The mismarketing of Medicare Advantage Plans

Medicare Open Enrollment is less than two months away. As a result, I bet you are being bombarded with the wonders of Medicare Advantage plans. Although the commercials espouse wonderful "perks" that are hard to fathom, remember this: The devil is always in the details. When I use the term "perk," I am referring to additional "advantages" that are given to those who are on a Medicare Advantage Plan, which are not offered to those who are on traditional Medicare. The average Medicare Advantage plan consumer does not receive all of the benefits I am about to list. But, depending on the type of Medicare Advantage plan selected, the consumer could use more than one of the perks offered. Common "perks" are: • Free transportation to health care appointments • Free dental coverage • Free over-the-counter medications/vitamins • Free fitness benefit • Free hearing aid benefit • Free vision benefit • Low or no cost monthly premium. Here is what this commercial is not telling you. Medicare Advantage plans are private insurance companies. This means Medicare Advantage plan customers are subject to certain rules, or jumping through hoops, which consumers on traditional Medicare do not have to comply with to get their coverage. Although Traditional Medicare will be experimenting with the use of "prior authorization" in 2026. That is another story for another day. For example, Medicare Advantage Plans: • Don't have to cover a doctor outside of a certain geographic area; If you travel, this isn't very helpful. • Don't have to be accepted by sophisticated hospitals, like The Cleveland Clinic or the University of Toledo Medical Center • Don't have to be accepted by local hospitals; You may recall the upset with regard to Firelands Health and United Health Care Medicare Advantage Plan in July. Thankfully, it was resolved, but who is to say that it won't happen again, and who is to say that it won't happen with other Medicare Advantage plans in the years to come? • Don't have to be accepted by physician practices/primary care practices; Keep in mind that if your doctor accepts your Medicare Advantage insurance today, you are not guaranteed that will always be the case. You might have to find another doctor willing to accept your insurance. • Don't have to be accepted by all rehab facilities. This is important. Rehab facilities are often used following a surgery or an acute hospital stay. Your insurance may dictate where you will go for rehabilitation and where you will not go. Want to go? From 1:30-3 p.m. on Thursday, Aug. 28, Serving Our Seniors is producing a forum titled The Mismarketing of Medicare Advantage Plans. Speakers are: • Jodi Roberts, Ohio Senior Medicare Patrol • David Painter, Ohio Department of Insurance community liaison, Ohio Senior Health Insurance Information Program To reserve your seat, RSVPs are due by noon on Monday. Call Serving Our Seniors reservation line, 419-504-0585. Leave your name, phone number and the date of this forum. An audience of 30 or more is required to justify the time and travel of the speakers. If the forum is canceled, you will be notified by phone.