GoHealth Medicare Commercial Review [Scam Or Legit?]

Dave Duford last updated on March 7, 2022

Are you looking for quality medicare coverage?

Perhaps you saw a GoHealth 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!

For straight facts about how GoHealth works and how you can be helped legitimately, then you’re at the right place.

This article will explain everything to know and how to get official help about the Medicare Coverage program.

It might surprise you when we look closer at the fine print together too!

Quick Navigation

A Closer Look
$144 Back
How to Officially get $148.50 back
Official Government Rules
Medicare Advantage Plans
Medicare Advantage Plan Coverages
Different Types of Advantage Plans
Disclaimer Fine Print Call Center
Important to know
Choosing Correctly
Compare Best Dental
Choosing Best Plans
Best Choice
Paid Actor Endorsement
Conclusion
Good News

A Closer Look

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:

You may qualify for up to $144 Added Back to your social security every month – Timestamp: 00:4-8 seconds

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.”

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 officially from October 15 through December 7.

These benefits they are talking about are that if you qualify for the low-income subsidy (LIS), then Medicare has extra help eligibility available for Medicare Part D.

How do you 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 prescriptions drug costs for Medicare Part D.

These 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.

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.

In addition to not meeting the low-income criteria (LIS), you most likely will be dealing with 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.

Official Government Rules

The amount of information that the U.S. government has for you to understand is actually very detailed.

Have a look and read, if you wish, at The official U.S. government Medicare handbook 2022 pdf.

https://www.medicare.gov/Pubs/pdf/10050-medicare-and-you.pdf

Medicare Advantage Plan (MAP) Part C

This type of plan is an additional way to get Part A and B cover but additional benefits.

These additional coverage plans are many times called Part C or Medicare Advantage (M.A.) Plans and are offered by separate private companies that have been approved by and must follow rules that Medicare governs.

Medicare Advantage Plans

Page 61 of the U.S. government Medicare handbook

These MA plans Part D drug coverage, normally 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 set a limit on 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 other 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 (HMOPOS) 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 are 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 qualify for benefits like $2,500 Dental Coverage – Timestamp: 00:09-00:12 seconds

Fine Print

The fine print in the red circles on this screenshot says – “Not affiliated or endorsed by any government agency. Plans vary by region and state.”

And

“Benefits amounts based on median amounts available, not all benefits are available in all plans and regions.”

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.

Disclaimer fine print Concerning the Call Center 800 number 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

Important to know about Medicare Advantage Plans

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 here.

The Medicare Advantage Plan (MA)( also known as Part C) is separate insurance that can include dental benefits, depending on the private insurance company you choose to then cover your medical and hospital benefits. It’s a healthcare option that basically replaces your coverage from your OriginalMedicare.

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, which covers dental expenses only if it’s part of an emergency or surgery.

Choosing Correctly

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 and your family.

An example of services could include fillings, dentures, routine dental exams, x-rays, or even gum disease treatment.

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.

Knowing the Plans Details

Comprehensive Dental

(extraction, periodontics, and restorative services)

Preventative Dental

(cleaning, X-rays, and exams)

Knowing in advance, the Costs involved

Monthly premiums
Yearly Maximum you pay for the health costs
Out-Of-Pocket costs
Copayments or Coinsurance costs

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.

See if you are eligible – Timestamp: 00:12-00:20 seconds

Same Disclaimer Fine Print

The fine print in the red circles on this screenshot says – “Not affiliated or endorsed by any government agency. Plans vary by region and state.”

And

“Benefits amounts based on median amounts available, not all benefits are available in all plans and regions.”

So, there is no guarantee that you are going to get this insurance. In addition to not meeting the low-income criteria (low-income criteria), you most likely will be dealing with a call center and only represent One company. That isn’t necessarily the best option.

Choosing Best Plans

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 for yourself and your family.

Important Considerations

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 Costs

Monthly premiums
Yearly Maximum you pay for the health costs
Out-Of-Pocket costs
Copayments or Coinsurance costs

800 number – Timestamp: 00:21-00:24 seconds

More added to Disclaimer Fine Print

The fine print in the red circles on this screenshot says – “GoHealth assists beneficiaries with applications and initial eligibility screening, but only the relevant state agency may determine eligibility. Provision of financial information to GoHealth is optional and does not affect enrollment eligibility.”

Many differences between plans and providers. Even differences in plans that are offered by the same providers. For example 50% coinsurance or a $50 copayment for a Dental Plan.

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 plan’s coverage.

Medicare Advantage Plan monthly premiums are typically ranging from $0 to over $100 depending on the coverage.

October 15 to December 7 enrollment periods, you can change from your Original Medicare and switch 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.)

Also, a 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.

Shop Around

Call a call center with limited options that might not have this or even know to suggest it. You definitely can’t shop around for the best private company since they don’t represent many companies as an independent brokerage agency does.

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?

A Paid Actor at Timestamp: 00:37-45 seconds.

This is a paid endorsement, and it’s somebody who is getting paid to make these comments.

It’s not somebody who actually bought the medicare coverage plan from the 800 number but instead an actor who got paid money to talk, so you should know this and always buyer be aware.

It’s not somebody who actually bought the medicare coverage plan from the 800 number but instead an actor who got paid money to talk, so you should know this and always be aware that just because its in the script, as you can see by now, it doesn’t mean it will happen. This is because there are many rules and regulations by the Government that need to be followed and processed

With a call center, you can’t see the person, and obviously, there is no guarantee that you are going to get the best insurance.

From Timestamp: 00:45-01:44 seconds

Basically, you can see for yourself there are just more paid actors and recaps of the screenshots we have shared together and already talked about today.

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, possibly adding up to yearly savings.

Call a call center with limited options that might not have this or even know to suggest it. You definitely can’t shop around for the best private company since they usually only represent one company.

Conclusion Fine Print at Timestamp: 01:44-01:53 seconds.

Final Disclaimer Fine Print

Visit medicare.gov or call 1-800-MEDICARE for a full listing of options.

This is an advertisement for insurance.”

Quoted Fine Print Above

Not endorsed or approved by any government entity.
Benefits and plans may not be available in your area
GoHealth may not offer all plans available.

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.

This is opposed to independent brokers that have the best policies and options to choose. You and your family are most likely to retain the best for you and save money because it’s not wasted on lesser inferior coverage.

GOOD NEWS

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?

Quality

We want to help to get you access to government benefits and a quality Medicare plan.

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