Answer: False

Many people choose Medicare Supplement plans for the freedom to see any Medicare-certified provider — and that flexibility is real. But Medicare Advantage plans are required by Medicare to have specific consumer protections that Medigap plans are not required to provide. Flexibility and protection are not always the same thing — and understanding the difference matters.

Answer: False

Medicare Advantage plans are required by Medicare to have an annual maximum out of pocket limit — meaning once you hit that cap, your plan covers 100% of covered services for the rest of the year. Medicare Supplement plans have no such requirement. For someone managing a serious or chronic condition, that distinction can have significant financial consequences.

Answer: True

Medicare Advantage plans are required to have formal appeals processes — and if your plan denies your appeal, you have the right to escalate it to an independent review organization. Most members never exercise this right because they don’t know it exists.

Answer: False

This is one of the most costly misconceptions in healthcare planning. Medicare covers skilled nursing facility care only under very specific circumstances — and only for a limited time, up to 100 days following a qualifying hospital stay. It does not cover custodial or long term nursing home care. Medicaid is often the primary payer for long term care — but qualifying requires meeting specific financial and clinical criteria that vary by state.

Answer: False

Brokers are typically contracted with specific carriers and may only present plans within their portfolio. And even state SHIP counselors — who provide free and unbiased Medicare guidance — may not be familiar with full range and/or in-depth understanding of specialized health plans such as Chronic Special Needs Plans (C-SNPs). If the people advising you don’t know these options exist, they will never come up in your conversation.