Medicare Advantage: A Rural Disadvantage

Sunset on Farm in rural area of Florida, just outside of a small town.

We are all familiar with the term “Medicare Advantage”, and you may know someone who loves their plan or cannot wait to get off of it. Servicing a client’s issue is never a problem, but when you have a lot of clients, small problems can wind up taking all day for the agent to solve. This can result in frustration for other Medicare beneficiaries waiting in line.

In my experience, these service issues are commonly identified as out-of-network doctors, uncovered or expensive medications, or actually using the benefits built into the coverage itself. These problems have elevated the minor nuisance of service work to losing clients because of a lack of trust.

Medicare Advantage in Rural areas

Understand that your agent is often picking the plan that meets your needs the most, but that the delivery end of the services can be somewhat out of their hands. We collectively advocate for these plans to hold up their end of the bargain, and thankfully we have been making progress year after year.

Senior man turning 65 in a rural area struggling with his Medicare Advantage.

In the past, especially in rural areas, Medicare Advantage had not expanded or achieved network adequacy. The closer we get to the swell of folks turning 65, the more interest these companies have shown. This has led to them investing the time, energy, and resources into these spread-out markets. Because the providers often run monopolies in small towns, it has become difficult to attain a level of providers in a given rural area in the network. For instance, in Baylor Hospital or North Mississippi Medical Center, there have been major issues with getting Medicare Advantage plans to be accepted. Major carriers have had falling outs with these and several more facilities in recent years. But where there’s a will there’s a way, and these hospital administrators and provider resource groups have come together to pave a path to a bright new future for Medicare Advantage and rural areas.

This is great news!

Whenever there is new competition in a business, that means competition in price, benefits, and customer service. As these markets are filled with options for the clients, we are finding that there is still a fear of these types of coverage. I understand this as someone who has personally dealt with Medicare Advantage issues in the past, but thankfully we’re seeing far less of these problems with the tone of billing staff at clinics beginning to change.

Medicare Supplement Route

In the past, going the Medicare Supplement route was the solution, but this often left people drawing extremely limited Social Security income paying upwards of 30% of their household revenue on a Medigap plan. Medicare Advantage is a great solution to many of these people, and we’re pleased to announce that we’ve seen great success and can begin to endorse these decisions on a case-by-case basis.

Please call or contact us when you’re ready to see if you’re one of those cases!

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