If you’ve watched TV during the fall, you’ve probably seen ads for Medicare Advantage plans. They often feature celebrities or smiling seniors talking about $0 premiums, free dental and vision, and even money back in your Social Security check. Sounds great, right?
But here’s the thing: those commercials don’t tell the whole story. In fact, many of them leave out important details—like network limits, denied care, and high out-of-pocket costs.
At Integrity Wound Care, we’ve seen how these plans affect our patients—and it’s not always for the better. Let’s take a look at what those ads don’t say, and why it matters if you need real, consistent medical care.
What the Commercials Say
Medicare Advantage ads usually promise:
- $0 monthly premiums
- Free dental, vision, and hearing
- Over-the-counter benefits
- Meal deliveries or gym memberships
- “Extra money back in your Social Security check”
But these perks can be misleading. They’re only available on certain plans in certain areas—and often come with trade-offs that aren’t mentioned in the ad.
What They Don’t Say
1. You Still Pay for Medicare Part B
The ads talk about $0 premiums, but you still have to pay your Medicare Part B premium (typically $174.70/month in 2024). That doesn’t go away.
2. Limited Provider Networks
Unlike Traditional Medicare, which lets you see any provider who accepts Medicare, Medicare Advantage plans have limited networks. That means you might not be able to see your preferred doctor—or get care when traveling out of state.
3. Prior Authorization Delays
A 2022 report by the U.S. Department of Health and Human Services found that Medicare Advantage plans denied 13% of prior authorization requests that would have been covered under Traditional Medicare. (HHS OIG Report)
4. Hidden Copays and High Out-of-Pocket Costs
Many plans advertise $0 premiums but charge copays for doctor visits, specialist care, hospital stays, and procedures. The average out-of-pocket max for in-network care in 2024 is over $5,000. (KFF, 2024)
5. Benefits Can Change Every Year
MA plans can change their coverage, costs, and provider networks annually. You could sign up for a plan that includes your doctor—only to lose that access the next year.
6. Limited Value of “Free” Extras
Many of the extra benefits—like dental and vision—are capped at low amounts. For example, vision coverage often maxes out around $100–$150 per year, which usually won’t cover the full cost of prescription glasses. Dental benefits may only include cleanings and exclude major work like crowns, dentures, or root canals.
Profits Over Patients: What the Ads Don’t Mention
Many people don’t realize that Medicare Advantage plans are incredibly profitable for private insurance companies—not because they offer better care, but because of how they get paid. One tactic insurers use is called “upcoding.” This means they classify patients as being sicker than they actually are, which allows the insurer to bill Medicare for a higher reimbursement.
This practice has been flagged by government watchdogs and adds billions in unnecessary spending—dollars that go to insurance company profits, not patient care.
On top of that, many insurers invest heavily in lobbying to protect this system and fight off tighter regulations. The result? Patients face denied services, narrow provider networks, and slow approvals for the care they need.
Many of our patients require advanced wound care, like regenerative treatments that help close chronic wounds. These are covered by Traditional Medicare under Part B, but Medicare Advantage plans deny these services due to network issues or prior authorization requirements.
Time is critical with non-healing wounds. Delayed care can lead to infections, hospitalizations, and even amputations.
Don’t Fall for Flashy Promises
Medicare Advantage may sound appealing on the surface, but for patients who need consistent access to care—especially advanced wound treatment—it often comes with costly trade-offs and frustrating delays. The ads highlight the perks, but rarely explain what you’re giving up in return.
Before you sign up for any plan:
- Read the fine print
- Ask about network access and prior authorizations
- Check what happens if you need specialized care or want to travel
If you’re already in a Medicare Advantage plan and finding it hard to get the care you need, you may be able to switch during open enrollment or special enrollment periods.
What We Believe
At Integrity Wound Care, we’ve made the decision to work exclusively with Traditional Medicare because it puts patients first. It allows us to provide medically necessary wound care without red tape, referrals, or coverage delays. Our team sees firsthand how faster access to treatment leads to better healing and fewer complications.
If you’re looking for straightforward, covered wound care that comes to you, we’re here to help.
Want to learn more? Call us today or visit https://integritywound.net.
And be sure to read the fine print—your health is worth it.