We’ve all seen the TV commercials where celebrities push free stuff associated with Medicare plans. “Free Dental coverage! Free vision! Free gym memberships!” How can companies offer all these free perks?
The plans referenced in these commercials are called Medicare Advantage plans (Part C). With an advantage plan, a private insurance company handles your Medicare coverage (so put that Medicare card away). This is not a Medicare Supplement. It’s usually a bundled plan that includes RX coverage (though not always).
These plans receive money from Medicare based on your enrollment. The insurance company then uses this money to build their own plan. They set the network, establish the co-pays, and create a “max out of pocket.” This plan may or may not have a monthly premium, and although it is usually cheaper on a monthly basis, the advantage plans can be more expensive if you have a health event.
So, what about all that free stuff? No, the insurance company isn’t generously giving things away, they simply know their numbers. They can offer a free cleaning at the dentist because they will turn around and charge a lot for an MRI. They cover the gym membership instead of the out-of-network doctor. They offer a zero-dollar premium because of the higher expenses down the road.
Although all these benefits (and lack thereof) are included in the summary of benefits and evidence of coverage, these plans still tend to catch seniors by surprise. Arming yourself with education upfront is the best way to prepare for the ins and outs of an advantage plan.
As a broker, I want you to understand both Original Medicare with a supplement AND Medicare Advantage. Once you know how each plan operates, you can confidently decide which plan is right for you. Enrollment and disenrollment in these plans can vary, so plan ahead!
We’re happy to help with the analysis, and our service is always free. Give me a call at 972-393-5080 or visit us at 2604 Long Prairie Road, Suite 100 in Flower Mound.
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