Is a Medicare Advantage Program a Scam? 5 Things to Know

We live in a digital age, and we can see that people have more opportunities to get the services they want much easier than ever before. We talk about practically all the industries out there, including healthcare. Think about it, the industry offers a wide array of different possibilities to those who require therapy or consult.

One of the services you can get these days in the healthcare industry is known as Medicare advantage. If you don’t know where to start looking for it, then be sure to visit Medicare Advantage plans in Virginia. Since we are talking about a massive industry, that generates billions of US dollars annually, you may come across scammers.

Sadly, we can see that these scams are quite common these days. For that reason, you need to be on the lookout for these and know what are the signs to spot them. Today, we want to talk about these things in greater detail. Without further ado, let’s take a look at some of the most important signs.

1. Free Plans, But Not Really


Let’s be honest, most people out there don’t know much about Medicare advantage programs, not just seniors. So, nobody should be surprised that agents marketing their programs as free, when they are not free, is one of the commonest scams they use to cheat people out of their money.

When you think about it carefully, you will see that nothing is really free, so it doesn’t make sense that this offer comes without asking for compensation. When you subscribe to one of these programs, that means that you will need to cover at least 20% of the costs there. Therefore, when you hear that they offer you a free deal, this is the first alarm.

Most of the programs out there have an annual cap that determines how much money will go out of your pocket. One of the biggest problems is that people believe what the agents say to them and they do not read the contract they sign. For that reason, it is essential to read the whole contract and determine what are the points that talk about costs.

2. False Additional Benefits

If you pay close attention to the offers you get, you will see that a lot of contracts will not include certain benefits. At the same time, the agents may talk about these benefits when they present the contract to their potential subscribers. For instance, they might not cover things such as prescription drugs, dental vision, or hearing aids.

A good example is that these programs usually do not cover basic things in dental or oral medical services. For that reason, people turn to the things known as Medicare Advantage plans. Still, we would like to point out that you should read about these carefully even advanced ones will not include these.

3. Threatening a Loss of Coverage


The next thing we want to talk about is getting a call and hearing that the prescription drug coverage plan cannot work properly without having the medical prescription. In that case, the false agent will tell clients that they need to purchase an additional benefit, otherwise the contract they have will be terminated.

We cannot think of a clearer sign that points toward a scam. They will claim that you need to subscribe to additional benefits before you can expect to reap benefits. In that case, it is essential to understand the thing at hand, and you should know that this thing is one of the biggest cheats out there. So, it is essential not to subscribe to these claims since you will get scammed.

4. Only Hospitalization Costs

Paying only hospitalization costs is a major element for the legit Medicare advantage programs. However, you need to determine whether this is the case in every document you get. As you can presume, this is a pretty important matter, but the truth is that it is not a part of every document out there.

Hospitalization costs are pretty high, and most people will immediately think that this is a great benefit for them. But in some contracts, you will not find this to be named inside it. In that case, the subscriber will need to pay both for hospitalization costs, not only them but also a wide array of different costs. When these costs accumulate, you will see just how massive this amount can get.

5. Bogus Medicare Representatives


The last thing, yet one of the most significant ones, is that you should be on the lookout for bogus Medicare representatives. Since we know that seniors are the main target for false Medicare representatives, the main thing you will see them do is market their programs as those that will be beneficial and help seniors save millions of their money.

The best way to describe it is to say that these sound too good to be true. We know, these offers always sound tempting, especially to seniors who are usually not aware of all the dangers of the digital world we have today. They are pretty easy to target for scammers, and that’s why it is important to help the seniors from your family or friends with this.

Also, you will see that many of these false representatives will tell seniors that they are immediately part of the program, after the first call. Those who have experience with this know just how untrue this is. Getting a call doesn’t practically mean anything, and there are a lot of steps that need to be made before someone can be a part of the program.


As we’ve said, scams are pretty common in the healthcare industry. So, understanding all the potential risks you will come across is quite important. However, you need to know what are the problems before you can sign the contract, or even think about getting one of these programs. Here, we’ve provided you with all the major things you should pay attention to avoid these pitfalls.

About Nina Smith