confused old lady medicare

The Ugly Truth of Medicare Advantage

Is anyone else offended by the ageism on some of the Medicare Advantage TV ads? I have seen images of an elderly lady in a “housecoat” as my grandmother used to call it, with unattractive large glasses, behaving in a confused manner. This is a very negative stereotype being perpetuated on national television.  Watch it here. These Medicare Advantage ads also can be quite misleading if…

you aren’t educated about how Medicare and various supplements work. Medicare Advantage plans basically take over your Medicare benefit administration, and can limit your care in a hospital, subacute rehabilitation, or inpatient rehabilitation should you need that.

Case example: A 75 year old has a stroke causing left-sided paralysis. After a few days in the hospital being stabilized medically, the case manager explains that inpatient rehabilitation, which is more intensive and provides three hours of PT/OT/ST each day, might not be approved by your Medicare Advantage plan. A referral will be made, but around 70% of people are denied inpatient rehabilitation by these plans. Therefore, referrals will also need to be sent to subacute rehabilitation in a skilled nursing facility. A case manager who works for the Medicare Advantage plan will decide which level of care you are approved for. However, if you have a traditional Medicare plan with a supplement, the facilities will evaluate your referral and decide if you can tolerate the intensity of Inpatient rehabilitation based on your medical condition and potential for recovering.

Medicare Advantage plans often have lower cost premiums, and advertise other perks, which is very appealing to some older adults. However, should you need medical or rehabilitation care, you might not get what other people, who are on traditional Medicare, would have access to.

A recent report on NPR stated, “Paid marketing skews heavily toward Medicare Advantage, which is more than twice as profitable for private insurers than any other type of coverage they offer. Nearly 9 out of 10 TV ads that ran last fall focused on Medicare Advantage, according to the Kaiser Family Foundation.”

Please educate all the seniors in your life about the importance of understanding how Medicare Advantage plans actually work.


Joan Garbow, MSW, LCSW, CCM is co-president of The Aging Life Care Association, New England chapter. Through her private practice, Joan Garbow and Associates, she provides expert guidance and assistance to individuals and families dealing with eldercare challenges throughout Western Connecticut.