Yes, they're back, and oh, the joys of turning on the TV and being bombarded by Medicare Advantage Plan commercials.
It is, after all, the middle of Medicare's annual "open enrollment" period. And these commercials, with their aging spokespeople, seem to come back around like clockwork.
In my opinion, one of the most fun (yet annoying) is Martha, the Medicare lady. Martha did some commercials before, but this is the first one I've seen. (You can view it HERE.)
Martha is a perpetually age 75 contrarian who adamantly refuses to call a 1-800 number to get her "free Medicare Benefits Check-up." (By the way, when did you last pay to talk to a salesperson about anything?)
As far as I can tell, nobody knows who Martha really is—maybe she's a real person named Martha, but I doubt it.
One viewing and you'll be thinking, "Oh, Martha, she's the epitome of grace, charm, curiosity, and enthusiasm."
If by grace, charm, curiosity, and enthusiasm you mean eye rolls, sighs, expressions, and gestures that suggest she'd rather be anywhere else, doing anything else but talking about Medicare, then she certainly is.
She explains her position early on when she says, "I already have my Medicare card; I am not calling!"
Yes, she has a Medicare card (just about everybody age 65 and over does), which means she's enrolled in Medicare Parts A & B (known as "traditional" Medicare). But does she have a Medigap plan? What about Parts C & D (Advantage and Prescription Drug Plans)?
Undaunted, the announcer relentlessly tells her she may not be getting all the Medicare benefits she's entitled to, that the new 2024 Medicare Advantage Plans are here, and now is the time to call to learn more about them.
Martha asks, "Why don't I get these benefits automatically?"
Why not indeed?! The announcer responds that these are secret benefits only available to those who spend the day by calling the 1-800 number on the screen (which is always displayed in colorful red, white, and blue and large font).
Okay, he doesn't say "secret," but I think you get the idea.
Then, with impeccable timing, Martha tells him she called last year. That implies that Martha either wasn't a good candidate for an Advantage Plan or just wasn't interested. But the tenacious announcer reminds her that 2024 plans may offer new benefit opportunities that she needs to learn about.
Really? Are there lots of new benefits in 2024 plans that weren't available in 2023? I seriously doubt it, but I'll concede it's possible.
But then, surprisingly, the heavens open, and Martha sees the light and exclaims, "It's time for me to call and get my free, no-obligation Medicare benefits review." (Wow, free and with no obligation—so amazing!)
Martha has once again ventured into the mysterious realm of unclaimed Medicare benefits. Will Martha buy an Advantage Plan this time? I guess we won't know until next year. And what if she would be better served by a Medigap plan (assuming she doesn't already have one)? Will they discuss those options with her?
Of course, she could have a Medigap plan and learn about all the "free" benefits she is missing out on. But if she wants to change plans, can she do that easily with no medical exam and regardless of any pre-existing conditions?
What I like about Martha
In this commercial, the announcer wants Martha to discover all of the wonders of her heretofore unclaimed Medicare benefits she is missing out on without a Medicare Advantage Plan. From the beginning, she's skeptical, and so should we be.
As she sarcastically recaps some of the benefits of these plans, her tone suggests she's secretly thinking that very few Medicare recipients will actually believe her. "Lower premiums," she says with a hint of skepticism that implies, "Sure, and pigs might fly."
But it's not just the benefits that get the "Martha treatment"; it's the whole Medicare experience. Please don't get me wrong—I think there is a lot to like about Medicare. But it can be very confusing, and these commercials don't do much to help.
Martha is no Joe Namath, Tom Selleck, or Jimmie Walker. But I share her disdain for Medicare commercials' overly cheerful and "you're missing out" tone. As annoying as they are, Martha's eye rolls and sarcasm seem to capture the attitude that many of us have toward Medicare commercials (even if we don't say anything out loud).
Maybe that's why there's now a new "Karen" commercial. Karen is a more likable lady who sees a Medicare commercial on TV and thinks, "Ugh, every year, I have to listen to these commercials."
After which the friendly, understanding announcer replies, "We're sorry Karen. And we know it's annoying. We want to make sure everyone on Medicare knows it's time to check and see if they can enroll in a plan that will save money or include additional benefits." Okay, fair enough.
Karen, unconvinced, thinks, "I just want these commercials to STOP!"
Amen, Karen. Surprisingly, the announcer says, "We do too." But goes on to remind her that this is the only time of year when she can make a change (which isn't 100% true, but basically so).
Karen predictably relents eventually and decides to make the call after she's assured she doesn't have to change Advantage Plans if she doesn't want to.
The pitch of the Martha commercial (and similar ones) is that you need to call the Medicare Help Line (not affiliated with the US government) for a "Medicare check-up" to help you determine if you're getting all the Medicare benefits you're entitled to. The underlying premise is that you're not if you aren't enrolled in a Part C Medicare Advantage Plan.
These commercials seem to portray an alternate Medicare universe where everything is better and, best of all, possibly FREE. All you have to do is choose the right plan. They seem to promise the moon and stars and a free lifetime supply of denture adhesive cream.
They are also full of buzzwords and catchphrases such as "zero-dollar premiums" and "extra benefits," as though they are secrets only a select group of us can be let in on. (I'm just waiting for one to offer me a lifetime supply of V-8 juice, which I really like.)
The real genius of these ads is creating an atmosphere of "FOMO" (fear of missing out) and confusion. They throw around terms like HMOs, PPOs, and ACOs, leaving us mere mortals scratching our heads.
Then there's the free use of the word "free": free calls, free check-ups, free benefits.
And try not to overlook the obligatory disclaimer at the end of each commercial, delivered so fast by the announcer that it's basically unintelligible, and the "fine print" on the screen is so small that no one (except maybe Martha with her oversized eyeglasses) can read it.
As I've explained in a previous article, these commercials are intended to do one thing: get you to call an 800 number that is a "funnel" to a Medicare Advantage Plan salesperson.
I want to be clear here. Advantage Plans aren't bad; they can be great for some people. The problem is that you must know exactly what you're buying, just like any other complex insurance or financial product.
Here are some essential things to know about these plans. Some things are good, and others. . . not so much.
Private insurance companies offer them. If you have Part A and Part B (which carries a premium), you can join a Medicare Advantage Plan, sometimes called "Medicare Part C." This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).
They're "all-in-one coverage" plans. One of the main selling points of Medicare Advantage Plans is their all-inclusive nature. These plans often bundle together hospital, medical, and prescription drug coverage. It's like getting a combo meal at your favorite fast-food place but for healthcare.
They offer "extra benefits" beyond Medicare Parts A & B. Many Medicare Advantage Plans offer additional perks that traditional Medicare doesn't, like dental coverage, vision care, and even gym memberships (but not a lifetime supply of denture adhesive).
They may cost less than Medigap (Medicare Supplement) plans. With some plans boasting zero-dollar premiums, Medicare Advantage can seem like a cost-effective choice for some people, and it can be. But remember: You still have to pay Medicare Part B premiums. Also, out-of-pocket expenses can be higher than some Medigap plans.
They are optimal when you use specified "in-network health providers. Unlike traditional Medicare and Medigap plans, many Advantage Plans operate within a specific network of healthcare providers. This is something that catches many people off-guard. If you go out-of-network, perhaps to see a particular specialist, you may not be covered (if you have an HMO Advantage plan), and even if you are (because you have a PPO Advantage plan), you will probably pay more out-of-pocket.
You may need prior authorization for some services or medications. You might need prior authorization before you can access certain services or medications.
Advantage Plans can vary widely from location to location. The coverage landscape of Medicare Advantage Plans can be a bit patchy. What's available in one area might not be in another.
Advantage Plans can change each year. Medicare Advantage Plans can be a bit inconsistent, subject to changes in coverage, networks, and costs each year. It's like playing a game of healthcare roulette—will your plan still cover your favorite prescription next year, or will you be forced to switch to the generic brand?
You can switch from an Advantage Plan to a Medigap plan. Switching from Medicare Advantage to Medicare Supplement (Medigap) coverage is possible if you meet specific requirements. If you are enrolled in a Medicare Advantage plan and are unhappy with your coverage, you can enroll in a new plan during the right enrollment periods.
You will probably need to answer underwriting health questions to switch from a Medicare Advantage plan to Medigap. This means you must answer health questions to enroll in a Medigap plan. Furthermore, an insurer may turn you down based on your responses to those questions.
The other plans
If you're eligible for Medicare, you can choose to purchase an Advantage Plan (Part C), a Medigap Plan (Medicare Supplement), or go with Traditional Medicare (Parts A & B only). You may also choose to buy a Medicare Part D Prescription Drug plan.
We've discussed Advantage Plans, so let's look at Medigap Plans.
Private insurance companies also offer Medigap plans. Many of the same companies that sell Advantage Plans also offer Medigap plans. And like Advantage Plans, the coverage parameters are set by Medicare.
Medigap plans cover most out-of-pocket expenses. Most Advantage Plans come with high deductibles and co-pays. With Medigap, your out-of-pocket costs can be minimized based on your chosen plan.
Medigap plans allow you to see any doctor or specialist who accepts Medicare. You don't have the in- or out-of-network problem that Advantage Plans do. (This is one of the reasons some people want to switch from an Advantage Plan to Medigap.)
Because Medicare governs them, coverage is consistent across policies. The coverage provided by Medigap plans is standardized across all policies in all states. In other words, a Plan G policy in NC is the same as in FL, and the premiums will not vary much from state to state.
Medicare Plans cost more than Advantage Plans. While the predictability is comforting, the monthly premiums for Medigap plans can be higher than those of Advantage Plans.
Unlike Advantage Plans, Medigap plans don't cover prescription drugs. To fill this gap, you might need to purchase a standalone Part D plan, adding an extra layer to your healthcare ensemble. (They also don't cover vision or dental, so you'll need separate policies if you want that coverage.)
A little snarky
I know my article has been a little snarky and sarcastic, and I admit that I enjoy poking fun at these commercials. But Medicare is very serious business for retirees. Wise stewards will carefully evaluate their options and select the one that is best for their situation.
If you're in the market for a Medicare Plan, I suggest you not get your information from TV commercials or the friendly person on the other end of the 1-800 number they put on the screen.
There's also no reason to be a "Martha." You want to understand and compare all your options, but I admit it can all be overwhelming.
There are some excellent resources out there, but a great one often overlooked is the Medicare Plan Compare Tool (a U.S. government site).
Which plan you select, if any, will depend on your preferences, budget, needs, and whether you prefer the all-in-one approach of an Advantage Plan or the more customized Medigap Plan. The tool will help you decide which one is best for you.