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  • Writer's pictureRaye Elaine, BCPA

Beware Misleading Advertising for Medicare Advantage


Its open enrollment time again and the private Medicare Advantage plans are advertising relentlessly. Beware their advertising claims and be very clear what your needs are medically before considering one. Although having everything covered and not needing to sign up for supplemental plan may seem easy and convenient, these plans basically take control over your Medicare benefits and then restrict which doctors, hospitals and specialists you can go to. You will need pre-authorization for tests and specialist visits.


If you become seriously ill and need specialty care at facility outside their network you will not be able to go on your insurance and will end up paying out of pocket. In contrast, with "traditional" Medicare plus a supplemental plan, you can see any doctor, specialist and get any usual tests anywhere you want to go, with no authorization or referral required.


In California there is an excellent resource called HICAP that offers free counseling for Medicare beneficiaries to sort out what are the best options for them. You can get one on one counseling where they will go over all your needs and then present the best options for you. They receive no payment from any of the plans, so they have no bias as do other insurance brokers, although they can be good resources too. https://cahealthadvocates.org/hicap/


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