Medicare Advantage plans are like a plan your employer would pay for

By Cheri Brown

Cheri Brown

Dear Medicare Cheri,

My Mom keeps seeing commercials about all the Medicare benefits she is entitled to. She has a Medicare Supplement and all her bills are covered, but she thinks she is missing out. What are these commercials for and is she missing out?

Signed, Is This a Trick?

* Dear Is This a Trick,

These commercials are for Medicare Advantage plans. Medicare Advantage plans are like a plan your employer would pay for you to have. You put your Medicare card away, and Medicare pays the company to take care of you. The positive side to Medicare Advantage is they have lots of extras such as over the counter items, hearing aids, dental and vision. They usually include prescription drugs. The negative side is they usually require you to work within a network and they have a primary care doctor that refers you to specialists.

I spoke with the writer, and her mom has a Medicare Supplement Plan F. This plan covers all Medicare A and B copays and coinsurance and you can see any doctor that accepts Medicare without a referral. They can be quite expensive especially as the beneficiary ages, and they must also purchase a separate prescription drug plan. Although these plans don’t usually offer extra benefits, people often choose them for the freedom that they offer.

The writer chose to keep her mother on the Medicare Supplement and will call me back in October to review her Part D prescription drug plan.

 

Dear Medicare Cheri,

I changed my Medicare Advantage plan last fall. I was told all my doctors were in the plan, but I am finding out they are not!  This is very upsetting — what can I do?

Signed, Disappointed

 

Dear Disappointed,

You have two options, one is you can return to your old plan between Jan. 1 and March 31 by completing a new enrollment form.

You can also verify which medical group the plan enrolled you in.  Insurance companies contract with Doctors through medical groups (in our area PMG and SCCIPA are most common). You may have been inadvertently enrolled into the wrong medical group and not able to access your doctors because of this. Talk to the plan for details.

Cheri Brown can be reached at [email protected].