Be wary of the complex pros and cons of Medicare plans

Along with crunchy leaves and pumpkins, fall brings a slew of advertising for insurance plans that fill the gaps in Medicare coverage. Misleading and confusing messages continue to reach beneficiaries and those nearing Medicare age.

To take myself as an example, I’ve received an invitation to a Medicare Advantage plan informational meeting. I’ve gotten a solicitation from my physician’s medical group offering a “zero-cost, no obligation way to review coverage” online or over the phone. The “review” is likely to bring a sales pitch for a plan.

A mailer from another plan offered “a friendly, money-saving Medicare Advantage Plan” that seemed to promise the moon: savings of up to $2,380 a year, maximum dental coverage of $1,500, and a $750 hearing aid allowance, a drop in the proverbial bucket considering the average cost of two hearing aids is about $4,500.

One seller seemed to think I was on both Medicare and Medicaid and pitched a “special needs plan.” Since I wasn’t a candidate for such an arrangement, was the insurer trying to get in the door to sell a regular Medicare Advantage plan?

Too many people fall for those kinds of pitches. Shopping to cover the gaps in Medicare is a task no one should take lightly. The stakes are too high. Medicare is a fine program, but it was never meant to cover everything. It’s based on the old Blue Cross model of insurance common in the 1960s where the company paid 80 percent of the medical bill and the patient paid 20 percent. An industry selling Medigap policies sprang up to cover the 20 percent, and deceptive sales practices plagued the business for years.

Congress ended that and standardized the coverage into 10 plans (11 today, including a high-deductible plan) that give people a broad choice for covering what Medicare does not pay. If people bought Plan F or Plan C as their supplemental insurance, they were pretty much covered for most illnesses.

Beginning next year, however, new Medicare beneficiaries — those who turn 65 on or after Jan. 1, 2020 — won’t be allowed to buy Plan F or C. Congress wants more beneficiaries in Medicare Advantage plans, so it eliminated the option to buy the most comprehensive plans.

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