71% of Medicare Advantage enrollees are satisfied with their plans, and a full 61% believe their plan outperforms previous coverage. But only 44% say they fully understand their plan, with 68% saying they’ve been confused by details like dental/vision/hearing coverage, out-of-pocket costs, transportation benefits, caregiver support, and home health services.
Worse still, 44% believe there is inadequate communication and education about the benefits they’re being offered. 1 in 4 beneficiaries report paying for services they believed to be covered by their plans. Another 10% believe they’ve been overbilled for services.
All told, 98% of seniors have some form of insurance – whether it comes from original Medicare, Medicare Advantage, or a retiree plan. Yet, they still carried $53.8 billion in medical debt as of 2020.
Put simply, misunderstanding your coverage could lead to unwanted, unnecessary, and even unwarranted bills. Here’s how you can avoid that:
Any time you enroll in a Medicare Advantage, Medicare Supplement, or Part D prescription drug plan, a licensed health insurance agent is bound by regulation to make sure you fully understand the product you’re about to purchase. Make sure these points are crystal clear to you before you sign on the dotted line:
This list is not exhaustive, so be sure to ask any other questions you have!
Over two-thirds of seniors with medical debt have two or more sources of insurance. That makes billing and claims harder for providers and patients to navigate – and opens the door to lots of errors. Between 2020 and 2022, Medicare found 53% of complaints about debt collectors involved attempts to collect a debt that wasn’t owed.
The probable culprit? Coordination between Medicare and Medicaid for those who have both. While doctors can’t bill you for any costs that Medicaid and Medicare don’t cover, that doesn’t mean it's unheard of. And many of us see fights with billing departments and debt collectors as hopeless, leaving us shelling out cash we don’t owe.
When you do have multiple sources of coverage, it’s essential to learn how they will (and won’t) work together. Licensed insurance agents are invaluable in this case – knowing these rules is part and parcel of their jobs.
Insurance agents do more than help you buy policies – they help you maximize your benefits throughout the year. Whenever you have a question about whether something will be covered or how much you might have to pay, your agent can help you explore your contract and carrier pricing tools to help you figure out what’s next.
Insurance agents can also help when things go wrong. It often happens that an insurance card gets lost in the mail or is otherwise misplaced. An agent can help you order a new one and download a digital copy. Or, if you get into a billing dispute with your insurance carrier, your agent often has access to exclusive phone lines and tools to help them resolve such issues.
In short, and especially if you’re not into all the legalese embedded in insurance contracts, your insurance agent should be the best resource you have to help you understand your coverage.
In an ideal world, 100% of Medicare Advantage enrollees would know their plans inside and out. But, in case you’re one of the 68% of folks who still have questions, know that your insurance agent is there to help.