Each year autumn brings cooler weather, color-changing leaves, and TV stations advertising Medicare Advantage. You will often see a celebrity (usually former football stars like Joe Namath and Mike “Da Bears” Ditka) gushing about amazing Medicare Advantage plans that include delivered meals, rides to medical appointments, private home aides, discounts at pharmacies, dental, vision, etc., at no cost to you.
Are these Medicare Advantage Commercials Too Good to be True?
The Short Answer:
Yes, often they are. These Joe Namath type ads are overpromising on “potential” Medicare Advantage plans that rarely exist, while not sharing any of the drawbacks. Medicare Advantage plans can be a good low-cost alternative to traditional Medicare but they seldom offer everything advertised on TV and do not provide the flexibility and wealth-protecting coverage of most Medigap plans.
The Detailed Senior65 Answer:
Many television commercials that run during Medicare’s AEP Open Enrollment (Oct 15-Dec 7) brand themselves as Medicare Advantage “Help Lines”, but they are actually produced by lead generation companies hoping to gain your contact information. They promote “possible” benefits of Medicare Advantage such as “private home personal aids” yet less than 4% of all Medicare Advantage enrollees have access to in-home care. These amazing no-cost plans are possible but not probable.
These commercials also do not inform you that many Medicare Advantage plans have limited doctor and facility networks and require referrals to see specialists. According to the Kaiser Family Foundation, 90% of all Medicare Advantage enrollees are required to receive prior authorization for key medical services.
Additionally, with Medicare Advantage plans, the insurance provider can deny certain medical claims and often this happens without good cause. The Centers for Medicare & Medicaid Services (CMS) fined 56% of audited Medicare Advantage contracts for making inappropriate denials.
The Big Takeaway on Joe Namath type Medicare Advantage Commercials
Medicare Advantage plans can be a good low-cost alternative to traditional Medicare but they rarely offer everything advertised on TV and do not offer the flexibility and wealth-protecting coverage of most Medigap plans.
If you currently have a Medigap plan, you can see any doctor who accepts Medicare (the largest doctor and facility network in the United States) without a referral. No Medigap insurance provider can deny ANY medical claims that takes place in the United States. If Medicare says your doctor visit or procedure is covered, then your Medigap plan has to pay its share.
Medicare Advantage extra benefits such as discounts at the pharmacy, gym memberships, free glasses, etc., are not insurance. They are just added low-cost perks that shouldn’t drive your healthcare decision. Most Medigap plans cover 100% of an additional 365 days at any hospital that accepts Medicare but the majority of all Medicare Advantage plans do not.
Medigap’s 100% coverage of an extra year of hospital coverage is something we would like “Broadway” Joe Namath to start promoting. After playing such a dangerous sport he, more than anyone, should know the importance of good hospital coverage.
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