It’s the season for Medicare Advantage promotions. From October 15 – December 7 each year, you can join, switch, or drop a Medicare plan. That’s why we see so many Medicare Advantage commercials (think Joe Namath and J. J. Walker).

What is Medicare Advantage?

“Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services. Some plans offer non-emergency coverage out of network, but typically at a higher cost.” Source: Medicare.gov

Medicare Advantage Plans have no premium and offer dental and eye glass coverage but there are often limitations to the coverage. While good for many low-income seniors it is far worse for those who can afford traditional Medigap Insurance coverage.

Yes, it has no premium, however, for those people who were members of a union or have retirement health insurance benefits it makes little sense. Far fewer doctors accept Medicare Advantage and the benefits can be seriously inferior.

As an example, traditional Medigap insurance will pay for someone’s co-insurance costs for inpatient rehabilitation care for days 61-90. Source: Medicare.gov

Medicare Advantage will not. With our population living longer it is almost inevitable that a senior will need to convalesce in a rehabilitation facility. In addition, many facilities do not accept Medicaid Advantage.

As Daily Money Managers we help people pay their bills, file insurance claims, and help with all the non-investment aspects of personal finance. Most of our clients are seniors. Unfortunately, insurance companies prey on individuals via television advertising and phone solicitations.

Many of these people are eager to talk to someone and are fooled by the lure of no premium and additional services.

We’ve had numerous clients switch from their traditional Medigap coverage, which they can easily afford, to Medicare Advantage, leaving them with worse coverage. We don’t find out until one of the doctors that they visited says they don’t accept Medicare Advantage and charges them full price.  We then have to go through the arduous task of changing them back to traditional Medigap insurance.

The Centers for Medicare and Medicaid Services has responded to complaints that recent Medicare Advantage advertisements and marketing materials have been “confusing, misleading or inaccurate,” at least in the minds of consumers. Source: Health Care Finance News

The best advice we offer is to talk to a professional Medicare Insurance specialist. There is no fee as they are paid by the insurance companies. If you have any questions please contact us and we’ll direct you to an expert who can help you.