CTMilller may be able to better answer it as he's already living it but I think it's related to Medicaid (the medical piece of social security) where some 'sales people' are saying if you opt out of it and go with them instead then the government will give you more social security as you won't be using the government piece. I did look into it after seeing one of those ads on TV but it was far too complicated for my brain to comprehend so I assumed it had some element of scam about it, a bit like the way people in the UK were enticed to opt out of SERPS and put the money in private pensions.