It starts in the summer. Commercials and billboards pop up targeting seniors, promising little to no-cost health insurance plans.
In the fall, it really heats up. Zero copays? Check. Dental and hearing included? Check. A gym membership? Check. A beloved retired athlete endorsing the plans?! Check again.
But is it all too good to be true? In many cases, yes. Many Medicare Advantage plans have hidden costs and restrictions that ultimately result in less value and more stress for the healthcare consumer. Often the marketing practices are deceptive, leading consumers to believe they’re dealing directly with Medicare.
And all that marketing is timed around Medicare’s Annual Election Period, or AEP, which runs from October 15 to December 7 each year.
Spot the difference
Unlike Original Medicare, Medicare Advantage (also known as Medicare Part C) is based on networks. To receive maximum coverage, beneficiaries are restricted to seeing in-network providers only. Contracts are regularly renegotiated, so a doctor or hospital that is in-network one year could be off the plan the following year.
Medicare Advantage plans are run by private insurance carriers that are paid by the government on consumers’ behalf upon enrollment. Plans may have lower or higher out-of-pocket costs than Original Medicare. You may also have an additional premium.
The gold standard
Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). It is accepted across the country. It has no networks, no copays, no pre-approvals, no prior authorizations and no maximum out-of-pocket costs. When coupled with a Medicare supplement policy, it provides predictable healthcare costs. It is the gold standard in senior healthcare plans.
While Medicare Advantage plans often seem more cost-effective, the hidden costs and limitations on care almost always make them a riskier bet.
