Medicare Advantage Plans 2025 and Beyond

The Most Popular Types of Medicare Coverages

Medicare Advantage plans are among the most popular types of Medicare coverage and they keep growing annually. These plans are designed by the government, meaning they set the basis parameters of coverage so all insurance companies participating essentially have the same core benefits.
The pricing may differ by insurance company, but the core products are all the same. So how does an insurance company differentiate itself from the competition? One way is to have larger networks of doctors and hospitals. The medication lists are essentially the same with variations by each insurance carrier.

Medicare Advantage - Insurance 4U Nevada - Las Vegas
Medicare Advantage – Insurance 4U Nevada – Las Vegas

Each Medicare Advantage insurance company tries to add ancillary services like gym membership, eye exams for glasses, dental benefits, and the latest craze pre-paid debit cards. Each insurance company began distributing these pre-paid debit cards so members could buy groceries (only certain kinds of foods are permitted), pay for gym membership, and even use the card to pay for dental, vision, and
hearing services. Even over-the-counter items are covered to help the members save money on stable items they use daily.

This pre-paid debit card has different names based on the insurance company and offers help in maintaining their lifestyle. I think these debit cards are helpful, but the trend seems to be that the
client wants to know which ancillary benefits they can use and how much free money they can get from the plans.

I believe determining whether their doctors and medications are covered by the plan is paramount. The debit card is an extra that should not be considered unless their doctors and medications are covered first. Believe this debit card started with the dual-eligibles (meaning Medicare & Medicaid). With those plans, the debit card amounts are higher with more flexibility and used to obtain new dual eligible business. It appears that offering those cards might make some dual eligibles use a MAPD plan
instead of just Medicare and Medicaid. Having extra money to buy staples is a big benefit for those dual eligibles and is helpful for those having some financial issues. The dual-eligible side of the MAPD business is growing much faster than the regular MAPD business.

Some Concern

My concern is that many seniors on fixed incomes need some help periodically and should be made aware of these benefits and which carriers offer them. What I don’t want to see is the debit card becomes the lead item instead of figuring out that their doctors and medications are covered. I believe these debit cards are an extra benefit and helpful for all seniors but have a place in the plan after the doctors and medications are provided by the plan. I’ve had a couple of potential clients ask before we started the
process how much of a debit card balance they get and what it covers. Thus, my concern.

Love selling MAPD plans as they have a place in the Medicare world but concerned that the insurance carriers are trying to lead with a small overall item and not concentrate on the real basics of healthcare and which doctors and medications are covered. There is a place for these debit cards as they provide extra benefits for the seniors, which is wonderful. Suffice it to say that we have beaten this issue up but want seniors to understand where in the MAPD plan these benefits are and not to ask first how much extra money they can get.

Compare this to underage insurance on the exchange where the amount of the monthly subsidy is more important than the plan the clients pick. Many don’t realize there is an accounting at the end of the year when they file their taxes and if they have underestimated their income, they owe the government back part of that subsidy. 54% of all Americans getting subsidies have underestimated their income to get bigger subsidies and then owe that money back.

Final Thoughts

In conclusion, we must strike a balance between the benefits, including the doctors and medications offered by each plan, and not use the debit card as the driving force behind picking a certain plan over others. The same holds for on-exchange business for the under-65 crowd. Everyone wants something for nothing and sometimes we lose sight of what the real issue is: getting insurance you can use.

I hope this information is useful and if anyone has questions, please contact me via phone or email and I will respond quickly.

Also, if you need Medicare information, take a look at Medicare 2024 Information.

The Barend Agency

The Barend Agency Inc.

Len Barend, Broker