AMAC investigates misleading Medicare commercials:
We all know there is no such thing as a free lunch, but one can’t help but be curious when inundated with Medicare advertisements claiming to offer free dental care and money back in your wallet. These ads target Medicare beneficiaries and leave you wondering… are these plans too good to be true? AMAC is here to give you the facts and dispel any misinformation.
What’s in a name? The type of plan referenced in the majority of these ads is a Medicare Advantage Plan. But that is not always clear because the ads tend to use language like “Part C,” “All Inclusive,” “All-in-One,” and “Bundle Plan” to describe them. This makes it hard to decipher which type of plan is being presented. As a rule of thumb, if the plan includes benefits other than hospital and medical coverage, it may be an Advantage plan.
What about those additional benefits? It’s true, some of these plans offer additional benefits for things like dental, vision, acupuncture, over-the-counter items, and even massage therapy. What they don’t tell you is that these benefits are not offered with all Medicare Advantage Plans and the benefit levels vary from plan to plan. Additionally, some carriers may even charge an additional premium for these benefits.
Are the plans free like the ads suggest? A number of these plans do have exceptionally low premiums, or even $0 premiums, BUT you are still responsible for your Part B premium (and Part A, if you do not get it premium-free). You are required to remain enrolled in Part A and B to be eligible for a Medicare Advantage Plan. And while the premium may be low, keep in mind that you may have deductibles, copays and/or coinsurances as you use the plan.
Will I really get money back? It depends! Some of these plans offer a “Part B Give Back” or “Part B Buy Back,” which means that they reduce the Part B premium that comes out of your Social Security check, giving more money “back” to you. If you read the fine print, they say they can get you up to a certain amount of money back. This is because not everyone is eligible to receive the full amount, and some carriers only offer a small amount back. If you receive Medicaid or Extra Help, you may not be eligible to receive any money back at all.
So, what’s the catch? There is much that goes unsaid in these ads, like the basics of how a Medicare Advantage Plan works. Medicare Advantage Plans take the place of your Original Medicare (Part A and B) to administer hospital, medical and prescriptions benefits through a private insurance company (certain plans can be purchased without drug coverage). While you will still be enrolled in Original Medicare AND continue to pay your Part A and B premiums, you will no longer use this coverage while enrolled in an Advantage Plan. Therefore, the Advantage Plan will be your sole insurance for doctor visits, hospitalizations, or outpatient services, all of which may be subject to varying copays and/or coinsurances.
Another fact about Medicare Advantage Plans that if often overlooked is that these plans operate off a network like an HMO, PPO, or PFFS. If your doctor does not accept the plan’s terms, you may have to choose another doctor or pay the full cost of your visit when you see them (unless it is an emergency or urgent visit). Doctors, hospitals, and facilities can drop out of the network at any time.
Medicare Advantage Plan choices are based on your service area, which is your residential zip code and county. That is why these commercials encourage you to “Check your Zip Code.” But if you move out of your service area, you will have to find a new plan in your new area. Some areas do not offer Medicare Advantage Plans at all.
Keep in mind that once you enroll in an Advantage Plan, you may only leave the plan at certain times of the year, like during the Annual Enrollment Period (10/15-12/7) or if you have a special circumstance.
Ultimately, these commercials can be misleading for those who do not know much about Medicare Advantage Plans and how they work.
There are Medicare Advantage Plans that do offer the benefits they are advertising, but not all of them. Since Medicare does not require the plans to offer additional benefits, this can be confusing when a commercial is shouting at you to “Get all the benefits you’re entitled to!”
If you decide that you would like to try an Advantage Plan, be sure to do your homework first! AMAC’s licensed Medicare Advisors can help you with your research by finding out which plans your doctor accepts, making sure your drugs are covered, and keeping in mind the additional benefits that are important to you. With just one call you’ll get a comprehensive analysis and help finding an affordable plan that meets your needs – no Joe Namath required.
If you would like to review specific plan options, the licensed agents at AMAC are happy to assist you. We are licensed with top-rated insurers throughout the country.
Call 1-855-611-4856 to speak with one of us today or request a quote below!