Rachel Roubein writes for the Washington Post on the new rules the government has put in place to protect older adults and people with disabilities from misleading marketing by corporate health insurers offering Medicare Advantage plans. While the rules are a step in the right direction, you can bet your bottom dollar that they will make little difference. Insurers will continue to mislead people, as will their sales agents.
The corporate health insurers offering Medicare Advantage plans will have to adopt a new marketing look. But, there’s no way that they will tell people about restrictions on their access to care in Medicare Advantage plans; restrictions that people do not face in traditional Medicare. Nor are the insurers going to explain that people are likely to spend more out of pocket if they need costly health care services and are enrolled in a Medicare Advantage plan than they would in traditional Medicare.
Since the advent of Medicare Advantage, the insurance company ads have been terribly deceptive. And, the insurance companies’ sales agents often steer people to plans from which they receive the highest commissions rather than to Original Medicare, even when Original Medicare best meets people’s needs. Complaints about deceptive marketing are rampant.
The new government rules are intended to keep corporate health insurers from deceiving people into believing their Medicare options are more limited than they are, or that they will get extra benefits that are actually not available to them. That’s good. It’s just not enough.
Moreover, there are no meaningful penalties on the insurers if they violate the marketing rules. CMS does not exercise its right to penalize Medicare Advantage plans in meaningful ways, let alone cancel contracts with the bad actors. And, a lot of the information people need to distinguish the good MA plans from the bad actors, such is denial rates, delay rates and disenrollment rates, is not available.
The new marketing rules do nothing to help people make an informed Medicare choice. People can’t understand critical differences among their options, such as whether a plan has a high denial rate or has a poor network of providers. All people have to go by is unclear, inaccurate and misleading information.
Best advice: If you can’t afford to spend $5,000 out of pocket—the typical amount people must spend for in-network care alone if they need critical care in a Medicare Advantage plan—you should consider enrolling in traditional Medicare. If you don’t have Medicaid or retiree benefits that provide Medicare supplemental coverage, you should also consider buying supplemental coverage. You can get low-cost Medicare supplemental (Medigap) coverage with an out-of-pocket cap. Or, you can get comprehensive Medicare supplemental coverage for about $2,500 a year. With Medigap plan G, you’ll have almost all your costs covered. No matter which supplemental insurance you choose, in traditional Medicare you will be able to see the doctors you want to see without needing approval from an insurance company that profits more when it denies coverage for your care. That’s what too often happens in Medicare Advantage.
Here’s more from Just Care:
- What are your Medicare premiums in 2024?
- 2023: Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
- 2023: Four things to know if your income is low and you have Medicare
- Ignore Medicare Advantage ads; they misrepresent costs and benefits
- If you’re in a Medicare Advantage plan, watch out! Your doctor or hospital might no longer be in-network
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