Don’t buy “pretty” Medicare plans

By SYLVIA GORDON
Guest Columnist

People see TV and print ads touting “FREE Groceries” or “UP TO $100 Back” in your Social Security check each month.

These types of benefits are considered “extra benefits” apart from the core benefits of a Medicare Advantage health plan. It’s akin to buying a car based solely on its color. No one gets excited about strong core benefits – unless you are already undergoing treatment. We all hope to never need a low co-pay on an inpatient stay for a joint replacement. But it’s easy to get excited about grocery money.

It’s unwise to make you plan decisions solely on the extras.

If you are very healthy and only see a doctor one to three times a year, these extras in private Medicare Advantage plans can be very enticing. For the healthy, these extras can add up to a lot of extra money each quarter. For the healthy, who are not worried about higher costs sprinkled throughout the plans, choosing the richest extra benefits available may be a smart option. But a surprise illness can be around the next corner. If you are suddenly using your core benefits seeing doctors, specialists, having inpatient and outpatient surgeries, etc. you may end up paying more for a plan with a lot of extras.

Private Medicare Advantage plan benefits change annually. The overall out of pocket costs tend to edge up with inflation, but they can be buried in the plan and hard to find. People don’t enjoy digging into the new benefits released each year. Many people are content to bury their heads in the sand.

While every company is required to send members an Annual Notice Of Change (ANOC) booklet, many people are overwhelmed and ignore it. That’s OK as long as you work with an agent who can translate it for you. If you prefer to call the insurance company, it too will explain this year vs next year’s benefits. You only have a few months to make the decision whether to stay with your current plan or move to a new plan.

The extra benefits are real – and attractive. Some plans in the nation pay for cell phone plans, utilities, rent, groceries, pest control, massage, pet food and more. Sometimes there is a slight bait-and-switch at hand. Famously, one company last year offered the richest dental benefits in the nation. People didn’t realize that very few dentists were in that network. This is a critical piece of the puzzle. You search for the best benefits and then have to cross reference it against the doctors and hospitals you want to see and visit. Before you choose a plan based on great dental, vision or hearing aids, look at that insurance company’s network of specialists. You may have to drive a long way to access an in-network specialist.

Millions of Americans will be shopping their Medicare Advantage benefits from Oct. 15 to Dec. 7. With a media blitz by dozens of insurance companies, you will see many of these extra benefits advertised. But before you are swayed by an extra benefit, make sure that you are not sacrificing strong core benefits.

Sylvia Gordon is co-founder of The Medicare Family, headquartered in Noblesville, where she educates thousands on Medicare and Social Security in all 50 states. You can learn more at themedicarefamily.com.