ARE THE EXTRA BENEFITS THAT COME WITH MEDICARE ADVANTAGE PLANS WORTH IT?

Michael T. Braden September 26, 2026 MEDICARE PLANS

ARE THE EXTRA BENEFITS THAT COME WITH MEDICARE ADVANTAGE PLANS WORTH IT?

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DO NOT BUY A MEDICARE SUPPLEMENT POLICY BECAUSE OF THE EXTRA BENEFITS

I began my career as a Medicare Broker 11 years ago, and I remember wondering how Medicare Advantage plans could offer so many Extra or Supplemental benefits that Original Medicare couldn't. Were Medicare Advantage plans that much better than Original/Traditional Medicare?

I invite you to follow along as I do my best to explain the history, logic, and allure of bright, shiny objects like the extra benefits offered by Medicare Advantage plans, which are not what they are cracked up to be. And why I don't advise anyone to enroll in a Medicare Advantage plan based on extra benefits alone.

If you feel like any Medicare Advantage plan is the best option for you and for giving you the best healthcare coverage for your needs, awesome! You can color me cynical, but I have seen far too many Medicare beneficiaries who have been promised the sun, moon, the stars, and even the Milky Way by pushy, dishonest, immoral Medicare Advantage Agents and Medicare Advantage carriers over the years, only to be left with disappointment that nobody bothered to explain the details of their plan correctly to them. So this article is dedicated to everyone who has been duped and misled by Medicare Advantage in the past.

RULE #1: IF SOMETHING LOOKS AND SOUNDS LIKE IT'S TOO GOOD TO BE TRUE, IT PROBABLY IS

A brief history lesson about Medicare Advantage Plans. Medicare started in 1968, but Medicare Part C, which President William Jefferson Clinton signed into law on July 30, 1997, was introduced that year. At the time, it was called Medicare Choice. The idea was for private insurance companies to offer a similar option to Medicare beneficiaries as Original Medicare.

Since Medicare Part C which we all now know as Medicare Advantage plans, were not part of the US Government, they were allowed to offer additional services to lure and entice Medicare beneficiaries to enroll in their plans., which we all now know as Medicare Advantage plans, was not part of the U.S. government, they were allowed to offer additional services to lure and entice Medicare beneficiaries to enroll in their plans. And they were successful. Medicare Advantage plans have long boasted low-cost and zero-dollar-premium healthcare plans, and they have always included extra benefits, as I kindly refer to them as Bright, Shiny, Objects!

These plans specifically target and market benefits they think will be most attractive to the public. The fact is, every Medicare Part C/Medicare Advantage plan is a heavily managed healthcare plan. They are designed to make a profit. And they, in my opinion, cleverly disguise and mislead the public.

HOW DO MEDICARE ADVANTAGE PLANS GET THE MONEY TO PAY FOR EXTRA BENEFITS?

Most people are shocked to learn that CMS/Medicare pays $1,000 per month to Medicare Advantage Insurance Companies for each Medicare beneficiary enrolled in one of their plans. That is a lot of money that adds up fast. This is how Medicare Advantage plans pay for their marketing and advertising budgets. These plans pay millions of dollars to lobbyists in Washington, D.C., and to content creators to push a narrative based on innuendo and half-truths.

MUCH LIKE A FREE GIFT WITH PURCHASE, WORDS LIKE "FREE" AND "EXTRA BENEFITS" ARE APPEALING TO THE PUBLIC

Everyone in America is and has always been trained to "Get a good Deal", whether it is on a car, a new home, or an 8G, UED 108-inch High-Definition Smart TV. The same is true for Medicare Advantage plans.

Here are some examples, and you decide for yourself if their tactics, although not illegal, are definitely suspect:

FREE SILVER SNEAKERS MEMBERSHIP

These can be great; it is good to stay active in retirement, but it is estimated that less than 30% of all Medicare Advantage beneficiaries actually use these gym benefits. And, because of the sheer number of Members, most health clubs reduce the hours when you are allowed to "use your membership" because they do not want to irritate their regular members who pay full price for their access to the facility. No one ever mentions this in their commercials, flyers, or brochures, and they certainly don't allow their agents to divulge it.

FREE DENTAL BENEFITS

This is my favorite example. You know, 4-5 years ago, Medicare Advantage plans used to offer 3-4K in dental benefits, but now it has been reduced to around $1,000 a year in Dental Benefits. They package it as Full Dental coverage, but that is not true. What they don't tell you is that those plans divide the total amount by 4 (So $250 Per Quarter, not $1,000), then load that amount onto their Flex/Benefit Card. But they will not tell you that unused amounts don't carry over from one quarter to the next. Also, almost every plan covers only very basic, preventive dental benefits. Some may cover minor fillings, but Major dental procedures are not included. Does that sound like a good deal to you?

FREE VISION BENEFITS

Medicare covers most vision conditions, such as cataracts, glaucoma, and other eye diseases or conditions. Pretty much anything you would see an Ophthalmologist for is covered by Original Medicare. But it does not include Routine Vision, such as annual check-ups at the optometrist's office, or coverage for Contacts and Eyewear. Like dental benefits, these routine vision benefits are usually divided into four quarters.

FREE HEARING BENEFITS

Routine Hearing covers costs at a participating In-Network Audio Clinic, and usually includes a benefit amount for Hearing Aids, Hearing Amplifiers, and Hearing Aid Batteries. Each plan usually has a limited dollar amount per ear. Again, these benefits are generally divided by four, and unused quarterly amounts do not automatically roll over.

If you are a veteran, try to apply for hearing aids through the VA. They have superior devices, and if your VA benefits cover them, all the better. But if you are counting on hearing benefits from your Medicare Advantage plan, compare what they offer with the OTC options at Costco and Sam's Club first.

OTC BENEFITS

OTC stands for Over-The-Counter benefits. These are typically items you can find and purchase at the Drugstore, items like vitamins, supplements, bandages, cough medicine, etc. Like the others above, these benefits vary by plan, and unused amounts don't automatically roll over from one quarter to the next. Overall, everyone should use OTC benefits.

CANCER TREATMENTS

Most insurance companies keep this in the fine-print section of their Evidence of Coverage document. Every Medicare Advantage plan has a 20% coinsurance for Radiation and Chemotherapy. That is steep, yet Medicare completely covers cancer treatments.

NOT ALL MEDICARE ADVANTAGE PLANS ARE BAD

Some excellent insurance companies offer decent plans, but never forget these companies are in business to turn a profit. I think some of the best plans available are CSNP (Chronic Special Needs Plans). These plans are designed for people with Chronic Health Issues, and the benefits focus on making their illness as manageable as possible. Many CSNP plans cover transportation to and from doctor's appointments, offer stronger OTC benefits, and include a Care Team to better meet members' needs.

If you are interested in a Medicare Advantage plan because it is convenient, all of your doctors are in the plan's network, you are happy with their Prescription Drug Coverage, and the cost and benefits work for you, then by all means join that plan; just please never join a plan because you think you are getting the deal of the century, because you aren't.

If you are looking into a Medicare Advantage plan, most brokers and beneficiaries trust the PPO plans and PPO networks 5:1 compared to HMO plans.

THE WORST THING ABOUT MEDICARE ADVANTAGE PLANS THAT NO ONE TELLS YOU ABOUT

Ask any Firefighter, Police Officer, EMT, or first responder; you will genuinely roll your eyes when asked about Medicare Advantage plans. They fondly call MA plans Medicare Dis-Advantage! Some plans are good, some companies are good, others are not-so-much! I honestly believe a lot of the negativity toward certain companies is well-deserved, based on how they treat their members. But what I find most damaging is when these companies consistently deny or delay care.

All too often, Medicare Advantage companies will require Prior Authorization for certain tests; ones that come to mind are Alzheimer's and Dementia testing, Neurological imaging, CT scans, and MRI's. These companies routinely delay care and refuse to approve and authorize medical treatments, all in the name of making money.

This is especially true in the Fourth Quarter (October, November, December). Because Medicare Advantage plans don't automatically renew, many of these insurance companies use stall tactics and ignore requests to save money. It's sad, but most of them don't care whether someone renews their MA plan for the next year. If not, they would rather have healthy people on their rolls.

Lastly, if you think you might be better off switching back to Original Medicare and picking up a Medicare Supplement or Medigap plan, reach out and speak to a local licensed, independent Medicare broker in your area. Brokers speak Medicare fluently, every day of the year; they have the knowledge, skill, and expertise to listen, answer all of your questions, and then help guide you along the right path.

KNOW WHAT YOUR MOOP IS

Every Medicare Advantage Plan has a Maximum-Out-Of-Pocket amount. These vary by plan and by state. In 2026, the National Average for in-network MOOP is $5,700 and can go as high as $12,000 for out-of-network care.

IF YOU ARE SERIOUSLY CONSIDERING ENROLLING IN A MEDICARE ADVANTAGE PLAN

I really do not like saying this, but please don't take a captive agent's word for anything. Many of these people only work during the Medicare AEP in the fall, and they are nowhere to be seen after the Annual Enrollment Period is over. This probably doesn't seem fair, but it's ultimately your responsibility to verify each year that your preferred Doctors, Hospitals, Labs, imaging offices, clinics, and Hospitals are in the plan's network for the coming year.

It's easy: you can find this info on the insurance company's website, on www.medicare.gov, or by calling your doctor's office to confirm their relationship with your plan.

WRAPPING THINGS UP

Well, congratulations, you made it through this brief article about what the Medicare Advantage Plan administrators do not want you to know. I hope you learned a few things, and that you will contact a local independent Medicare broker in your area if you have any additional questions or comments about today's article on whether the Extra Benefits available with Medicare Advantage plans are worth it.

Full disclosure, I have seen far too many people hurt and intentionally misinformed by captive Medicare agents (Captive agents typically work for only one company, and by law they are not permitted to give you information about any other plans or any other company). I have seen far too many unscrupulous salespeople, like an Uncle of mine. I recall my Mom telling me about him when I was growing up; she would say that man is so full of _rap that if he ever tells you good morning, it's probably time to put on your pajamas and go to bed. I just really detest people taking advantage of others, especially seniors! That is probably the main reason I wrote this article; I simply wanted to inform Medicare beneficiaries about things they might not know.

At Braden Medicare Insurance, we strongly support every Medicare beneficiary working with a local, independent Medicare Broker or Certified Medicare Planner in your area.  There is no charge for their Medicare knowledge and experience.  You will always decide which plan/option is best for you. Let your Medicare Broker do the heavy lifting for you. That is what they do, 24/7.

If you are not sure how to find a local independent Medicare Broker near you, Michael Braden, the owner of Braden Medicare Insurance Services, invites you to email him directly at mike@bradenmedicare.com or call him directly at (480) 225-1393.

You can also call Medicare directly with questions at 1-800-MEDICARE (1-800-633-4227)—or visit the Medicare.gov website to start a live chat. TTY users should call 1-877-486-2048.