24 Sep Why Two Zero Premium Medicare Advantage Plans Can Differ by Thousands: A County Level Look at Out-of-Pocket Exposure
By Lara Goulson, licensed independent insurance agent, Goulson Insurance Services, Los Angeles
Medicare Advantage enrollment has crossed half of all Medicare beneficiaries nationally, and the marketing that accompanies it has converged on a single number: the monthly premium. In a large competitive county that number is usually zero, which means it carries almost no information. The figure that actually determines financial exposure in a bad year is a different one. It is published, and almost nobody looks at it. According to CMS (Centers for Medicare and Medicaid Services), every Medicare Advantage plan is required to publish an annual in-network out-of-pocket maximum — the figure that defines a member's worst-case financial exposure in a given year — yet this number is rarely the focus of plan marketing or consumer decision-making.
[caption id="attachment_76226" align="aligncenter" width="500"] Photo by Pixabay: https://www.pexels.com/photo/close-up-photo-of-a-stethoscope-40568/[/caption]