Opinion: Will Medicare pay for my groceries?

Adam Kyle

Ah, the autumn season. We’re well into that time of the year that reminds us finite beings of our mortality, the cycle of life and death, and the beauty of change. There’s no shortage of reminders that summer is over, and fall has come. It’s full of flannels, pumpkin spice flavored everything, Target’s home decor section, and for older adults, mailboxes overflowing with Medicare solicitations.

But it isn’t just mail, either. Everywhere you go, you are hit with Medicare information. Joe Namath is on TV more now in Medicare commercials than he was when he was playing football. And of course, each one promises all kinds of benefits – if you call to see if you “qualify,” that is.

Since 2020, when the insurance companies and marketing agencies adapted to the pandemic by turning to TV advertisements, I’ve gotten calls in the office on a daily basis asking if there’s any truth to these claims. For the last two years it had been: “What’s up with these commercials saying I can get $144 back on my Social Security?”

Now, they have switched tactics and are talking about money for groceries and utility bills to be paid through a Medicare plan. So, again the calls are coming in. “Can they really do that?” 

Technically, what the ads are saying is true. But just like the money back on your Social Security check, it mostly applies to a small demographic of Medicare beneficiaries known as dual eligible, or those on both Medicare and Medicaid.

People who are dual eligible qualify for a certain kind of Part C/Medicare Advantage Plan called a Dual Eligible Special Needs Plan. These D-SNPs offer benefits in addition to what Medicare covers just like any other Advantage Plan, but the amounts are usually higher, and they usually have some benefits that the average Medicare beneficiary does not have access to.

For example, while most Advantage plans in southwest Missouri offer a quarterly credit to purchase over-the-counter pharmacy items, D-SNPs generally offer a lot more, and that credit can usually also be used to purchase either healthy groceries and/or pay for gas and utility bills.

So, why do they advertise these benefits if they know the vast majority of people who call in will not qualify for them? The short answer is that they want you to call and ask anyway. They know that in this economy groceries cost a fortune. God forbid if you want to actually eat healthy, because you may have to take out a second mortgage just to buy some organic eggs. If the TV says maybe your health insurance will pay for it, isn’t that worth a call? Most people would probably say yes, and the advertisers know it.

But when you call and find out you don’t qualify, their hope is that they can offer you something else that sounds good. “Yes, Mr. Medicare beneficiary, you don’t qualify for the groceries, but how does $5,000 in dental sound?” If Mr. Medicare beneficiary says that sounds good (because who wouldn’t want that much in dental coverage), then they may very well switch his Medicare plan, sometimes without checking to make sure it covers his meds or his doctors and sometimes without informing him that they are actually making a plan change.

How can you remain safe this Medicare season? There are many ways to do so. You can reach out to a trusted, independent broker who is contracted with multiple insurance companies and can comparison shop for you. You can also go to Medicare.gov and compare plans in your county. The one thing I tell my clients is to never give out your Medicare number unless you want to make a change and you have confidence that you know what you are changing to.

Most of us in this business are honest and want what’s best for our clients. But like all industries, there’s some big money out there that cares about getting your business but not about preserving your well-being.

Adam Kyle is a broker specializing in Medicare health plans at Kyle Insurance Services Inc. He can be reached at adam@kyleinsuranceservices.com.