As most of us on Medicare know, this is the time of the year when we receive those annoying phone calls and mailings trying to get us to join a Medicare Advantage program (Medicare Part C) that will “give us the BEST benefits at little or no cost to us.”
Is there anyone who really believes that an insurance company that exists to make a profit for the owners/shareholders of the company wants to provide you with excellent coverage for little to no cost? Why would these companies hire people to call us, spend money mailing us literature, or hire actors and former athletes to make commercials to influence us to purchase their product?
According to the Kaiser Family Foundation (KFF), the gross profit margin per enrollee in the Medicare Advantage market for 2023 was $1,982. This report highlights that older adults represent the largest group of healthcare consumers, generating significant revenue for insurance companies. The top five health insurance companies offering Medicare Advantage products in 2023 reported a combined profit of $44.5 billion!
Additionally, AARP states that people with Medicare will have access to an average of 15 Part D plans and 34 Medicare Advantage plans that include prescription drug coverage next year. With so many choices, along with confusing terminology and high-pressure sales tactics, it’s no wonder that navigating the best plan can be frustrating.
In September, President-elect Trump mentioned that he has a "concept of a plan" for improving medical care. Hopefully, this concept addresses the findings from a study published in 2023 in JAMA Network Open, a monthly open-access medical journal published by the American Medical Association, revealing that 20 percent of older adults do not take their medications as prescribed due to cost. This plan should prevent seniors from falling into bankruptcy while trying to cover their medical expenses. It should ensure that seniors receive the prescriptions their doctors recommend rather than being limited to those that their insurance will cover. Furthermore, it should allow seniors to seek treatment at facilities of their choice rather than restricting them to those within the insurance carrier's network.
With one party poised to gain control of the government’s Executive and Legislative branches, it will be evident how committed they are to addressing these critical and often life-threatening issues, as well as their proposed solutions. In the meantime, you may be able to save money or find better coverage by shopping around and comparing different Medicare Advantage or supplemental programs to cover the costs not paid by traditional Medicare.
Note: Your SOAR Executive Board does not endorse any product or claim any plan superior to another. However, we will continue to provide information on these types of plans to the best of our ability so that our members can decide what kind of plan best suits their needs.
Please stay safe and enjoy this holiday season! And thank you for all that you do to promote and support SOAR.
-SOAR President
Bill Pienta