Whether or not you are Medicare eligible, you have likely seen countless TV and print ads by health insurance companies offering you what sounds like a free lunch if you sign up for a Medicare Advantage plan. The ads are often profoundly misleading and don’t begin to help people understand the tradeoffs they are making, at times gambling away their health security, because many Medicare Advantage plans engage in widespread inappropriate delays and denials of care. New government advertising rules are designed to eliminate some of the misleading elements in Medicare Advantage ads, but not nearly enough of them.
Joe Namath and other superstars will continue to be able to promote Medicare Advantage plans without warning you of the risks you could be taking if you sign up for some of these plans. But, as of September 30 of this year, the Medicare Advantage plans will no longer be able to use Medicare’s logo in their ads in ways that suggest that they are Medicare or the federal government.
Medicare Advantage plans are the corporate health insurance alternative to traditional Medicare, which is offered directly through the federal government. While traditional Medicare provides coverage to people for care from almost all doctors and hospitals and defers to the opinions of treating physicians when determining whether care is reasonable and necessary, Medicare Advantage plans restrict access to most physicians and hospitals and often come between their enrollees and their treating physicians, second-guessing people’s care needs and denying care inappropriately to maximize their profits.
Because the government pays Medicare Advantage plans upfront, regardless of the cost of the care they deliver, the less care they cover, the more profits they earn. Prior authorization requirements, which all Medicare Advantage plans impose, allow them to delay costly care, also helping to maximize their profits.
But, a combination of relentless marketing by the Medicare Advantage plans and the additional costs in traditional Medicare for supplemental coverage and prescription drug coverage lead many people to opt for a Medicare Advantage plan. In fairness, it’s hard to understand the risks of Medicare Advantage and how it is so fundamentally different from traditional Medicare when it comes to having your care needs met. And, as long you’re healthy, you can save money in a Medicare Advantage plan. Of course, health insurance should be there when you will need costly care, as the vast majority of us will at some point.
The new government rule does not allow for “overly general ads about the Medicare Advantage program that often tend to confuse and mislead individuals,” according to Xavier Becerra, the Secretary of the Department of Health and Human Services. The rule appears to forbid ads that do not name one specific Medicare Advantage plan. Health insurers also can only use the name Medicare in limited instances and cannot feature a Medicare card.
When Medicare Advantage ads contain a toll-free number, some people think they are calling the federal government and not an insurance company or its agents. Now, companies won’t be able to have ads that promote benefits unless they are available to people where the ads are being aired.
Here’s more from Just Care:
- When will the Medicare Advantage scam end?
- Don’t assume a five-star Medicare Advantage plan will provide the care you need
- What we don’t know about Medicare Advantage plans
- Ten ways to improve Medicare Advantage
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
