Medicare Coverage Helpline Ads Need Context

A VERIFY viewer asked if a Medicare ad claiming to refund money in your Social Security check is legit. This is why this ad needs extra context.

Open enrollment for Medicare runs from October 15 to December 7 each year. TV ads are already appearing asking people who are eligible for Medicare to change their subscription.

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 each 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, as the ad claims.

THE QUESTION

Are Medicare Ads Claiming to Refund Money in Your Social Security Checkup True?

THE SOURCES

THE ANSWER

This needs context.

Medicare ads claiming to refund money in your Social Security check need context.

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WHAT WE FOUND

Medicare is a federal health insurance program for people age 65 or older in the United States. Certain individuals under age 65 may also qualify for Medicare, including those with disabilities and those with 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 qualify for Original Medicare, which includes hospital insurance (Part A) and medical insurance (Part B). The federal government provides and manages these types of plans.

But the SSA says there are other parts of Medicare that are regulated by the government but administered by private insurance companies, such as Medicare Supplemental Insurance (Medigap), Medicare Advantage (formerly known as Part C), and Medicare Part D.

Supplemental policies help Medicare pay co-payments, coinsurance and deductible expenses, according to SSA. Medicare Advantage includes all of the benefits and services included in Part A and Part B, as well as prescription drugs and additional benefits not included in Original Medicare, such as vision, hearing, and dentistry – bundled into one plan. Medicare Part D helps cover the cost of prescription drugs.

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The ad that JB emailed VERIFY about is trying to sell people a Medicare Advantage plan through the Medicare Coverage Helpline. The helpline is operated by Benefytt Technologies, a health insurance technology company.

“The Medicare Coverage Helpline is a free service that puts you in touch with a licensed insurance agent to discuss Medicare plan options in your area,” the company says on its website. “Sales agents only offer health plan plans that are contracted with the federal government.”

If an individual 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 contracted by the government. These plans are similar to other health insurance plans that people can get through their employer or a state health organization.

The Kaiser Family Foundation (KFF) says some Medicare Advantage plans may cost more than Original Medicare but may offer more comprehensive coverage; while others may cost less monthly, but may require more out-of-pocket expenses later on.

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The Medicare Coverage Helpline ad highlights Medicare Advantage plans that offer a “premium reduction benefit” and refund money in your Social Security check. Here’s how that works.

If you have Original Medicare, an amount is deducted from your Social Security check each month to pay for that plan. But if you opt for a Medicare Advantage plan, it’s a little 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, the private insurance company sends some of that money back to your Social Security check, meaning you get a bigger payment each month. The exact amount varies based on the plan.

The downside is that you might get a plan with a smaller network of doctors or charge more for procedures than Original Medicare. So while you can get more money for your Social Security check each month, it could end up costing you more in the long run. That’s why the Medicare Coverage Helpline ad JB emailed our team about the context of needs.

It is important to consider your anticipated needs and financial situation when choosing to switch to a Medicare Advantage plan. Medicare offers a comparison tool on its website to help you decide whether switching makes the most sense.

VERIFY contacted the Medicare Coverage Helpline for comment, but did not hear back at the time of publication.

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