Approximately 30% of Americans turning 65 are opting for a Medicare “Advantage” plan. In my experience, this most often happens for the following two reasons:
- They have been relatively healthy up to 65 years old
- They believe this great health will continue into their senior years
- Medicare Advantage plans at $0 per month can be quite attractive
- They miss, or minimize the often $6,700 Maximum Out-of-Pocket PER YEAR
Sadly, there are many situations that we have seen where a Turning 65-senior has chosen one of these “free” Medicare Advantage plans only to have to experience the limitations and large hospital admission co-payments by having a serious illness that takes them into full usage of their chosen plan.
When they were first turning 65, they thought their great health would continue far into their senior years, only to discover that this is the time frame where most all medical claims are experienced in life. Sadly, when they signed up for a Medicare Advantage plan, particularly an HMO plan, they find that the restrictions now imposed on them, the trade off for little or no monthly premium, now can significantly and adversely not only affect their availability of specialty care (replaced with tight networks) but also expose them to more money spent for medical care than their non-“Advantage” plan senior counterparts.
On the contrary, the biggest proponents of Medigap (Medicare Supplement) plans are those who have had to use them with a serious illness. For example, those with a special kind of cancer who can now choose the best cancer treatment centers in America without consequence because their Medicare Supplement plan allows them to go anywhere. Those who would have otherwise been exposed to a $6,700 out-of-pocket cost with their Medicare Advantage plan for a series of hospital admissions who though, because on a SUPPLEMENT plan instead, pay $0 for their admissions and, more importantly, get to CHOOSE their hospital instead of only being able to go to the one that was the lowest bidder that joined the “Advantage” plan's restrictive network.
In an illuminating article by the non-profit Kaiser Family Foundation, the choice of a Medicare Advantage plan when a senior is turning 65 can prove disastrous for future healthcare choices for the rest of a senior's life. See the article here:
It is very important that now-Medicare-eligible seniors have the full information on the good, the bad, and the possible devastating effects of picking their Medicare plan.
Chris Westfall is an independent Medicare agent and has been a licensed insurance agent for over 20 years.