Open enrollment for Medicare runs from Oct. 15 to Dec. 7 each year. TV ads asking people who are eligible for Medicare to consider changing their plan are already starting to pop up.
In an email, VERIFY viewer JB said he recently saw an ad about some Medicare benefits he may be missing out on.
“You may be entitled to the Medicare benefit that adds money to your Social Security check every single month,” former NFL quarterback Joe Namath says in the ad.
JB wants to know if he can really get more money in his monthly Social Security check, like the ad claims.
Are Medicare ads that claim to put money back in your Social Security check true?
Medicare ads that claim to put money back in your Social Security check need context.
WHAT WE FOUND
Medicare is a federal health insurance program for people aged 65 or older in the United States. Certain individuals younger than age 65 can also qualify for Medicare, including those with disabilities and those who have permanent kidney failure, according to the Social Security Administration (SSA), which helps administer these benefits.
There are four parts of Medicare, and each represents a different coverage plan. The Social Security Administration automatically enrolls people who are eligible for Original Medicare, which includes hospital insurance (Part A) and medical insurance (Part B). The federal government provides and manages this type of plan.
But the SSA says there are other parts of Medicare that are regulated by the government but run by private insurance companies, such as Medicare Supplemental Insurance (Medigap), Medicare Advantage (previously known as Part C), and Medicare Part D.
Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance and deductible expenses, according to SSA. Medicare Advantage includes all benefits and services covered under Part A and Part B as well as prescription drugs and additional benefits not included in Original Medicare, such as vision, hearing, and dental — bundled together in one plan. Medicare Part D helps cover the cost of prescription drugs.
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The ad JB emailed VERIFY about is trying to sell people a Medicare Advantage plan through the Medicare Coverage Helpline. The helpline is run by Benefytt Technologies, a health insurance technology company.
“The Medicare Coverage Helpline is a no-cost service that connects you with a licensed insurance agent to discuss Medicare plan options in your area,” the company says on its website. “Sales agents only offer plans from health plans contracted with the federal government.”
If a person signs up for a Medicare health plan through the Medicare Coverage Helpline, they would opt out of Original Medicare coverage and replace it with a Medicare Advantage plan offered by a private insurance company that’s contracted by the government. These plans are similar to other health insurance plans that people can get through their employer or a state healthcare exchange.
The Kaiser Family Foundation (KFF) says some Medicare Advantage plans can potentially cost more than Original Medicare but may offer more comprehensive coverage; while others may cost less monthly but might require more out-of-pocket expenses later.
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The Medicare Coverage Helpline ad highlights Medicare Advantage plans that offer a “premium reduction benefit” and put money back into your Social Security check. Here’s how that works.
If you have Original Medicare, every month an amount is deducted from your Social Security check to pay for that plan. But if you choose a Medicare Advantage plan, it's a bit more complicated.
When you select a Medicare Advantage plan, money comes out of your Social Security check for the standard Original Medicare amount. Medicare then sends that money to your plan’s private insurance company. But, if you have a premium reduction benefit, then the private insurance company sends some of that money back to your Social Security check, meaning you’ll get a larger payment each month. The exact amount varies based on the plan.
The downside is that you may end up with a plan that has a smaller network of doctors or charges more for procedures than Original Medicare. So, while you may get more money in your Social Security check each month, it could end up costing you more in the long run, which is why the Medicare Coverage Helpline ad JB emailed our team about needs context.
It is important to consider your expected needs and financial situation when choosing whether to switch to a Medicare Advantage plan. Medicare offers a comparison tool on its website to help you decide whether switching plans makes the most sense.
VERIFY reached out to the Medicare Coverage Helpline for comment but did not hear back by the time of publication.
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