Are you looking for quality medicare coverage?
Perhaps you saw a ClearMatch TV Commercial, and now you’re wondering, “Is this legitimate?”
There are many commercials concerning M.A. Plans with paid endorsement actors that make you feel like you aren’t getting everything you deserve or missing out on coverages. These missing benefits are shown in large letters repeatedly and imply free and just call this number.
We all know that seeing the disclaimer fine print it’s so obvious of the holes and indeed brings to mind, if it’s too good to be true, then. First and foremost, Federal law states explicitly that in advertisements, all that we see and hear must not be misleading and must be the truth!
Well, not to worry!
Get straight facts about how GoHealth works and how you can instead find help legitimately; then you’re at the right place.
This article will explain everything and get official help about the Medicare Coverage program without a rushed decision!
It might surprise you when we look closer at the fine print together too!
- Let’s Look Closer
- Medicare Health Insurance
- Official Government Rules
- Medicare Advantage Plans
- Medicare Advantage Plan Coverages
- Different Types of Advantage Plans
- Qualify for $148.50 back
- Important Advantage Plans
- Compare Best Dental
- Choose Best Plan
- In The Real World
- Good News
Let’s Look Closer
First of all, I feel we should take another look at the commercial and take a closer look.
We can go through the commercial together, and I will Timestamp the section so you can have time to look closer and refer to it easier again if you wish.
We can look at some important details together to investigate to help you determine which insurance is best so then you can make the right choice for yourself and your family.
Then in the different sections of the article, we will talk about the various elements of what is in the fine print, what they are talking about, and how it really works.
Alright, so, let’s start and break down the different parts of this commercial:
Medicare Health Insurance – Timestamp: 00:02 Seconds.
Disclaimer Fine Print
The fine print in the red circles on this screenshot says – “Not affiliated with or endorsed by Any Government Agency or Federal Medicare Programs-Plans Vary By Region And State.”
Really? Hmm, I think I would rather see with my own eyes the Official Rulebook, ALL the options available, AND take my time to decide. How can I do that with a fast-running commercial phone number?
A call center, a Medicare call center, that just has generally 1 company that they hurriedly trained the 100-200 agents for the call center to get money from this massive Commercial, especially during this time of year Oct 15-Dec 7th enrollment period.
Especially since the amount of information that the U.S. government has in the Medicare handbook 2022 is very regulated and can’t be understood fully over a phone call to a call center.
Instead, sit down with a caring, trained insurance agent to have the proper time to compare and ultimately decide what plan is best for you and your family and not rush into a decision over the phone.
Official Government Rules
Have a look and read, if you wish, at The official U.S. government Medicare handbook 2022 pdf.
Official Medicare Advantage Plan (MAP) Part C
This type of plan is an additional way to get Part A and B coverages and extra best benefits for yourself and your family!
These additional coverage plans are many times called Part C or Medicare Advantage (M.A.) Plans are available by separate private companies that have been approved by and must follow rules that Medicare governs.
Description Of Medicare Advantage Plans
Page 61 of the U.S. government Medicare handbook
These MA plans Part D drug coverage, commonly and in many cases to get this coverage, you will need to use the health care provider in that private companies plan network.
The benefit is that the private companies limit the total amount of out-of-pocket money you spend each year for the specified covered services.
Remember you will still have Medicare; however, you will get most of your original Parts A and B coverages from your new Medicare Advantage (M.A.) Plan, not your original Medicare.
You will receive an additional specific card that you will now use for your new Medicare Advantage Pan to get your new Medicare-covered services officially.
(Always keep your original red, white, and blue card from Medicare in case you ever drop your M.A. plan and wish to once again return to only your original Medicare benefit plan.)
Some of these M.A. plans also offer non-emergency coverages at a higher cost out of this private network.
Description Of Some Medicare Advantage Plan Coverages
See Page 61-62 of the U.S. government Medicare handbook
The Medicare Advantage (M.A.) (Part C) Plans will cover all of your Part A and B benefits except any hospice services or clinical trials and temporarily the new benefits that happen because of national coverages or legislation has determined.
If you transition to an M.A. Part C plan, the Original Medicare will still cover the cost involved for hospice care, some clinical research studies, and some of the new Medicare benefits.
The MA Part C does and must cover all urgent care, emergency care, and nearly all the necessary medical services that the Original Medicare covers.
Description Of The Different Types of Medicare Advantage Plans
See Page 66-70 of the U.S. government Medicare handbook
• Health Maintenance Organization (HMO) plan: See page 66.
• HMO Point-of-Service (HMO-POS) plan: This HMO plan may allow you to get some services out of network for a higher copayment or coinsurance. Also, on page 66.
• Medical Savings Account (MSA) plans: On page 67.
• Preferred Provider Organization (PPO) plan: At page 68.
• Private Fee-for-Service (PFFS) plan: See page 69.
• Special Needs Plan (SNP): See page 70.
Medicare Advantage Plan Enrollment means
• That most Medicare services will also be covered through the plan
• Most of your Medicare services aren’t paid for by your Original Medicare Plan
• Additionally, most of the Medicare Advantage Plans offer prescription drug coverage.
Medicare Advantage Plan Enrollment Extra Benefits means coverage for
- Fitness Programs (like gym memberships or discounts)
- Some Vision, Hearing, and Dental services
And More Benefits depending on what is chosen, for example
- Transportation to doctor visits
- Over-the-counter drugs
- Services that promote your health and wellness
- Tailored benefit packages for certain chronically ill enrollees
Seek a professional, courteous, licensed, and above all experienced Agent that you can take the time to plan before you enroll to see exactly
- what benefits does each plan specifically offer
- if you might qualify
- if there are any limitations
You May Be Eligible For Up To $148 Every Month – Timestamp: 00:03-00:12 Seconds
Disclaimer Fine Print
The fine print in the red circle on this screenshot says – “Certain beneficiaries may qualify for help paying their Part B Premium as part of each State’s Medicaid/or Medical Assistance Program.
Provision of Financial Information to ClearMatch Medicare is optional and does not affect enrollment eligibility.”
This part is called the Refund Part B buyback during A Special Enrollment Period (SEP), allows a Medicare beneficiary to join, switch, or drop their prescription drug plan (PDP) Medicare Part D or Medicare Advantage plan (M.A. or MAPD) outside of the annual Open Enrollment Period (AEP) that runs from October 15th through December 7th.
Medicare has extra help eligibility if you qualify for the (LIS) low-income subsidy that is available for Medicare Part D.
Qualify For $148.50 Back From Medicare
If you have Parts A and B, you can enroll in an Advantage plan with a give-back option. These plans reduce your Part B premium up to the full standard amount of $148.50 each month and add the money to your Social Security check.
However, only eligible beneficiaries are those with a limited income for a program with the government that helps pay for costs for Medicare for Part D.
The Commercial says Up to $1,776 a year.
Yes, if you actually qualify for the low-income subsidy, then the monthly savings could add up. But only the beneficiaries of Medicare that get (LIS) the low-income subsidy can get some assistance to pay the monthly premiums, coinsurance, copayments, and monthly premium for their Part D.
Many people do qualify for the Medicare Extra Help savings and don’t even realize it.
To correctly calculate your eligibility for the low-income subsidy, Medicare doesn’t count any resources like your home, insurance policies, or car. So for you to find out if you qualify, the best way is to apply.
The requirements are if your assets and annual income limits are below the eligibility threshold. These limits could change yearly, so you should check the most recent levels and pinpoint more accurately the requirements online at Medicare.gov.
Plans May Include Dental – Timestamp: 00:25-00:44 Seconds
Disclaimer Fine Print
The fine print in the red circles on this screenshot says – “Not affiliated with or endorsed by Any Government Agency. Plans Vary By Region And State.”
“Plans Vary By Region And State. Plans with these benefits are common nationally but may not be available in your area.”
According to What THE FINE PRINT essentially implies, there is NO GUARANTEE what the Commercial is saying is the case.
Important Medicare Advantage Plans
If you are a senior with Original Medicare, you will most likely need to purchase additional dental insurance coverage. This is due to Medicares Part A, which is hospital insurance, and Part B is medical insurance, possibly covering dental expenses only if it’s part of an emergency or surgery.
The Medicare Advantage Plan (M.A.)( also known as Part C) is separate insurance that can include dental benefits, depending on the company you choose.
An example of services could include fillings, dentures, routine dental exams, x-rays, or even gum disease treatment.
When choosing the best Medicare Advantage plans, you should consider something that includes coverage with dental, vision, and hearing and, of course, with the services that are most important to you.
Knowing the Plans Details
- Comprehensive Dental
(extraction, periodontics, and restorative services)
- Preventative Dental
(cleaning, X-rays, and exams)
Depending on your area and needs, United Healthcare, Kaiser Permanente, Cigna, WellCare, Aetna, and Humana are some examples of good private companies to choose your Medicare Advantage Plans.
Is the plan available in your area and nationwide at competitive prices? Many top companies to choose from have premiums ranging from $0 to over $100 each month, depending on your needs.
Reports say that Medicare Advantage enrollees have access to dental coverage; however, not many have Medicare Advantage.
Congress is battling whether or not to add more benefits, as you can read more about this here.
Before you make a wrong commitment, the best advice to do instead is deal with
- A Professional that has access to the best carriers in your area
- A Broker Independent that can shop around for the best program!
- A program that is not just a Zero Premium Plan but gives you the least amount of Copays and deductibles and maximizes the benefits you’re eligible for?
Timestamp 00:45-01:22 Seconds Is Only A Recap And The Phone Number For The Commercial
No Pushy Sales Tactics at Timestamp 01:23-01:30 Seconds
Disclaimer Fine Print
The fine print in the red circles on this screenshot says – “Plans vary by region and state. This is a solicitation of insurance made by ClearMatch Medicare, a brand of HealthPlanOne, LLC.
Guarantee applies to Medicare Advantage plans only.”
Choose Best Beneficial Medicare Advantage Plans
Finding a list of Medicare Advantage Plans that are in your coverage area.
Choosing the Best Type of Plan
- Special Needs Plans (SNP)
- Preferred Provider Organization (PPO)
- Private Fee-For-Service (PFFS)
- Health Maintenance Organization-point of service (HMO-POS)
- Health Maintenance Organization (HMO)
- Knowing the Plans Details
Know Costs in advance
- Monthly premiums
- Yearly Maximum you pay for the health costs
- Out-Of-Pocket costs
- Copayments or Coinsurance costs
Again, you may qualify for this, however, it’s all dependent upon you qualifying for the (LIS) low-income subsidy. Only eligible people can get some assistance that lowers your monthly premium that can then possibly add up to yearly savings.
Many Decisions to make for Expanded Coverage in your Medicare Advantage Plan. Recommend that you consider talking to a broker or consultant to go through every detail with you before you commit to enabling the best coverage for the money and peace of mind for you and your family.
Calling a call center with limited options, might not have this or even know to suggest it and definitely can’t shop around for the best private company since they don’t represent many companies like the brokerage independent agency like us at Direct Express Support can and will help you and prove to you so you can make the proper choices.
Recap And Phone Number at Timestamp 01:34-01:43 Seconds
Disclaimer Fine Print
The fine print in the red circles on this screenshot says – “Certain beneficiaries may qualify for help paying their Part B Premium as part of each State’s Medicaid/or Medical Assistance Program. Provision of Financial information to ClearMatch Medicare is optional and does not affect enrollment eligibility. Plans vary by region and state. Plans with these benefits are common nationally but may not be available in your area. Guarantee applies to Medicare Advantage plans only.”
When you see the Free preventive screenings, in the commercials, know that Medicare covers this.
Again, the commercial leads us to believe that we get a huge discount on prescription medications. The normal is that beneficiaries have a 25% responsibility for the cost of medicines. Anyone with Part D drug coverage qualifies automatically after the total drug cost is $4,080, for example.
The latest and best plan for you should weigh out with an independent broker before rushing into any decision.
The Fine Print Disclaimer that says zero-premium doesn’t mean it’s zero costs. Most of any service has an out-of-pocket cost. These out-of-pocket shares of costs will be paid until the Plan member reaches the plan’s out-of-pocket maximum limit. Another example here.
Most Important When Calling The Call Center
Disclaimer fine print says
- Not affiliated with or endorsed or approved by any government agency or federal Medicare Programs.
- Medicare hasn’t reviewed or endorsed this information.
- Only if they meet certain criteria, then can members enroll.
- Medicare may not offer all plans available in your area.
- The agent may not offer Medicare Advantage Plans.
The fine print means that a misleading question becomes an intention or makes us believe something that is not true or incorrect.
In fall 2019, the American Medical Association (AMA) passed a resolution.
These Medicare Commercials are offered by companies/corporations to make a profit. The purpose of these tv commercials is to get you to act fast.
- Do your research
- Be informed
- Get all the truth
In The Real World
Many prefer a Medicare Advantage Plan because coverages include a prescription drug program, dental, vision, and hearing care bundled together under one plan. These plans often have lower monthly premiums (even $0) depending on the coverage of the plan.
Because many plans are different between plans and providers and even differences in plans that the same providers offer can be, for example, 50% coinsurance or a $50 copayment for a Dental Plan.
Medicare Advantage Plan monthly premiums typically range from $0 to over $100 depending on the coverage.
Some Enrollment Rules
- You can then enroll in a separate Medicare Advantage plan
- When you are eligible to enroll for your Original Medicare
- When you have officially reached the age of 65 or younger, if you have a qualifying disability
- Some plans even offer meals delivery. Plans are based on your location with different eligibility and costs.
- Special Enrollment Period (SEP) you may be able to qualify for this if you have a life event happening, such as a move, or experience loss of income.
- October 15 to December 7 enrollment periods
(during this time, you can change from your Original Medicare Plan and then to a Medicare Advantage Plan or even change from one Medicare Advantage Plan to another when circumstances you see the benefit you to make a change.)
Recap And Final Fine Print Disclaimer at Timestamp 01:44-01:53 Seconds
Disclaimer Fine Print
The fine print in the red circles on this screenshot says – “Not affiliated with or endorsed by any government agency or federal Medicare Programs. Medicare has neither reviewed nor endorsed this information. Outside of the Medicare Annual Enrollment Period, members can enroll in a plan only if they meet certain criteria. Callers will be connected to a licensed insurance agent. This is a solicitation of insurance made by ClearMatch Medicare, a brand of HealthPlanOne, LLC, and may not offer all plans available in your area. Visit Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048). Guarantee applies to Medicare Advantage plans only.”
Quoted Fine Print Above
- Not affiliated with or endorsed or approved by any government agency or federal Medicare Programs. Medicare has neither reviewed nor endorsed this information.
- Members can enroll in a plan only if they meet certain criteria.
- ClearMatch Medicare may not offer all plans available in your area.
This means it is a 3rd-party call center and may not go to GoHealth. A call center with limited options, stating so many disclaimers in the fine print. A call center that you don’t know or have a relationship with.
You are just calling a random person without verifying; are they experts? Do they understand the business? There is not much quality control with that, so again, the buyer beware.
The good news is many times we help people with Medicare questions because there may be the opportunity to get back extra benefits, such as dental vision, hearing, and reducing your copays to get back your $148.50 out of your paycheck that Social Security takes away each month.
Are you interested in free Government benefits that you may be eligible for?
Knowing the cost, and what you are entitled to while benefiting from additional coverage that you might not even realize you qualify for is worth a look for you and your family.
Since we are independent brokers, this allows us to shop all the major insurance carriers to find you the best deal in terms of price and coverage.
You’ve got lots of different options here at Direct Express Support. Many times you could qualify for a better policy that starts immediately.
Right now, it’s real easy to get more information;
You can just simply fill out the form you see on your screen that says something like Get Help Now
if you are on your Desktop P.C.,
fill out the form on the right that’s titled Get Your Life Insurance Quote Now