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2023 Medicare Update


With the recent hard-sell and subsequent popularity of Medicare Advantage health plans, the Centers for Medicare and Medicaid Services (CMS) announced significant marketing requirement changes for those insurance representatives that sell Medicare Advantage and/or traditional Medical supplement insurance policies.

The CMS updated marketing rules to say:

  • The following disclaimer must be mentioned within the first minute of any call to a potential customer. It also must be displayed prominently on any marketing materials and insurance company sales websites:

“We do not offer every plan available in your area. Any information we provide is limited to those plans we offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options.”

The disclaimer does not supersede or delete any of the following standing Medicare insurance sales call rules:

  • Cold calling prospective or current Medicare members is not allowed.
  • Unsolicited sales approaches like sending texts, placing flyers on cars, and calling Medicare beneficiaries are still prohibited practices.
  • Emails that contain a method to opt out, direct mail and print ads are still permissible.
  • Marketing materials that explain specific plan information must be pre-approved by the CMS Marketing Department.

These insurance company/broker marketing changes have been enacted to help ensure that those eligible for Medicare know exactly what they are purchasing.

The Medicare Advantage Disadvantage

When a person turns 65 they can enroll in traditional Medicare. Traditional Medicare Parts A & B pay for 80 percent of an enrollee’s yearly medical bills. Medicare Part A is the hospital insurance

component and is usually premium-free. Part B is general medical insurance. Part B costs $170.10 per month in 2022 but will be reduced to $164.90 in 2023.

The current Medicare Part B deductible is an amazingly low $233.00 per year. Prescription drug plans are not included in Parts A and B, however, and prescription drug coverage must be purchased separately.

While traditional Medicare is government health insurance, Medicare Advantage Plans involve private insurance. While these plans sometimes offer zero monthly premium amounts and add vision, dental and drug coverage to their benefit roster, there are definite drawbacks.

With traditional Medicare, there are usually no co-pays or co-insurance charges. Members can see any doctor that accepts Medicare without a referral. Members can go to any hospital for surgery.

If enrolled in a Medicare Advantage plan, the playing field is radically changed:

  • There can be copays for office visits.
  • A referral can be needed for specialist care.
  • Instead of the traditional Medicare deductible of $233 per year, certain Medicare

Advantage plans have out-of-pocket costs that can creep up to almost $10,000 per year.

In addition, a Medicare Advantage policy holder may be unable to access the best care available. MD Anderson, the number one cancer center located in Houston, Texas, only accepts one local Medicare Advantage plan. A cancer patient with the wrong Medicare Advantage policy could be denied insurance coverage for life-saving care at that premier institution.

Good Legal Advice is Paramount

Medical insurance issues are only one significant consideration for elders. If you or your parents are reaching age 65, make sure that you consult with an experienced elder care attorney that can help with estate planning, living wills, special needs trusts, and provide advice about Medicare v. Medicare Advantage. If you are facing an estate planning situation be sure to call a Canton elder law attorney at the Law Office of Brian S. Karpe at 1-860-217-1458 or contact us online.



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