Can you really get a Medicare Advantage plan for $0? Leslie James, of Insurance Strategy Inc., can help provide the answer

By Leslie James, Vice President; Lead Sales Agent Insurance Strategy, Inc

You watch the ads on television showing there are Medicare Advantage plans out there for $0 per month with all sorts of benefits. How is this possible? What’s the catch? How is it that your coverage when you are working for an employer or buying insurance on your own when under 65 can cost so much, including deductibles and copay, yet when you’re on Medicare, there are plans that cover everything and the kitchen sink?

Medicare Advantage plans and how they are designed are overseen by CMS (Center for Medicare and Medicaid Services). Each year, the insurance carriers are given a “rulebook” called the Final Call Letter that is issued with the parameters for the upcoming calendar year for benefit levels, structure, network availability and more.

In 2018, the definition of “supplemental benefit” changed. There were studies that found the correlation between a person’s medical health and other factors. Here are some examples:

• If someone has diabetes and can’t afford both to eat and take their medications, that person is more likely to develop serious health issues and be hospitalized more often.

• There is a direct relationship between oral hygiene/dental health and cardiovascular issues.

• Seniors are more prone to falling and having accidents when at home.

This change in the definition of supplemental benefits allowed the carriers to start offering benefits that would prevent these things from happening. One of their objectives is to prevent medical issues from arising and to keep seniors healthy. So, in the fall of 2018, beneficiaries started seeing the introduction of more enhanced benefits for dental and coverage for items that you could find at the drug stores like vitamins, bandages, toothbrushes and pain relievers. Some plans even offered coverage for transportation to and from medical appointments as many seniors couldn’t drive or were having procedures but had no one to drive them.

As the seniors took advantage of these new benefits and more studies were published showing positive outcomes, the popularity of these benefits has become a cornerstone to the benefits offered by Medicare Advantage plans. Please keep in mind that the carriers can change the benefits offered annually and they can differ by product. Some of these plans have little to no premium and can have copays and co-insurance on other benefits offered on these plans.

It is important to review your medical and prescription coverage annually to see what the best fit is for your personal situation. Each person’s needs vary. This is why seniors looking for help should speak with an insurance agent who is required to take many hours of annual training. Please call me for a free consultation.

As lead sales agent and vice president at the family-owned Insurance Strategy, Inc. (ISI) and ISI Infinity Group, Leslie James has 30+ years of experience in the industry. She holds a license as an agent in Ohio for health and life insurance and is certified for Medicare sales. She’s involved in many industry organizations. ISI is headquartered at 6902 Pearl Road, Suite 405, in Middleburg Heights. Find out more at InsuranceStrategyInc.com or call Leslie at 440-842-9922 for a free consultation.