Medicare Advantage insurers offer “extra” benefits to lure people to sign up for a Medicare Advantage plan. But, what they don’t tell people is that Medicare Advantage plans engage in widespread inappropriate denials of care and cover significantly fewer health care services than the government-administered Traditional Medicare. Moreover, as Jasmine Laws reports for Newsweek, most enrollees don’t use their “extra” benefits.
The HHS Office of the Inspector General has now twice reported on widespread and persistent inappropriate delays and denials of care for people in Medicare Advantage plans. The denials tend to be for costly life-saving and health-promoting services, such as rehab care, skilled nursing care, hospital care and cancer care. Other researchers have arrived at similar findings. In short, if you’re in a Medicare Advantage plan, you have a very high chance of having your Medicare Advantage plan refuse to cover critical medically necessary care if you develop a complex condition.
Moreover, the data show that seven in ten Medicare Advantage enrollees do not use their “extra” benefits. These benefits range from some vision, dental or hearing services to payment for select over-the-counter drugs and other health and wellness items. A lot of these benefits are costly because they involve high copays or hard to access because they require you to find a network provider who will accept the benefit.
If you’re currently enrolled in a Medicare Advantage plan, you can appeal the denials of care and you will likely prevail. But, it could take so long to get the care you need, that you still could be gambling with your life.
You should definitely take advantage of your “extra” benefits. Call customer service to find out whether you have supplemental benefits, what they are exactly and how to use them before the end of the year. It’s possible that you can also log into your Medicare Advantage account to find the answer to these questions, but it’s also possible that your insurer has made it as hard as possible for you to find out and doesn’t post it on its web site. Note, that if you don’t use these benefits before the end of the year, you will lose them.
You might also be able to find out about your extra benefits through a free app called Chapter OTC. The app is designed to tell you about your over the counter benefits, where to get the items you want and how to have them deliverred.
Here’s more from Just Care:
- Humana sued for inappropriate Medicare Advantage care denials
- Does UnitedHealth use flawed AI to deny care in Medicare Advantage?
- Extra benefits in Medicare Advantage: Truth or Fiction?
- More than 4 in 10 Americans face cost barriers to care
- Medicare Advantage inappropriate denials of care abound
