Is Medicare Advantage a Scam?

Is Medicare Advantage a Scam?

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Exploring the Realities of Medicare Advantage Plans

Medicare Advantage also known as Part C of Medicare was established to create a privatized Medicare option with the purpose of better patient outcomes and increased efficiency in the senior healthcare market. It had a rocky start. Right out of the gate there was misrepresentation of the plans by people who did not understand them. This brought on the Scope of Appointment, which over time got watered down due to language in the Scope of Appointment rule that said you had to get the form signed “if practical”.

If you are ever wondering if something is rigged in writing, look for phrases like “if practical”. This creates a gray area that ended up being exploited for years.

About 6 years ago, I was still in the trenches helping Medicare beneficiaries everyday. Now I have a team of agents I manage that do most of that side while I oversee them and ensure the quality of their work. But during that time, I wrote Medicare Advantage Plans occasionally for people who couldn’t afford a Medicare Supplement or did not get one in the required time frame to avoid underwriting and were now locked out of the ability to get on a lettered plan.

Then came Joe Namath, SelectQuote, GoHealth, Pakistani and Indian Call Centers where everyone’s name is Fred or John, and eventually William Shatner, JJ Walker, and more spreading the good word of all the benefits.

The American public is already split into two factions:

  • People who care about quality and will pay for it
  • People who care about whatever freebies they can get (and expect)

A friend of mine after watching the most recent Senate Hearing on Medicare Advantage said he was angry that they blamed the commercials for this because the government has trained them to expect handouts and not care about the consequences.

I couldn’t have said it better myself. Then the government authorizes a private entity to hand out freebies, and it’s evil capitalism’s fault. It is honestly a huge hypocrisy that they’re so hard on the Medicare Advantage carriers for doing the same thing the government has done since LBJ.


Now that I have been on a soapbox for a minute, let’s talk about the topic at hand. Is Medicare Advantage a Scam?

It may not be suitable for everyone, perhaps not even for as many people as have already enrolled.

There are certainly lots of agents getting trained to present Medicare Advantage only. This is happening in these large call centers I named above.

When an agent is only trained to present one side and doesn’t know about Traditional Medicare with Medigap and how good it can be, they tend to shove square pegs into round holes. There are probably hundreds of thousands of people on Medicare Advantage Plans now that would have bought a Medigap plan had they been presented both sides by an experienced agent or broker.

We have ourselves a mess where the Democrats want to demonize the private companies on the Medicare side. It is funny though that they are silent about the problems with Obamacare currently though there is a nightmarish fiasco going on that no one seems to be overly concerned with at the moment.

Medicare Advantage is not a scam. The talking points about it being bad like Prior Authorization, Limited Networks and more are easily explained in a way that isn’t that threatening when explained by someone who isn’t trying to sell you one side over the other.

I have had a grandparent and parent both on Medicare Advantage and four grandparents on a Medicare Supplement. We present both sides and make sure our clients get what they’ll be happy with. There is no one size fits all, and if you want to explore all options or even if you know you want a Medigap plan or Medicare Advantage Plan, you can call us and we will facilitate. We will also service the ever-loving mess out of your policies for the rest of your life. Our award winning client retention team does nothing but eat, sleep and breathe getting people’s procedures authorized, claims paid, and premiums lowered.

Get Help from Bobby Brock Insurance

If you want a brokerage built by someone who has seen all of the problems and solved them, that’s Bobby Brock Insurance. If you want businesses built by someone who has never sat belly to belly with a Medicare beneficiary and discussed the issues with them, that’s the Joe Namath advertisers and people calling you from the Middle East.

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Justin Brock

President & CEO of Bobby Brock Insurance