Perhaps you saw a commercial from Medicare advantage Review T.V. Commercial with Famous Actors, and now you’re wondering, is this legitimate?
Many commercials concerning MA Plans with paid endorsement actors 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 call this number.
We all know that seeing the disclaimer fine print it’s so evident 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!
If you want to know some helpful straight facts about how Medicare Advantage Coverage works, then you’re certainly at the right place.
- Closer Look
- Fine Print Disclaimer
- Enrollment Rules
- Official Government Rules
- Description of Medicare Advantage Plans
- Description of Medicare Advantage Coverages
- Different Types of Medicare Advantage Plans
- Choosing Your Plan Correctly
- Medicare Advantage Facts
- Beware Call Centers
- Facts Before Switching Back To Original Medicare
- Good News
- Life Insurance Without Visiting You
Closer Look at the Commercials on T.V.
No matter the narrator, all the commercials speak of what you deserve to get. In very large bold fonts, they list benefits while encouraging you to call a free number where you can sign up today.
Kaiser Family Foundation states an average Medicare Beneficiary in 2022 has a choice of:
- 54 Medicare plans
- 766 Medicare Part D prescription drug plans
- 3,844 Medicare Advantage plans
What we see or hear in an advertisement has to not be misleading, and it must be truthful, According to Federal law. These commercials on T.V. in the way they say it is true. However, so much is left unsaid that is the most important part of the information that you need to make a proper decision.
For example, the fine print in these T.V. commercials says 0 premium, 0 deductible and 0 co-pay and also says free when it isn’t really free. Or that you will get back $148.50 from your social security check.
This is available if you actually qualify for the low-income subsidy, then the monthly savings could add up. Only qualified (LIS) the low-income subsidy beneficiaries of Medicare will get some assistance to pay their monthly premiums and coinsurance and copayments for their Part D.
If your annual income limits and assets are below the eligibility threshold, then you could qualify. Every year these limits can change, and Medicare doesn’t count any resources like your home, insurance policies, or car, so to correctly calculate your eligibility for the low-income subsidy at Medicare.gov you can find the most recent eligibility levels.
The Fine Print Disclaimer
In those commercials that say 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.
This is because many plans and providers are different. The same providers offer differences in plans such as 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.
A few important points that are not mentioned in the commercials:
- Unless an emergency, benefits are only available through selected providers, which limits the individual’s choices.
- The plan needs to approve the physician’s order before you can get care.
- Limits on your benefits. For instance, only 2 meals a day for five days after hospitalized with a limit of 4 total hospitalizations.
- Members are many times required to select only 1 benefit per calendar year.
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.
- A few plans do offer meals delivery. Those plans are based according to your location with different eligibility and costs.
- The (SEP)Special Enrollment Period is where you may be qualify for if you have a recent life event happening, for example, a move, or experience a loss of income.
- The enrollment period is October 15 to December 7.
(You are allowed to change from your Original Medicare Plan to a Medicare Advantage Plan and you can even change from one Medicare Advantage Plan to another if you see something that benefits you to make a change.)
When you see the Free preventive screenings, in the commercials, know that Medicare covers this.
Again, the commercials lead 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.
Official Government Rules
The amount of information that the U.S. government has for you to understand is actually very detailed.
You can click here for the official .U.S. government Medicare handbook 2022 pdf.
About (MAP) Medicare Advantage Plan Part C
An additional way for you to get additional benefits and still receive your Part A and B coverages.
Separate approved private companies offer coverage plans called Part C or (M.A.) Medicare Advantage Plans. They must follow the rules governed by Medicare.
Description of Medicare Advantage Plans
This is page 61 in the Medicare U.S. Government Handbook
To get these Part D drug coverages, you will need to use a health care provider approved by that company plan network.
There is a benefit of these private companies in that they set a limit on the total out-of-pocket money for specific covered services each year.
The Advantage Plan will cover most of Part A and B now, not your original Medicare.
You will get a new Medicare Advantage plan card to use for your new services. Remember to keep your red, white and blue original Medicare card in case you wish to return to your original Medicare benefit plan.
Non-emergency coverages can be purchased at a higher cost on some M.A. plans.
Description of Some Medicare Advantage Plan Coverages
This is pages 61-62 in the Medicare U.S. Government Handbook
Except for hospice services or any clinical trials and temporarily any new benefits because of new legislation or new national coverages, your new Medicare Advantage plan will now cover all of your Part A and B benefits.
However, your Original Medicare will still pay the cost for hospice care, some of the new Medicare benefits, and some clinical research studies.
Your new M.A. Part C will cover all emergency care and urgent care and most of all the same medical services that your Original Medicare covered.
The Different Types of Medicare Advantage Plans
This is pages 66-70 in the Medicare U.S. Government Handbook
- (HMO) Health Maintenance Organization on page 66.
- (HMO-POS) HMO Point-of-Service is another HMO that you could get some services that are out of the network for a higher copayment or higher coinsurance that is also on page 66.
- (MSA) Medical Savings Account can be found on page 67.
- (PPO) Preferred Provider Organization can be found on page 68.
- (PFFS) Private Fee-for-Service can be found on page 69.
- (SNP) Special Needs Plan can be found on page 70.
Enrollment in (M.A.) Medicare Advantage Plan means:
- Most of your Medicare services are covered
- Most of your Medicare services are no longer paid by your Original Medicare Plan.
- Most of the Medicare Advantage Plans do cover your prescription drugs.
Extra Benefits Enrollment in a Medicare Advantage Plan means:
- Coverage for some Hearing, Vision, and Dental.
- Gym Memberships or discounts for Fitness Programs.
Additional Benefits if you choose, for instance:
- Over the counter drugs
- Health and wellness services
- Doctor visits transportation
- Some chronically ill enrollees can seek additional tailored benefits packages.
Choosing your Plan Correctly
Consider if the best Medicare Advantage plan includes dental, vision, hearing and services most important to you.
For Dental an example would also include x-rays, fillings, routine dental exams, dentures and even a gum disease treatment.
Many plans have differences depending on the plan and providers. Some of these differences can be 50% coinsurance or a $50 copayment for a Dental Plan.
Medicare Advantage Plans cover dental, vision, hearing, and a prescription drug plan bundled together in a package deal under one plan. Many people prefer this type of plan as they tend to offer lower monthly premiums (even $0) just depending on the plan.
These Medicare Advantage Plans normally range anywhere from $0-over $100 for a monthly premium depending on the extent of your coverage.
Some good private companies are Cigna, WellCare, Humana, Aetna, United Healthcare, Kaiser Permanente. Check your area and needs for coverage areas.
Recommendation for you to consider talking to a broker or consultant.
Before you commit, speak with a professional to get the best coverages for the best price to not waste money and receive the best benefits possible.
Knowing the Plans Details
- Comprehensive Dental
(extraction, periodontics, and restorative services)
- Preventative Dental
(cleaning, X-rays, and exams)
Consider the Costs involved, including:
- The Monthly premiums
- The Yearly Maximum you pay for the health costs
- Out-Of-Pocket costs
- Copayments or Coinsurance costs
Medicare Advantage Plan Facts
The T.V. commercials act like they are going to do everything for you so easily! We will drive you to your doctor’s appointments, and we will give you dental and hearing and vision and prescription drugs. They promise too much.
Unfortunately, many people think it sounds like they will save loads of money and even get some money back monthly on their Social Security checks. So, they sign up without really knowing what they are getting.
Kaiser Family Foundation did a survey that 7-10 Medicare beneficiaries did not compare the coverage options.
A MedicareAdvantage.com also did a survey of over 1,000 beneficiaries states that 3-4 people felt it was difficult to understand and confusing.
Additional Important Facts
Medicare Advantage plans have a limit for your annual out-of-pocket costs on your covered services. $0 premium plans and small annual out-of-pocket plans are available, but the 0 co-pay is misleading. 0 co-pay is for your primary doctor.
Also, with Medicare Advantage, you pay as you use the services. For example, $400 a day for 5-6 days of hospitalization or $50 to pay a specialist. People tend to think that $0 premium means free, but it’s not.
These out-of-pocket expenses can add up to as much as $7500 a year or even $11,000 a year if you use a provider that is out of your policies network.
And again as I mentioned earlier above in this article, your plan has to review and approve the services before you receive it!
If you choose to switch back to your Original Medicare in 2022, there is a medical underwriting that if you have become ill, then a health provider must check you out before you can get coverage approved. Plus, in most states, you can be rejected for even the most comprehensive of Medigap Medicare Supplement plans.
People need to do more research. That’s why An Independent Broker Professional that can access all of the best carriers in your area.
An Independent Broker Professional can shop around for the absolute best program that suits you. An Independent Broker Professional gives you the least amount of Copays and Deductibles yet can maximize the benefits you are eligible to receive.
Beware Calling a Call Center
The fine print is stated in a way that means misleading question becomes an intention or it makes us believe something that is not true or incorrect.
In the fall of the year 2019, (AMA) the American Medical Association passed a resolution.
Medicare TV commercials are offered to make a profit by large corporations of companies. The purpose of the commercials is to get you to hurry and make a deciesion fast.
- Research first
- Be informed and know your options
- Find out all the truth
If you do call the number on the commercial, you will find that the call center has limited options and won’t suggest the best coverage for the best price because they are limited and not independent brokers that can shop many of the largest insurance carriers.
At Direct Express Support we can help you so you can make the proper choice and you are never rushed into a decision.
You may be talking to a pro or talking to a brand new person. There’s no continuity of quality of service, much less the quality of and availability to carriers.
Bottom line, you are calling a call center. The way these people are hired, as they’ve brought in, they work during the A.P. Period only and then either fired or let go. So you’re always dealing with new people. You’re never dealing with the same age, and you’re not getting service.
You need a pro, and you need pros working with you that will serve us and help you after the sale and whilst you have access to the best carriers!
Best Advice is to Contact a Professional
- An Independent Broker Professional that can access all of the best carriers in your area. to shop around for the best program that suits you.
- An Independent Broker Professional gives you the least amount of Copays and Deductibles yet can maximize the benefits you are eligible to receive.
An independent broker experienced in answering your Medicare questions, verifying an opportunity to receive extra benefits, like dental vision and hearing, and helping get back your $148.50 that Social Security takes away each month out of your paycheck.
We pinpoint legitimately what you currently pay, what you are entitled to, and benefit from additional coverage the many times people were unaware they qualify.
Many times, additional coverage while spending less, we can help find these answers for you before you decide without rushing you.
Click here for free Government benefits.
Think Before You Switch back to Original Medicare
A nonprofit health research group called The Commonwealth Fund found that both Medicare Advantage and Medicare enrollees are satisfied.
However, the benefits of the Advantage plans means:
- Medicare Advantage plans offers better care management.
- Treatment plans that reviewed their prescriptions and medical concerns more quickly.
- Health Care Professionals seemed to give clearer instructions about priorities in caring for their specific condition and clearer instructions about symptoms to monitor.
- What did you spend on healthcare last year and the year before?
- Premiums and out-of-pocket that you can afford in the upcoming year.
- Confirm your prescription drug coverage is included or get a Part D plan.
- Do you need dental, hearing, and or vision?
- Do you have special needs like chronic health conditions for your long-term needs?
- Does my healthcare provider accept Medicare, or do they participate in an HMO network?
- (CMS) The Centers for Medicare & Medicaid Services developed a 5-star system to rate the quality of a Medicare Advantage plan. So what is the rating for the plan you are investigating?
The CMS star rating measures things like management of chronic conditions, availability of care, member experience and complaints, customer service, drug pricing, and more.
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
The good news is that many times we have helped people with Medicare questions. There may be the opportunity for you to get back extra benefits for you and we can qualify you in a few minutes and show you before you decide.
- An Independent Broker Professional that can access all of the best carriers in your area.
- An Independent Broker Professional can shop around for the absolute best program that suits you.
- An Independent Broker Professional gives you the least amount of Copays and Deductibles yet can maximize the benefits you are eligible to receive.
- The latest and best plan for you should weigh out with an independent broker tailored solution before rushing into any decision.
- An independent broker experienced in answering your Medicare questions, verifying an opportunity to receive extra benefits, like dental vision and hearing, and helping get back your $148.50 that Social Security takes away each month out of your paycheck.
Here at Direct Express Support, you’ve got lots of different options. And many times you could even qualify for a better policy that will start 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.P.C.,
fill out the form on the right that’s titled Get Your Life Insurance Quote Now
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