Can You Believe Those Medicare Advantage Commercials?

Can You Believe Those Medicare Advantage Commercials?

Ask Bob: What's the Difference Between Traditional Health Insurance and Medicare Advantage?

Experts help our reader sort through the difference between traditional health insurance and Medicare Advantage.
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Question

Sometime will you compare traditional health insurance (Blue Cross, United Health) to Medicare Advantage? What is not said in the Medicare Advantage commercials? What do I pay that is different? Why should I leave Blue Cross Plus Prescription insurance for it?

Answer

We asked two of our Medicare experts to help us answer this reader’s questions.

Katy Votava, president, Goodcare.com

Can you not use Medicare?

It depends on your circumstances, says Votava. “If the other coverage comes through current employment to the employee or spouse you don’t need Medicare once you’re 65 or over. If the employer has 19 or fewer insurance-eligible people there are serious gaps in coverage without Medicare.”

If you don't sign up for Medicare at age 65, can you get on it in the future?

Yes, you can get in the future. But, notes Votava, “The question is can you get it when you want it and or will you face coverage delays, lifelong penalties in steep out-of-pocket costs while you wait to get into Medicare?” The answers to those questions depend on a variety of circumstances.

Can you use non-MedAdvantage or non-Medigap with your Medicare?

Yes, if a person is employed in a company with 19 or fewer employees. Votava explains, “The reason is that Medicare Part A&B must be primary in that circumstance. The employer plan covers 20% as a secondary payor. In my experience, by the time people pay for the employer plan and their Medicare B premium they’re often better off leaving the employer plan.”

Can you go on Medicare and not use a MedAdvantage or Medigap + Part D plan?

Yes, you can. Those coverages are not required by law. You may regret it in the short and long-term, notes Votava. “Folks I’ve seen who have done this and become seriously ill in the meantime have paid over $150,000 out-of-pocket until they could secure those other coverages. That’s a pretty bitter pill to swallow when you’re already seriously ill.”

There are a lot of big questions when considering Medicare. Check out Votava’s book Making the Most of Medicare: a Guide for Baby Boomers.

Jae Oh, MBA, CFP, managing principal, GH2 Benefits, LLC.

What is not said in the Medicare Advantage commercials? 

Watch “Can You Believe Those Medicare Advantage Commercials” – a Retirement Daily video, with Oh, author of Maximize Your Medicare, who discusses what's factually correct and what isn't.

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Question

Sometime will you compare traditional health insurance (Blue Cross, United Health) to Medicare Advantage? What is not said in the Medicare Advantage commercials? What do I pay that is different? Why should I leave Blue Cross Plus Prescription insurance for it?

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