Private Medicare Advantage plans offer a lot of extra benefits that are filling up all the ad time on your TV during the last three months of the year.
When I explain to people that the benefits being touted are real, they seem shocked. The ads have a scam quality to them, but the benefits are legitimate. The catch is that not all plans have the same benefits. The benefits you see on TV may not be available in Indiana at all.
In 2021, an insurance company was running a full-page color ad in the Indianapolis Star that read, “You may be eligible to receive $148 back in your Social Security check each month with this Medicare Advantage plan.” In reality, that company didn’t offer a plan like that anywhere in Indiana. Some companies will advertise statewide about their benefit, while that benefit may only be available in five counties. It’s a disservice to mislead the public with these types of ads – but the benefits are available somewhere.
The question then becomes, if X is offering rent assistance, groceries, and pet food as a Medicare Advantage benefit, why? What does this have to do with Medicare?
As it turns out, a lot of the health outcomes are not driven by how well you adhere to your doctor’s advice, but how hard you struggle to meet your basic financial needs. If you are discharged after a heart attack to a home with no heat and you now can’t drive to get groceries, you are likely to wind up readmitted to the hospital. The Medicare Advantage insurance company makes more profit when you get healthy and stay healthy. If they can help you with groceries, you might eat better. If they can help you with pet food, maybe you’ll have more money left to buy your own food. Pest control is an urgent health need if your house is infested.
Private Medicare is putting money into social determinants of health because they work. Giving you a gym membership in 2006 was considered revolutionary! Imagine: your health plan allowing you to use the gym for free. It turns out that the vast majority of senior citizens didn’t use the gym benefits. Many companies got rid of that benefit or scaled it back and instead invested money in things that people do use.
One extra benefit that is often available in plans for people who have both Medicare and Medicaid is transportation. Many people can’t drive or don’t like to drive. Or they don’t like to drive when they are sick or don’t want to spend the money on high gas prices. Many plans offer some type of transportation benefit, either their own service or with Lyft or Uber vouchers. Each plan will have a set number of trips per year. Some plans will take you to your doctor, while some will take you to the pharmacy and grocery store.
What plans are available to you are based on your county and plan benefits change each year. It pays to take full advantage of your window to shop plans from Oct. 1 to Dec. 7 each year.
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.
I recently got an Aetna advantage plan and went in for my shingles vaccine only to discover it cost me $250 out of pocket. I got a debit card in the mail but they can’t even cover a vaccine. Idiots.