Medicare Open Enrollment or Open Hunting Season?

It’s that time again — Medicare Open Enrollment runs from October 15, 2014, through December 2, 2014. The airwaves and newspapers are chock-full of polished ads extolling the benefits of various Medicare Advantage Plans, showing healthy looking older people enthusiastically explaining how their chosen Medicare Advantage Plan has changed their lives. More money in your monthly Social Security check! Prescription drug coverage with little or no co-pays! Free over-the-counter medications! Paid gym memberships!

PLEASE BEWARE! Many local physicians and rehabilitation centers do not accept all Medicare Advantage Plans. Consequently, by switching from traditional Medicare to a Medicare Advantage Plan your choices for treatment become limited. Moreover, these plans are sold to Medicare participants with the implication that they do everything that traditional Medicare does, plus more. In my experience, this is just not true. One Medicare Advantage Plan only covered rehabilitation for a period of two weeks for a participant who had suffered a severe stroke. Another participant who broke her back was allowed only one week of covered rehabilitation under her Medicare Advantage Plan. A third Medicare Advantage Plan participant was discharged from a rehabilitation facility while still on a feeding tube, and the family was given very little instruction on how to care for her and maintain the tube. These individuals are still suffering to this day due to the lack of adequate rehabilitation. Had these clients been on traditional Medicare, with a good Medigap (Medicare Supplement) policy, they would have received the proper treatment and rehabilitation and would be enjoying much-improved quality of life now.

While Medicare Advantage Plans may be fine for healthy younger seniors, you still run the risk of having inadequate coverage in the event of a major illness or accident. As part of their sales pitch, Medicare Advantage Plans say that participants can always return to traditional Medicare in the event of serious illness. Although this statement is true when a participant is in a facility, they do not disclose that it is impossible to obtain a Medigap Policy for at least 90 days because of the pre-existing condition. In this situation, a person returning to traditional Medicare would be personally responsible for paying all expenses not covered by Medicare during that exclusion period. Make no mistake – when enrolled in a Medicare Advantage Plan, you are off of traditional Medicare. I advise my clients to run, walk, or roll away from any salesperson who tells them they no longer need their Medicare card.

Medicare Open Enrollment reminds me of Open Season for hunting, and seniors are the prey!

Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes to their Medicare prescription drug and health plan coverage