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Beware of Medicare Advantage Plans

You might find yourself wishing you were on Medicare

If your senior loved one is on Medicare, they probably start getting those calls around September. Maybe you’ve taken over power of attorney and you get the calls instead. I’m talking about the Medicare Advantage marketing calls that seem to increase in volume every year.

Everyone knows that Medicare takes over as the primary health insurance, usually when you turn 65. Medicare is managed by Federal government, but there is an option to standard Medicare called Medicare Advantage. These plans are run by a private insurance company that receives a monthly stipend from the government. They are supposed to cover the same benefits that Medicare provides, but for most, the coverage does not end up being as good.

Kaiser Health News recently published an article detailing how many members of Advantage plans do not get as much time in rehab after surgery as those in Medicare. Traditional Medicare leaves it up to your doctor to decide whether you need rehab, but the insurance company gets to decide when you have an Advantage plan. Since they get to keep more money if you don’t go to rehab, there is an incentive to deny you. Also, Advantage plans often do not cover as many rehab centers as Medicare. This means you may be forced to go to a lower quality facility.


Here are my recommendations:

· If you have an Advantage plan and want to go back to Medicare, you are allowed to switch from January 1 – March 31 each year. Call 1-800-MEDICARE to switch.

· If you have Medicare, but want a little extra coverage, consider a Medicare Supplemental or Medigap plan. Your still in traditional Medicare, but the supplemental plan will cover copayments, coinsurance, and deductibles.


Penny Brandt-Roy helps clients find senior communities in the Metro Atlanta area. For more information on her free service, visit www.orchidsenior.com.

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