A high percentage of Medicare Advantage plan members make a critical mistake, according to a study from Mass General Brigham, a major hospital system.
Medicare beneficiaries can choose between original Medicare and a Medicare Advantage plan.
Advantage plans are required to cover everything that original Medicare covers. Advantage plans also may offer additional benefits, which many do.
Most Advantage plans offer some level of dental, vision and hearing benefits, which aren’t covered at all by original Medicare. Advantage plans also often pay for additional services, such as transportation to medical appointments, fitness club memberships and more.
The Advantage plans receive more money from Medicare per beneficiary than original Medicare pays on behalf of each of its beneficiaries.
The problem, according to the study, is that most Advantage plan enrollees aren’t using the additional benefits. That’s based on data from 2017 to 2021.
Many Advantage plan beneficiaries believe their coverage is free, because their plans don’t charge additional premiums. But each Advantage plan member pays the same Part B premium that original Medicare enrollees pay.
Another problem is that many people in Advantage plans aren’t aware of all their benefits. The study found that only about 54% of Advantage plan members were aware they had vision and dental coverage.
People in Advantage plans were no more likely to obtain care for vision, dental or hearing issues than original Medicare beneficiaries. Out-of-pocket costs for those services were a little lower for Advantage plan members than for those in original Medicare, but not a lot lower.
In general, Advantage plans cover about 25% of the total cost for dental, vision and hearing services.
The Advantage plan members who know about the benefits might have concluded they aren’t worth the additional out-of-pocket cost.
