does not. In our experience, Basic Medicare is more tolerant paying for treatments recommended by doctors than Advantage providers. Last, switching from an Advantage back to Basic Medicare can be difficult since health issues may restrict availability of a Supplement and Supplement rates will be higher due to age. My view is that Advantage plans look great in early retirement if in good health but get really bad as health declines with age. I strongly recommend avoiding them.
I’m sticky to my Original Medicare plan along with my husbands employer plan. Cost us near $13K a year, but we pay no deducible and $0 for each service.
Too many people don’t want to read all the fine print on the coverage and those ADS on TV don’t help because they don’t explain the details. I have gone to seminars to listen to the talk given but you have to ask and look how the plan works for you. I always check to make sure my plan covers whatever service I see any doctor for, including whether I have a copay or not. The dental and vision coverage needs better explanation on exactly what it covers. I still haven’t considered dental because it is too vague in what it covers beyond an exam.
By the way, not all HMO’s require referrals to see a specialist. That statement in the article should be corrected.
The whole system needs to dumped in the trash and start over with honest people setting it up. All these “advantage” plans are nothing more than an advantage for insurance companies to take in a mountain of $$$$ from government subsidies (tax payer $$$). How can insurance companies spend billions $$$$ annually to advertise things that they say are “Free”??? Think about it. All they are interested in is getting that mountain of money from the government (the tax payers). The whole system is rigged so the only ones getting suckered are the tax payers and the elderly that were forced to participate in the system their entire working lives and now have to continue paying so the insurance companies and politicians can continue to reap the rewards.
Just make sure you are covered by your employer’s health plan at age 65, otherwise when you retire and apply for Medicare part B, at age 70, which currently is $180.00 per month, you will incur a penalty added to the current cost of Part B for the rest of your life.
See if your company’s health insurer can recommend a life change insurance provider to help you navigate the Medicare maze.
One more clarification, you do not have to enroll in Part B until you no longer have medical coverage with your employer. Why pay for something you don’t need.
Hi Penny, there is a phone number at the end of the article that you can call to start looking at you can do once you are fully retired.