Resource Library

Agents and brokers for MA plans receive commissions per enrollment and often receive additional “administrative” bonuses that balloon MA spending. These financial incentives drive aggressive and misleading marketing aimed at people looking for coverage. As a result, beneficiaries fall into the “MA Trap,” finding themselves enrolled in an MA plan that doesn’t meet their needs and without an efficient way to switch back to Original Medicare.

As the cost of care rises, beneficiaries increasingly look for plans that promise discounts or additional benefits. MA plans take advantage of this and flood potential beneficiaries with marketing calls, mailers, ads, and even in-person solicitation that can be deceptive and easily misunderstood.

Original Medicare has significant gaps in coverage, including very limited coverage of dental, vision, and hearing care. By advertising supplemental benefits that seem to fill these gaps and help tackle the cost of care and living, MA plans captivate the attention of beneficiaries struggling to afford care. But these benefits are not standardized or clearly communicated, falling short of their original promises.

Our comments are informed by our work helping callers to our National Helpline navigate and afford their care. These experiences drive us to support efforts within this rule to bring more sustainability and rationality to Medicare payment, including by establishing greater site neutrality.

Our comments are informed by our work helping beneficiaries, including callers to our National Helpline, navigate, understand, access, and afford their care. Based on this experience, we know many people with Medicare want and need to maintain deep and trusting relationships with their providers. Finding the right provider fit, spending time with that provider, and staying with that provider over the years is a priority for many people across Original Medicare and Medicare Advantage.

To make it clear what a difference MSP enrollment can have in the lives of older adults and people with disabilities, and to support advocacy efforts to expand MSP eligibility and enrollment, Medicare Rights has compiled a set of case studies from its national helpline. These cases show what obstacles beneficiaries commonly face when trying to enroll and stay enrolled in MSPs and reinforce the role the benefit plays in real people’s lives.