Joe Namath may have delivered the New York Jets’ final Super Bowl championship, but the old quarterback is throwing a bunch of cops into his TV commercial for private Medicare plans.
He is one of many unlucky men and women selling Medicare Advantage plans to the more than 54 million Americans 65 and older who are eligible for Medicare. That includes more than 100,000 of us in Orange, Ulster, and Sullivan counties.
These pitches, which also flood our mailboxes during this registration period, which ends December 7th, complicate the potentially mind-boggling range of insurance options.
First, some basic facts:
Medicare Advantage is the all-in-one alternative to the original Medicare health insurance. Original Medicare includes coverage for hospital stays (Part A), doctor visits and procedures (Part B), and prescription drugs at an additional cost (Part D). Before signing up for Advantage plans, you must have the original Medicare and pay the Part B premium of $ 148.50 (in 2021). While Medicare Advantage plans include medical, hospital, and drug insurance, they can also include additional benefits that traditional Medicare does not, such as: B. Dental, hearing and visual protection without an additional premium.
Especially in these pitches from celebrities like Namath, William Shatner, and Jimmie Walker, they can also promise everything from free food delivery to money deposited into your social security account.
“Buyers watch out,” says Erinn Braun, Orange County Office for the Aging’s Health Insurance Counseling and Assistance Program Coordinator. She provided a lot of information for this column.
Ads like Namath’s can be misleading or downright misleading, starting with the red, white, and blue colors that suggest the ads are from the government, as are the state logos on some mailers. While the plans themselves are perfectly legal and can be great for many of the 27 million Americans enrolled, they often don’t deliver what these pitches seem to promise. Plus, these pitches don’t tell nearly the full story of the benefits of these plans – many of which aren’t even offered in your area.
Unlike Original Medicare, which is accepted by virtually all doctors and hospitals, Medicare Advantage plans include a network of doctors and hospitals that you must visit to be covered. So if you hear from a great gastroenterologist in New York City and she’s not on your Advantage plan network, your insurance may not cover your visit. Also, unlike the original Medicare, you may need prior authorization to cover a medical procedure or equipment such as insulin pumps.
And while the Medicare Advantage plans sound great for dental and eyesight coverage, some plans in your area might just include routine visits, not more expensive items like dental implants and glasses. Additionally, the average annual coverage limit of Advantage Dental Plans is between approximately $ 1,000 and $ 1,300, according to the Kaiser Family Foundation. The dentists and ophthalmologists you visit must also be on the plan’s networks. That means your eye doctor or dentist may not accept your plan.
As for the meals and the money Joe Willie suggests?
Again, buyers watch out.
Some Advantage plans may offer meal delivery for qualified individuals, but only one or two plans in your country will offer these benefits. And your doctors or hospital may not accept these plans. The same goes for the money that Namath says could go to your Social Security account. Not only will that money go towards making the required payment for Part B of the original Medicare, but very few, if any, plans in your area can offer this benefit, and those plans may not include your doctors.
Finally, when you call the number given by Namath and other pitch people, you reach a salesperson who is in business to … you guessed it … sell you a Medicare Advantage plan.
For help choosing the right Medicare plan for you, contact your county’s Office of the Aging. Orange: 845-615-3710, Sullivan: 845-807-0241, Ulster: 845-340-3456. A trusted insurance agent can also help. Medicare.gov and 1-800-Medicare provide a wealth of information.