Big changes coming to Medicare Advantage. Watch here: kzitem.info/news/bejne/o6ilm62GioSmmpg&lc=UgyT2GavDuzM9YIeIJV4AaABAg
@carolpool5583
Жыл бұрын
I am an RN who worked for an HMO at one time that offered Medicare Advantage Plans. I was trained to deny claims as a prior approval/utilization review nurse. I only lasted 3 months there because I could not in good conscious continue to deny services to clients who in good faith signed up for the plan only to have something really bad happen and find they could have the procedure they needed or the stay in rehab that would help them recover. I remember one 80 year old Spanish speaking only, tracheostomy patient that need home health to come an teach the wife to do the trach suctioning. The HMO would only pay for 1 home health visit and NO disposable supplies. I was supposed to tell the family to reuse the sterile trach suction catheters by soaking them in 3 parts water and 1 part Clorox. That was the end for me, I could not lend my name to that kind of 3rd world care in this country where poor people suffer disproportionally in cases like this.
@skblack5050
Жыл бұрын
How does one get out of it?
@lafl333
Жыл бұрын
The atrocities that occur in our healthcare system are astounding….I know 1s hand working with the clinical trials…
@lynnjudd9036
Жыл бұрын
That's awful! I totally agree as I was a CNA for eight years.
@soniahaydee868
Жыл бұрын
Happened to me, I have Medicare advanced plan they denied my tooth inplant after so many calls with no help to me end Paying over a $1000 to have y implant. Thank you for this information 👍
@jyh4344
Жыл бұрын
I think the ISP you worked for is very un ethical, my ISP is the opposite , treat me fast and well, I was under HMO at that time
@BrewMoe
2 жыл бұрын
I spent the last half of my career working in the billing office for a medical specialist group. I dealt with everything from private insurance, worker's compensation, medicare, medicaid, etc. By a large margin, the problems I encountered with payment denials came from Medicare Advantage plans. And most of those happened because people did not understand the rules of their plans. Thanks for the informative video.
@qweeknee4208
2 жыл бұрын
Exactly!
@pacmanc8103
2 жыл бұрын
Although, it would seem as though a lot of the issue is with provider groups not confirming Advantage plan coverage prior to treatment. It seems like pre-auths are needed - I’m not sure how most patients would even know how to communicate with insurance carrier or have the relevant information. Stuff only the provider could know.
@Melanie-ix4nq
2 жыл бұрын
I'm seeing the payment denials because of in proper billing to the insurance company (using the wrong code) I'm showing that on one of my claims in my portal.
@SipLeila
2 жыл бұрын
So, who at Medicare is working on weekends, holidays, and evenings? I worked for Medicaid and we never worked those hours.
@SipLeila
2 жыл бұрын
@@Melanie-ix4nq That is common but it is often the nurse's fault.
@magdalopez5200
2 жыл бұрын
My husband and I were paying over $700 a month for premiums alone with Medicare and a Supplement plan, so we changed to Medicare advantage plan Preferred Care with UHC and here in Miami it works fairly well. We never had any issues to go to specialists. Even though my husband takes a lot of medications, at the end of the year we end up saving money.
@domerbuz3813
Жыл бұрын
Thank you. These dummies never consider $700 per month or $8400 a year for supplement insurance. Have had Advantage plan so have saved nearly $90000.
@danielhurley2894
Жыл бұрын
@@domerbuz3813 I agree with you. For me a Medicare Advantage Plan works great.
@Eagle127
Жыл бұрын
@@domerbuz3813 How many times have you been hospitalized ?
@lantanaleah
Жыл бұрын
@@danielhurley2894 I have an Advantage plan. I’m raising a red flag but doubt that our representatives in Congress will. They receive massive donations from the healthcare and pharmaceutical industry who also spend massive amounts on lobbyists. My doctor and physical therapist recommended further treatment, but after the initial 90 days (which included only ~16 visits because my copay was $35), request for authorization was sent to a contractor for Aetna who did not respond to phone calls, voicemails, or emails-so no further treatment. I filed a grievance w Aetna; their response 2 months later was that I had treatment and they had no further request for authorization. Phone calls to Aetna- rep said there was no request w Aetna, didn’t know anything about the contractor but admitted they do use outside contractors. I had a previous experience with an insurer who also contracted with outside companies whose job it is to deny claims. My neurosurgeon received a payment of $150 months following my 6 hour surgery. There is no good health insurance company or plan in this country.
@crand20033
Жыл бұрын
@@domerbuz3813 Stay healthy!!
@mt-nv4jd
Жыл бұрын
I am a Medicare Advantage Survivor. After many issues that convinced me of their intention to deny all claims they possibly could, I went back to Original Medicare with a G Supplement. You cannot qualify for this if you have certain medical conditions. Fortunately I did not wait to make the change.
@debhelms4106
11 ай бұрын
I’m in the process of getting back to regular Medicare and going on plan F… praying I’ll get back to my red white and blue card🙏🙏
@maytrang671
11 ай бұрын
@@debhelms4106 Plan F is no longer available since January 1 ,2020. My husband had signed up for Plan F in October 2019.
@Dee--Jay
10 ай бұрын
so how much are your payments for plan G
@jeannie5389
10 ай бұрын
I'm going to try the same, I didn't know there was a difference, Medicare Original V Medicare Advantage.
@GAderly-fn5ly
10 ай бұрын
Odd you say these things! MA plans have to cover EVERYTHING STANDARD MEDICARE does! BY LAW! So when those saying MA plans DENIED something , original Medicare would ALSO have denied it. I'm NIT in ANY kind of sales but you all must get educated so you can know when someone is lying to you. If you never learn ANYTHING else....just know the MA plans have to cover EVERYTHING that original Medicare does! BY LAW!
@cynthiasalim2031
2 жыл бұрын
I was paying $235 a month for my medicare supplement. I am relatively healthy, take no prescription drugs, pay out of pocket for dental and eye care. I just cancelled my supplement and signed on to a highly rated medicare advantage program. I think this was a good move for me.
@KenJackson_US
2 жыл бұрын
I'm weighing that too. Though I guess it is kind of a gamble. If I continue as I am, it would be the best option. But if fall into depression or something and regain my previous weight and get cancer or something, it would start costing me a lot. I have to decide.
@guitreebasdeo5566
2 жыл бұрын
There are many Good Advantage Plans, and Good Supplement Plan G or Plan N. They are both good,depending on your situation! GET THE FACTS! You have 1yr from the time to change your Supplement Plan G to go back if you do not like the Advantage Plan without any medical questions.
@judymoore7469
2 жыл бұрын
I have plan N which is $96 monthly. I was very healthy, just a wellness check by-yearly. I slide in the bathroom and broke the tibia in 4 places, the fibula and ankle, along with damaged tendons. I did not owe anything.
@KenJackson_US
2 жыл бұрын
Ouch, @@judymoore7469! Hope you're doing better. Though when I put myself in that situation, I calculate five years of $96/month is $5760. But with no medigap at all, I would have had to meet the deductibles and 20% on much of the remainder. So, if I remained otherwise healthy for five years, I wonder which would have been the better deal.
@cynthiasalim2031
2 жыл бұрын
@@judymoore7469 My plan was F which was discontinued. I was grandfathered so they couldn’t drop me. But they kept raising the monthly premium. I went with a very highly rated plan. I have friends who have this plan and they are all very pleased with it. I just learned that I will have to pay a monthly penalty because I wasn’t previously enrolled in prescription coverage. It’s not a lot but it is for life.
@bobpickering1
2 жыл бұрын
I’ve been on Medicare Advantage for eight years. Nobody “sold” me anything; I just researched my options online. There are no additional premiums for Medigap or drugs. The network includes every provider I’ve ever heard of except one. Co-pays are reasonable. It’s probably the best insurance I’ve ever had.
@Starfish2145
2 жыл бұрын
Wait till you get seriously ill or are hospitalized. You might change your mind.
@barb8664
2 жыл бұрын
Copays for some are $50. For specialists. If you see cardiologist, podiatrist, urologist, etc couple times a year it adds up.
@bellesouth3052
2 жыл бұрын
Just don't get seriously.
@cydkriletich6538
2 жыл бұрын
Bob Pickering: Was your father in the Air Force? (My dad was and my folks were very close to “The Pickerings!”) I even think his first name was…Bob!
@Sasha-eo6jz
2 жыл бұрын
It was the same thing for my parents. Then my father actually got sick at the age of 83 and he has been severely impacted by having a Medicare advantage plan limiting the amount of care that he could receive - which could be life-changing. Everyone is healthy until they aren’t.
@BryanMcCann-ks9jh
10 ай бұрын
Inflation and Recessions are part of the economic cycle, all you can do is make sure you're prepared and plan accordingly. I graduated into a recession (2009). My 1st job after college was aerial acrobat on cruise ships. Today I'm a VP at a global company, own 3 rental properties, invest in stocks and biz, built my own business, and have my net worth increase by $500k in the last 4 years.
@Calvertmarian
10 ай бұрын
You need a Financial Advisor my friend so you don't get ripped off in the market. They provide personalized advice to individuals based on their risk appetite, placing them among the best of the best. There are bad ones, but some with good track records can be very good.
@Calvertmarian
10 ай бұрын
I know I've wanted to start investing for a few months, but just haven't had the courage to start because the market has been down for most of this year. Please how can I reckon with such skills and what are his services like?
@MedicareonVideo
10 ай бұрын
Congratulations on your impressive achievements! It's inspiring to hear how you were able to overcome the challenges of graduating during a recession and pivot your career to achieve such success. Your story highlights the importance of being prepared and adaptable in uncertain economic times. It's great to hear that you have diversified your investments and built a solid net worth. Your journey is a testament to the power of hard work, resilience, and strategic planning. Thank you for sharing your story with us!
@freedomone776
7 ай бұрын
Big deal.
@matt3024
5 ай бұрын
@user-ep5ce1cc5m What the f*** does that have to do with any of this?
@imasahm
2 жыл бұрын
My sister just sent me your link and I'm so glad she did. I handled all of my mother's medical affairs, though I know nothing about the world of Medicare. I know that she would get very frustrated with Medicare Advantage and being required to keep going to her PCP over and over, which meant paying him over and over. You are correct - ultimately, it ended up costing her more to be on Medicare Advantage. Now that my sister and I are about to be at the age where we need to make informed decisions, your video has helped us tremendously. Thank you for taking the time to do this.
@MedicareonVideo
2 жыл бұрын
Happy to help!
@anitaking2574
2 жыл бұрын
Usually you don't pay anything to go to your PCP in a Medicare Advantage Plan.
@Stargate555
2 жыл бұрын
I am in agreement with you 100%. The problem also is that many people get fooled by MedAdvantage plans with the little perks that are thrown at them. For example, free travel to and from doctors, some minor eyeglass coverage or even dental. But they do not realize that if anything Catastrophic happens to them that it becomes a waiting game for approvals and in one instance in my family we lost a uncle due to this. It’s crazy how they put a dollar value on someone’s life. Thank You for spreading the truth!
@MedicareonVideo
2 жыл бұрын
They also don't realize the "free" is for a very small portion of low - no income folks.
@michaelplunkett5124
2 жыл бұрын
@@MedicareonVideo fact check. It’s “free” for rich people, too. I’m a working physician and on Humana Gold I pay nothing a month. I had a $20 copay for my ophthalmologist referral but the cataract surgery is 100% covered. Oh, by the way, latest info-Medicare Advantage now has 47% of Medicare enrollees. Are these people all stupid, or they on to something?
@roberthoeller5516
2 жыл бұрын
I enroll people in Medicare advantage plans. 95% of the people I deal with survive just on their ssn, ssi, or ssdi benefits. If you can afford a Supplemental plan, I highly recommend it but you will have to purchase a standalone dental, vision, and/or hearing plan which could run another $100/mo. 75% of the people I help are C-SNP or D-SNP eligible.
@keilana6
Жыл бұрын
Problems is a great many retired people have limited income. Need more equitable coverage & price.
@GAderly-fn5ly
10 ай бұрын
What a STORY! DID you make this up by yourself?
@nanay456
2 жыл бұрын
It really depends on the client’s health situation. I only recommend Medicare supplements if the clients has a lot medical health issue. Not all MAPD require referral to see specialist.
@thelakeman5207
2 жыл бұрын
When you are a senior, health issues pop up out of no where. It's better to have good coverage when you get sick. I went with Medicare and a good supplement that pays hospitalization 100%. Eventually, all of us seniors end up in the hospital.
@erniebell1858
2 жыл бұрын
I've been trying to get my Korean wife enrolled through Medicare. However, since I am a retired service member in Korea and my wife is Korean they said I have to go through the US Embassy in the Philippines. I started in March 2021 and some of the delay was sending certified mail to Manila. I did that through a military postal service. It took a month to get to Manila, the Philippines and sat there for 3 months due to a lock down. Finally around October the Medicare section in Manila said all the correct paper work was done and was sent to the US for processing. My wife still hasn't received anything and now it has been 11 months and 2 weeks since we have started. I contacted Medicare in the US but they said I have to check with the US Embassy in the Philippines. However, the US Embassy says they have to wait for Medicare to finish in the US. Talk about lazy, worthless and incompetent people. As a retired US Army service member, I was proud to serve my country. My only regret is that we also serve and protect those who could care less about us.
@ursulasmith6402
2 жыл бұрын
Universal health care is the answer!
@rustynail7866
2 жыл бұрын
Have had absolutely no problem with Medicare Advantage plan, 4 years and counting. I must have picked a better plan than the one you're describing.
@haroldcampbell8271
2 жыл бұрын
Advantage plan for us, have not paid a dime in premium since retirement in 2013, great coverage and little costs. This guy is nuts and says the same things over and over. You just need to have common sense and know what your limitations are under Advantage. This video is nonsense.
@russellspeer3989
2 жыл бұрын
@@haroldcampbell8271 I have an Advantage plan (Intervalley - in So Cal); it is a great plan since my wife and I have little to no medical issues. Our out of pocket expenses have almost exclusively been Dr. office visit co-pays. However, what he is saying has great truth to it for many seniors; especially if one has medical issues, and or travels a lot. Our network is very small geographically, so if the wife and I travel or are visiting relatives elsewhere, only an emergency visit is covered. We really like our plan for us as it stands, and as we currently use it... I would not presume to apply our situation and plan as the end all, neither would I use our experience to decry the information put forth on this site. When and if we move, I will strongly take into account the good info I received on this site. YMMV.
@savannahsmiles1797
2 жыл бұрын
@@haroldcampbell8271 He is NOT nuts, different strokes for different folks and NOT all MAPD plans are equal. You have to understand that it IS managed healthcare and some hospitals are not there for your BEST interest Harold, and if you can't comprehend that. Then for goodness sake your are obtuse. Healthcare is a BUSINESS and it isn't in the healing biz anymore, it is FOR profit and you are the product capiche!
@beekind6267
2 жыл бұрын
@@savannahsmiles1797 so sad that what you say about no longer healing is a scary, sad truth. 😔
@jjbud3124
2 жыл бұрын
I've had Medicare Advantage for 17 years now. The last two years I've had one that, so far, nothing out of pocket at all, ever, except for one expensive drug. Excellent doctors in my area, that I've been using for years even before I turned 65. First time in my life I've had real "universal" type medical care and I absolutely love it. Never a worry about a co-pay, no charges for surgery. My husband had a stent placement after a heart attack a few years ago. The cost to us was $0. We went to Georgia to visit our son and my husband got sick while there. He was treated at Emory University Hospital. Charge? $0. I feel like I'm living in Europe. The first 15 years we had MA, we did have small out of pocket expenses. I have always chosen physicians I knew compared with the benefits of each plan. I will chose a plan that has a co-pay if the doctors and hospitals I want to use are members. All the top physicians my this area accept the plan I have now. I'm happy as a bug in a rug.
@CynthiaBowers-o8r
Ай бұрын
The same issue was applied with Medicaid as well. When I called my local social services they informed me that , ". Federal government ' took ' the medical aspect of that from us." So I could no longer contact local social security but a toll free number.
@ttocselbag5054
Жыл бұрын
I’m with you my man. I don’t want some corporate bureaucrat dictating hierarchical booshite to me! 😬
@joannejohnson85
2 ай бұрын
This man speaks the truth. Been in the business 30+ years and he is 100% accurate. You may hve it good now on MA but when their numbers dont look good..they can and will change the rules WHENEVER they want!
@haydenwatson7987
11 ай бұрын
I am 65 in good health with no medical problems. When I turned 65 i signed up for a Medicare advantage program. Can I get off advantage and go back to Medicare with supplements?
@MedicareonVideo
11 ай бұрын
Reply: Hi! If you're interested in switching from a Medicare Advantage program to Medicare with supplements, you do have the option to do so during certain enrollment periods. It's important to note that the eligibility and timing for making this change can vary, so it's best to consult with a Medicare expert or contact Medicare directly to get the most accurate information for your situation. They can provide guidance on when you can make the switch and any requirements that may apply. Remember, understanding your options is key to making informed decisions about your healthcare. Good luck with your Medicare journey!
@camillefulginiti9048
Жыл бұрын
I am a 74-year-old woman who has been on Medicare and Medicaid due to low income. I recently sold my home and now have money in the bank which I will no longer be eligible for Medicaid. I want to go about getting a supplement insurance along with my medicare and am concerned about what the best one would be
@pamagujar183
2 жыл бұрын
How do you change from Advantage to just Medicare?
@BlaiserAid
Жыл бұрын
Interesting video, thanks. Well, I've been on Medicare and a Medicare Advantage (MA) plan for almost 5 years. The MA plan I have been using has a zero premium, includes an Rx plan better than the one I had with "regular" health insurance before Medicare through the NY Health Care Exchange (Obamacare). The MA plan includes some Vision and dental benefits, and is with a Blue Cross/Blue Shield company. The network is quite large - in fact I've been made to understand that it stretches across the country. I've looked at their participating doctors list and have seen that there are many, MANY doctors in MANY cities. So if I'm traveling and need care I likely will not have to pay out-of-network prices. It's true that I have not had anything really major, but I did have hernia repair surgery last year, which cost me just the $350 copay. I saw the "bill" - it was above $20,000 dollars , so I feel like I'm getting a pretty good deal. What am I missing? And you say it would be difficult to drop the MA plan and get a Medicare Supplement plan during the next enrollmnt period at the end of the year? So what are my options?
@CherylSmith-v2k
5 ай бұрын
Thank you this was helpful. I have a brain injury and still Could understand cause You make It clear. Could you answer a question? I have Medicaid after being hurt so bad at work no doctors let me Work. And now I have disability. I don’t understand if I keep Medicaid or now Do Medicare? I don’t k is who to get help From with this
@user-st6nt4ou6f
Жыл бұрын
Overjoyed to see this video that tells the truth anout these advantage plans. So many are uninformed and listen to these shills that describe the " terrificbenefits" of advantage plans". Friends all have these afvantage plans and they tell me how their experiences are, thinking they are getting good benefits while being shifted around from plan to plan depending on what your mexical needs are
@Ladyunderoos
2 жыл бұрын
As someone who works in hospital billing, I ALWAYS advise to stick with traditional Medicare.
@MedicareonVideo
2 жыл бұрын
I hear that a lot!
@gordonbrown5901
2 жыл бұрын
Both my wife and myself have the Advantage plan. We live in Maryland and we're with Kaiser. I've not had many problems but my wife has and the care she's received has been stellar. I can't speak for other providers.
@briancaine9130
Жыл бұрын
My mom, retired federal worker, has Kaiser in Virginia with Medicare Advantage. Can’t say enough positive about her care and coverage.
@rochelleholmes9271
Ай бұрын
I signed up for Humana HMO in 2022. I went to my eye doctor they said my Medicare is Medicare Advantage which I was upset!! I didn't want advantage but looks like that is from Humana HMO. I only go to doctors for checkups.
@donjuan2065
Жыл бұрын
Give a bloody example that compares both original medicare, and medicare advantage side by side, like somebody getting a hip replacement in net work , and out of net work.
@davidd34
Жыл бұрын
At 72 and physically disabled by numerous accidents etc over the years I find either that med so called "professionals" are totally incompetent or Not able to treat me due to contrasting health conditions (Brain & heart issues) that if they try treating one condition it Negatively affects the other. So I no longer go to drs. Family has been told that in a med emergency Not to contact 911, ambulance, fire or police depts, cause if they do something not knowing my conflicting health conditions it would probably Kill me and to just let me/us deal with the situation the best we can and go on living our lives. So Medicare is a Total waste of money for me.
@nKaDoen
Жыл бұрын
Where I live, in rural West Texas, medicare advantage is a terrible option because there are almost no in-network doctors nearby. Usually have to drive to Dallas, 7 hrs away.
@voxveritas333
2 жыл бұрын
My wife and I signed up for Medicare plus the G supplement plus Medicare D. At First it was fine, but after 3- 4 years it was costing us 700 dollars a MONTH. We kept it when we were traveling. It did pay claims, but we did have to pay some stuff. It just became too expensive to keep. So, we changed to the Advantage type after moving to a higher population area. Referrals are not a problem most of the time. Now our max out-of-pocket is 700 dollars a YEAR. My drug copays were 25 bucks for the YEAR, no deductible. True, we have to stay within the provider groups, but we have quite a few to pick from. Original Medicare is great, if you're rich or can go to wherever you have the money to afford to seek out expensive care. Not so much if you live in a backward state or a medical wasteland. Either way you go, you're screwed. Insurance companies, PBMs, hospitals, medical groups, drug companies, crooks who cheat Medicare at every turn are what we Americans are stuck with at this point. The ruling rich overlords will never change it. Congress and the courts have been bought, and YOU AND I have been stuck with the bill.
@MedicareonVideo
2 жыл бұрын
Can usually keep the price down by comparing each year.
@tdtommy89
2 жыл бұрын
@@MedicareonVideo Wouldn't that be hoping that the client could also pass through underwriting?
@GPSinger
2 жыл бұрын
Absolutely. This comment spells it out the way it is. Doctors don't like to take original Medicare. In effect, you have a more limited network by staying on Medicare original, and you have to pay for both the supplement the medication premium. I strongly recommend the Medicare advantage plans with no monthly premium. They have enough providers of all types that you still have choice.
@debbiemoore5945
2 жыл бұрын
True- either pay up front(supplement) or pay if you have an unexpected hospital stay (advantage)
@savannahsmiles1797
2 жыл бұрын
@@JohnDavis-yz9nq John I am licensed agent and EITHER way can bleed ya...it is the hope of Medicare that NO ONE uses it.
@SomebodysGrandmother
Жыл бұрын
I really like my Advantage plan! Haven't had any problems, never denied coverage never any monthly output, always had complete coverage.
@akita96th
Жыл бұрын
Have you been really sick yet? The kind of sick that cost over a $100K I have..Thats when you will hate that advantage plan...Did you buy that advantage plan because Donald Trump and the GOP supports them?
@mrsatire9475
7 ай бұрын
Wellcare was not accepted at enough facilities and they refused to cover scripts and diagnostics ordered by Doctors not in their plan
@SomebodysGrandmother
7 ай бұрын
Check out Cigna, I really like it, Cigna advantage plan.. 3.000 a year dental, nothing is not covered, like a blank check! Broke my back in several places a year ago this October, no exaggeration, Ive had every diagnostic procedure there is plus any doctor, any hospital therapy, Chiropractor, braces medicine, never a copay yet, much more.. I'm sorry I didnt check this out years ago.. I've had Viva (can't be trusted), used my ss plan when I first started ss which is zero helpful! 😅
@meditation6054
7 ай бұрын
I don’t know which Advantage plan you have but I’m a physical therapist and every patient that has an advantage plan have consistently been cut short on coverage for services! Every Advantage plan cuts services!
@mrsatire9475
7 ай бұрын
@@meditation6054 That's the plan advantage (for them)
@ramsrams81
2 жыл бұрын
Why I think you are a crummy agent: 1) Supplement plans in my state go for $220 per month, plus the drug card at $35 per month. That's over $3,000 per year paid in premium WITHOUT FAIL! 2) Most Advantage plans have a $0 premium with reasonable co-pays and no deductibles. 3) Although extremely unlikely, the maximum out of pocket could be as low at $4,500. This compares favorably to the fixed out of pocket cost for a supplement of $3,060. 4) Catch up with the times! Many Advantage plans are PPOs, which allow the enrollee to see any provider who takes Medicare. 5) You have to carry around only one card....only one party to call when there is an issue. With the supplement, you have to handle your Medicare card, the supplement card, and the drug card. Good luck getting to the right people. 6) Advantage plans offer extra stuff that isn't covered by Medicare nor its supplement. Dental, eye care, hearing aids, fitness memberships, Over the Counter items, flex cards to augment the Dental/Vision/Hearing, etc. 7) Even some HMOs, like Aetna, do not require a referral to an "in network" provider. BTW, I have been a Medicare agent for 10 years and have NEVER received a call from one of my clients complaining about a lack of a qualified specialist in the area. So, Mr. Expert, be careful the next time you say the word "NEVER". In the vast majority of situations, an Advantage plan is a much better deal to the consumer. About the only time a supplement is preferred is when the enrollee is on a Part B medication.....very rare.
@3121813
Ай бұрын
Many high end hospitals in California will not take advantage plans C supplemental coverage plans anymore they only accept A@B with D prescription coverage and G supplemental. Never get supplemental C advantage plans you will be denied medical care at many hospitals.
@MedicareonVideo
Жыл бұрын
Don't forget to download my free Medicare book ! medicareonvideo.com/freebook It would be VERY helpful to me if you could leave a 5 star Google review here: g.page/r/CWv2A0RReuvvEAI/review
@trafficjon400
11 ай бұрын
why it lies to you? it must if its worse than any thing else. maybe thisis a hoax to get people off this so maybe it will help this program out.
@LegacyStacker
9 ай бұрын
Hi Keith! I'm with you, thanks for helping us to get on the right track! 😎🏆
@brendasmith4220
6 ай бұрын
what if ur disabled on feeding tube 24/7 needing supplies every month chronically ill get sick all the time
@daveforeman6931
2 жыл бұрын
I worked both for a HMO and medical biller in my working life. Yes, traditional Medicare AND a supplement are the way to go. HMOs ALWAYS had lots of customer service calls regarding problems- especially when a person was traveling and had a medical emergency and could not use a network provider. I remember one time the HMO denied paying ambulance service saying it was not "medically necessary". The person died IN the ambulance. That was nuts- the family got the bill after denial. They were livid.
@MedicareonVideo
2 жыл бұрын
I have heard that as well
@GAderly-fn5ly
Жыл бұрын
I don't believe that at all!
@GAderly-fn5ly
Жыл бұрын
There is much more money to be made selling these supplement plan so they make up lots of stories.
@arthuurwong49
Жыл бұрын
Not true -agents selling Medicare advantage plans usually get paid 3x as much commissions as original Medicare
@flyinglpranch3886
11 ай бұрын
I'm sure the logic was, "Well, they died enroute; they could have died just as easily at-scene and saved the ambulance call; so, obviously, the ambulance was not Medically Necessary!" Jerks!
@frankl3107
2 жыл бұрын
I tend to agree with most of your points. However it is truly scary that many people on Medicare and paying for a supplement are completely unaware that their care is still being "managed" by providers who are in ACO/Shared Savings/Direct Contracting arrangements. So, the beneficiary is getting the worst of both worlds. They are paying for a supplement but unknowingly have providers "managing" their care behind the scenes to line their own pockets.
@malycopeland3612
Жыл бұрын
traditional medicare plans with supplemental plans are not managed by anyone but the patients Dr's. That is a false statement
@themedicarelife4939
Жыл бұрын
Very true! Ask questions, Be informed, Get informed and then decide!
@akita96th
Жыл бұрын
I don't know what you are talking about and I dont think you do either. When I get sick I can go to any big city hospital in any state I happen to be in without having to call and check to see if I am in a network...Any Hospital that takes medicare will also have to take your supplement period...You do not have to get permission for your care. You are not managed. Thats a lie.
@kimcooper1833
Жыл бұрын
All health care is managed for profit and business. People are so used. People are taught to be sick. And big money is made. This country rips people off more than any other country.
@soulman7soulman784
11 ай бұрын
Undisputedly “Beneficiaries” are definitely managing their care
@joyfurden8375
2 жыл бұрын
I’ve had a Medicare advantage plan for about ten years, and never had a problem even though I had a stroke, rheumatoid arthritis, and pneumonia. I take nine Rx a month and this past month, February,I paid out 37.00. thanks for your input I’ve had the same doctors for many years.
@RosaSanchez-mu9df
2 жыл бұрын
What insurance did you have
@lindaallen8800
2 жыл бұрын
Wow - I pay a fortune for RX
@marciasloan534
2 жыл бұрын
Agree. Me2 ZERO PROBLEMS ❤️KELSEY-SEBOLD HOUSTON TX
@MrN75nokia
2 жыл бұрын
Get em Joy you don’t need the supplement plans my Mom paid $179.00 a month for G and never used it $6000.00 down the drain
@cynthiamurphy3669
2 жыл бұрын
Joy, that's great to know. I stayed on the original Medicare for a few years but finally switched to Medicare Advantage and am very pleased with it thus far. Seems much easier to me all the way around. I like my docs and the network.
@georgesouthwick7000
Жыл бұрын
Unfortunately, many of us can’t afford anything else. We have had a Medicare Advantage plan for the last 10 years and it has delivered excellent care for us. It all depends on which plan you choose. Do some research and compare the different companies for their customer satisfaction ratings, and get input from friends who have these plans.
@rhondarowley6705
Жыл бұрын
Until you have something catastrophic go wrong and you aren't in your coverage area.
@km4hr
Жыл бұрын
@@rhondarowley6705 My UHC advantage plan documentation says it covers emergencies no matter where I am or what hospital I go to. Are they lying?
@marysimmons9542
Жыл бұрын
Is it possible to switch back to original Medicare, having no medical scenario?
@amalias8888
Жыл бұрын
@@km4hr They won't cover emergencies 100%...you will be left with what ever the doctor charges that your plan C won't cover. Read the fine print and NEVER believe an insurance company.
@landscapevision6553
Жыл бұрын
Very slated and MIs information by this you tuber..but what do u expect from You tube! LOL’s
@dianayates6446
Жыл бұрын
You’re right on point. I’ve worked in healthcare business for 20yrs. When asked, I tell people to hold onto their traditional Medicare. Don’t buy into the selling points. When my parents became Medicare eligible, I advised them the same way. Stay with traditional.
@kiaraosorio7276
Жыл бұрын
Why? Doesn’t that mean you don’t get part D or C the prescription drug cost and more? I’m confused and new to this
@dianayates6446
Жыл бұрын
@@kiaraosorio7276 part C is Advantage. Part D is drug. You can get drug coverage with your supplemental insurance. Or you can buy a stand alone Part D coverage.
@10speed4
Жыл бұрын
The problem with brokers are they make their $$$ by selling insurance and insurance plans. One insurance plan pays them more $$$ than the other one, example, if they sell plan G they get paid more by the insurance company so, who do you trust 🤷♀️.
@judybritt6288
Жыл бұрын
@@10speed4 Who do you trust? I trusted my doctor's Financial Office workers' opinions. They deal with Original Medicare, Medicare Advantage programs and supplemental coverages on a daily basis. I used their advice as a guide to help me find an insurance broker. That person told me the same as this speaker has related. Medicare is backed by the government. If your Dr decides you need a test, procedure, or surgery, you get it with original Medicare, no questions, no refusals. The amount Medicare does not cover is paid for by your supplemental insurance, no questioning. But, if you have Medicare Advantage, it is run by private insurance companies who: - can refuse coverage, even though your Dr has prescribed the test, procedure or surgery. - they (insurance companies that run Advantage plans) can go out of business, leaving you with no coverage. - The private insurance company that runs your Medicare Advantage plan can significantly increase your cost of coverage by increasing your premiums & deductibles, as much as they want, as many times as they want. Medicare does have increases in cost & deductibles, but not as much, or as often as Advantage Medicare's increases. - Original Medicare is the same coverage, no matter where you live in the US. If you have Medicare Advantage, the coverage can vary, depending on which state you are in. Private insurance companies do not have the same coverage in each state. So, if you move to another state, you may not get the same coverage that you had in the state you moved from. This experience shaped my decisions on choosing my Medicare coverage. Years ago, I was very ill (not on Medicare then, had private insurance policy). It was a long, serious illness. Long story short: though I had an insurance policy that was supposed to cover the care I needed- the insurance company continually refused tests, procedures, and surgery needed to save my life. They refused to pay for things that were supposed to be covered under my policy- that I continued to pay each month. They were trying to save money- at the risk of my life. Obviously, I survived. But- due to my previous experience with insurance companies, I was not about to go with Medicare Advantage when they could do the same thing to me again- deny coverage they had promised. This is my experience, my opinions & my conclusions from the info I was given. I suggest you research the differences in Medicare & Medicare Advantage carefully before you decide which to choose.
@GAderly-fn5ly
Жыл бұрын
Thanks, I hope many stay with regular Medicare. That way those of us getting all the extras at no cost will continue to reap the rewards. If everyone went with the Advantage plans they would take away our great benefits. I also tell some folks to stay with Medicare. As for my wife and myself, we have had the Medicare Advantage plans for 17 years and they have saved us hundreds of thousands of dollars. We never see a medical bill and pay NOTHING for our plan. Our plan pays us back what is taken out of our Social Security checks plus gives us a grocery card for 50 dollars each for groceries. We also get 75 dollars each for OTC products. We have comprehensive dental and vision included at NO COST. And of course it includes prescriptions at no cost. Oh, yes, they have a nice minivan to take us to our appointments or pharmacy. We do our grocery shopping while at our Walmart pharmacy . But, PLEASE , folks stay with regular Medicare! You are paying for our extra benefits! Our doctor's office even pay us to see the doctor and to get our flu shots. Our Doctors office ALSO has a van to take us to and from appointments . So PLEASE folks stay with the old Medicare.
@jyh4344
Жыл бұрын
I had very different experience with HMO plan. I think ( correct me if I am wrong ) all the long waiting of referral and complaint are really depending which Medical Group that you Choice, For my 40 years with HMO and the same Family doctor and Medical Group, I had no issues being on HMO. I even got sent to USC to treat my Bone Tumor under HMO, my ISP authorize a biopsy in 24 hours, and to see a spec list. because my ISP was willing to sign special contract to send me since at that time only 1 Doctor in the West Coast can save my life.... I don't think private insurance compamy has anything to do with you., It is your Dcotor and ISP are or are not willing to treat ( manage ) you fast and well, PICK A GOOD ISA AND PRIMAY DOCTOR
@sadie4me2
10 ай бұрын
I have a Medicare advantage plan and I wouldn’t ever think of leaving unless there was some dramatic change. This coverage has gotten me through two bouts of cancer, and they have never caused me any grief or delays. Also, I had rotator cuff surgery recently, and I was shocked at how little I had to come out of my own pocket, really, really shocked!
@MedicareonVideo
10 ай бұрын
Thank you for sharing your positive experience with Medicare Advantage! It's wonderful to hear that you've received excellent coverage and support during your health challenges. Medicare Advantage plans can be a great option for many individuals, especially when it comes to providing comprehensive care and minimizing out-of-pocket expenses. It's important to find a plan that suits your specific healthcare needs, and we're glad you have found one that works well for you. Thank you for watching and for your valuable feedback! 🙌🏼
@debbieklose8776
9 ай бұрын
I get so confused with all these variety suggestions and warnings, I’m about to start Medicare and have been told to always go with advantage plan. This is stressful and so very confusing shouldn’t be.
@sadie4me2
9 ай бұрын
@@debbieklose8776 I remember being in your shoes and I will agree at first it is incredibly confusing. However, the supplemental plan comes with a monthly premium that you must pay. With a Medicare advantage plan there’s no cost ….you just select if you want an HMO or PPO plan, and confirm that your providers are included in the network. Good luck
@trafficjon400
9 ай бұрын
Go by proof of experience? takes one to make a video.@@debbieklose8776
@willay747
7 ай бұрын
What is the name of your medicare advantage plan? Sounds good!!
@ronmorales
Жыл бұрын
For regular folk the Medi-gap premium can get really high as you get older. Best option is to research and educate yourself the difference between Medi-Gap vs Medicare Advantage. The entry rate for Medi-gap may be great but increases rapidly. The competition in the Medicare advantage is really providing great benefit but remember to alway look at the Medical Group you choose. The Medical Group make all the difference in the quality of your care.
@johnsonpaul1914
11 ай бұрын
You are correct. there are thousands upon thousands of us out here that survive on Social Security only and we simply can afford nothing other than the zero premium medicare advantage. I dont know what you mean by medical "Group"
@GAderly-fn5ly
11 ай бұрын
I don't care what medical group I get. You can change every month. Very few care about your health, they only want that free Medicare money! If they are good doctor and have a good practice they don't want to deal with Medicare. In Florida very few actually understand English. They can say English words but have no idea what you are really saying. You HAVE TO. E YOUR OWN ADVOCATE!
@GAderly-fn5ly
11 ай бұрын
@johnsonpaul1914 ALL the MA plan are owned by groups then bought out by a major company like Anthem. Those owned by those big broker houses are the o es that give you trouble. You MUST know what your plan pays for and what they don't. ALL must cover EVERYTHING that original Medicare does. Most cover some type of Dental but many don't ACTUALLY have dental offices that will honor their plan. These EXTRA services are proctored by other companies that care NOTHING about you. There actually is NO OVERSIGHT over any of these plans except Congress itself. CMS just turns your complaint back to your plan. That's like letting a fox guard your chickens. CMS is like a union for the Medicare Advantage plans. They protect the MA plan NOT YOU! CONGRESS does have control over all these plans so make certain you know your congressman. IF you are lucky he is a Democrat, the Republicans won't help you.
@Nicksonian
2 жыл бұрын
He is selling supplemental so take that with a grain of salt. Supplemental is going to cost you hundreds-maybe a few hundred, maybe many hundreds-a month extra. I have ACA Marketplace insurance with Kaiser Permanente (an excellent healthcare system) which has generally served me well except for the high deductible. About to turn 65 and I can choose a Kaiser Advantage plan that COSTS NOTHING EXTRA, and continue with the same coverage as I had before. No brainer? Pretty much.
@maryg1338
2 жыл бұрын
Fortunately you never had to get an authorization for a treatment that your doctor prescribed. I have worked in medical offices and would need to get these authorization. So here I am talking to some kid that was selling bicycles last week, trying to explain why it’s necessary. Finally, the doctor would ask for a peer to peer. After waiting sometimes a week to be able speak with the company’s doctor and convince him/her, that it is necessary.. (wait time) and often they would make you try different treatments that were less expensive before granting the authorization. Advantage plans do work for some... but, sadly not all
@kitcatmeowpurr745
2 жыл бұрын
He is telling the truth about Medicare DIS-Advantage ! The proof is that the very BEST (Ivy League) physicians and state of the art, cutting edge hospitals are no longer accepting Medicare DIS-Advantage Plans. UNLESS that Medicare DIS-Advantage Plans are issued from a EMPLOYER'S GROUP Plans (patient's fromer employer provided medical coverage). Medicare DIS-Advantage Plans have become a NIGHTMARE and ENDLESS approvals, and increasing patient co-payments, and splitting up single visit lab tests into separate charges to force the patient to pay for co-payments for EACH lab test during a single visit ! Also, they are REDUCING the lifetime limit of hospital visits to force patients to go back to straight Medicare. Manage Care plans offer to drive you to doctor's visits, pay your gym membership, and fluff your pillows, BUT HIDE THE FACT THAT THEY ARE REDUCING COVERAGE ON THE MOST EXPENSIVE MEDICAL COSTS, LIKE SURGERIES, HOSPITAL VISITS & REHAB STAYS ! They even offer plans that pay your Medicare Premium, but HIDE the fact that these very plans that return your Medicare Premium, pay for LESS MEDICAL SERVICES ! The ones that claim to pay for your prescriptions will only do so for GENERIC drugs, but refuse to pay for drugs that have no generic option ! Then if your physician prescribes a drug that has no generic, these plans will only pay a "PORTION" of the drug price. But you can get that same non generic expensive prescription FROM CANADA FOR LESS than what the Medicare Advantage Plan is paying ! If you talk to a Medicare Advantage "agent" who helps you to find a plan during open enrollment, give him/her THE ZIP CODE of WHERE you WANT TO RECEIVE MEDICAL TREATMENT. You will find that the BEST PHYSICIANS & HOSPITALS IN THE MOST EXCLUSIVE NEIGHBORHOODS DO NOT ACCEPT MEDICARE ADVANTAGE PLANS !!! UNLESS that Medicare Advantage Plan is issued by.the patient's EMPLOYER GROUP POLICY! Then if you give them a zip code from a WORKING CLASS OR POOR NEIGHBORHOOD, YOU WILL FIND LOTS OF PHYSICIANS that WILL accept Medicare Advantage, and also WEEKS TO MONTHS TO GET AN APPT !!! EVEN LONG WAIT TIMES FOR EXISTING PATIENTS !!! Btw, IVY LEAGUE DOCTORS DO NOT WORK FOR KAISER !!! ALSO, RICH PEOPLE NEVER GO TO KAISER, FOR A REASON ! Kaiser IS NOT & NEVER HAS OFFERED, "CADILLAC MEDICAL CARE !" KAISER HAS ENOUGH HORROR STORIES, TO FILL A HALLOWEEN MOVIE THEATER FOR THE NEXT CENTURY ! Rich people, go to Johns-Hopkins, Mayo Clinic, UCLA, Cleveland Clinic, St John's Providence (Santa Monica CA), etc.
@Nicksonian
2 жыл бұрын
@@kitcatmeowpurr745 I have had Kaiser Permanente for three years. Kaiser is one of the best health organizations in the US. Although my ACA coverage had a fairly high yearly deductible ($6,000) that’s not unusual anymore. Next month I switch to Kaiser’s Medicare Advantage plan. The coverage and cost is nearly identical.
@OB17358
2 жыл бұрын
@@Nicksonian kaisers attitude towards high cost populations is questionable. Oncology, premature babies and elder populations disproportionately cost more. Look closely at how these populations are treated by Kaiser before signing up with them.
@kenm3209
2 жыл бұрын
Would love to see a video talking about 2 or 4 scenarios of different couples, different medical needs and different financial situations and a detailed decision process based on example benefits, costs, and availability; and maybe show a Decision matrix about when Advantage might be better vs straight medicare... Maybe in a liberal state like MN, where it seems the HMO's have a good reputation for good coverage... GREAT video by the way Thank you.
@trumpetingangel
Жыл бұрын
After working in healthcare (I'm a psychologist) through the heyday of managed care, and knowing how important it is to me to be able to choose my own doctor (they aren't all the same!), I went straight to Traditional Medicare. I know that there are some great Medicare Advantage plans that people really like. But people often love their plan until they get very sick. Then the claims start getting denied. My best friend and I were seeing the same physical therapist. I could get as many sessions as my doctor would recommend. She had to beg for more sessions, haggle for a reasonable cost due to confusing payments from her Medicare Advantage plan, and end PT before she was better. It was appalling! You may believe you are saving money with a MA plan. But if you have to pay for physical therapy or some other service that isn't covered, you'll send up spending more. And God forbid you need prior authorization for something before getting much-needed treatment! There are horror stories of people who have died waiting for that prior authorization. Ever notice how many ads there are for MA plans? Guess where they get that money? It comes out of the premiums they collect. That's money that won't go to healthcare. This is just wrong.
@GAderly-fn5ly
11 ай бұрын
Most of these stories are made up by those selling those supplement plans. The MA plans MUST cover EVERYTHING that original Medicare does BY LAW! In more than 15 years on a MA plan we have NEVER been turned down for ANY care covered by Medicare or the .A plan! There are rules these plans MUST go by. Several times my MA plan has even gone out of network for me and paid the ENTIRE cost even though I would have had a copay in network. If you can't read your plan, please have someone else read a d explain it to you. I call CMS first if I expect a problem. If my MA plan doesn't have a supplier within a reasonable distance, they have gone out of network. At one point Walmart optical refused to sell me the transition lens for the plans agreed upon price so I purchased the glasses anyway but complained vigorously and they sent me out of network to purchase another complete glasses both frames and lenses and paid the entire 420 dollars!
@glw5166
9 ай бұрын
@@GAderly-fn5ly Nobody should to have to complain that much to get what they need. Very glad that it worked out for you but it may be denied for another.
@GAderly-fn5ly
9 ай бұрын
@glw5166 You have to be your own person when it comes to your health! NO one can speak for you better than yourself. Those on original Medicare are much more at risk than those on an MA plan. MA plan personal and doctors help you oversee your health plan. They want you to stay healthy. Original Medicare folks want you to come as often as possible to see all kinds of doctors as that's where they make the big bucks. With MA plans your primary care doctor gets your referrals for you. They KNOW if you really need a specialist and they willingly refer you to a specialist if needed. It's not the MA plan that gives you the referrals but your PCP. IT'S NOT the MA plan that gets you the referrals, it's your PCP. It doesn't cost your PCP for your referrals and even your MA plan has specialists on contract so referrals are NOT a problem. With original Medicare doctors get paid from each other for referrals so they will give you referrals even if they know you don't need that specialist. They will pass you around from one specialist to another just for the money. With MA it doesn't work like that. You have no advocate with original Medicare, you are on your own. You can go bankrupt on original Medicare. MA plans protect you with max out of pocket expenses. If you need lots of Healthcare and many doctors you reach your max early and then there's no charge after that. Even you prescription drugs have a max out of pocket, then it's all free. This doesn't happen with original Medicare even with those super expensive supplements. My wife had both knees replaced, at different times of course. The first cost us 295.00 and the second cost us 195.00 TOTAL! That INCLUDED aftercare and rehab! Her second knee replacement, they gave her a sw
@Rnjeepshoelver
9 ай бұрын
Totally agree ALL the ads are for advantage plans , and 0 dollars for the premium 🙄, you don’t get something for nothing… never Advantage for me
@trumpetingangel
9 ай бұрын
@@Rnjeepshoelver Right. They are making money off of those plans, and that's money that just doesn't go to healthcare. Plain and simple.
@two_boomers_and_a_dog
2 жыл бұрын
Not being able to go back to Medicare Part A&B after moving to an Advantage plan makes it clear to me which is the best decision. I will stick with the original and get a supplement so I can have health care choices. Thank you for the very informative video.
@nhmooytis7058
2 жыл бұрын
You can drop the Advantage during open enrollment, if you move, and if you get Extra Help, at any time.
@kathyneichoy9384
Жыл бұрын
You can go back but getting a supplement may be harder. They now can ask health questions to see if they will approve you.
@themedicarelife4939
Жыл бұрын
@@kathyneichoy9384 Depends on where you live. Some states have no underwriting.
@GAderly-fn5ly
11 ай бұрын
You are so wrong about EVERYTHING you posted! You can ALWAYS go back to original Medicare at the end of each month! Why would you post such lies?
@g.e.boroush5176
9 ай бұрын
One can choose to go back to Traditional Medicare during open enrollment if they do not like the Advantage Plan program.
@carinwiseman4309
Жыл бұрын
Nobody would choose Medicare advantage plan....but people can barely pay to live now, and the price of supplements plus Medicare B cost is just too much for most per month
@rogerdsmith
2 жыл бұрын
This advice is good for those that can afford the Medicare option. Couple of years ago I was climbing up out of homelessness. And I should the age where I had to either go on Medicare or Medicare advantage. I had no choice but to pick the best possible Medicare advantage plan that I could. Still don’t have sufficient money for month-to-month living expenses. But I’m not on the street anymore. Every situation is different and specific. Is he saying something good? Yes. Is it the best advice for everyone? Not by a long shot.
@elfiepapini4470
10 ай бұрын
Why didn’t u apply for Medicaid? Even cheaper!
@ElectrologyNow
2 жыл бұрын
My very first doubts came when I heard the name "Medicare ADVANTAGE!" Sadly, in our (1984) culture, terms are often designed to trick the buyer by using a name that is the exact opposite of what your going to get. These HMOs should be called "Medicare DISadvantage."
@dh2392
2 жыл бұрын
Well, it is an advantage to those selling them, lol.
@anttiroppola4414
2 жыл бұрын
Typical corporate speak. Any terms around the subject usually mean the reality is the exact opposite. Advantage. Value. Quality. Trust. Integrity.
@bethdavis7812
2 жыл бұрын
there are advantage plans that ae not HMO
@dh2392
2 жыл бұрын
@@bethdavis7812 and they are PPO, or Preferred Provider Organization. Yes, you can use doctors, etc not on the preferred list, but you'll pay more to do so. Also premiums, and out of pocket expenses are higher.
@ElectrologyNow
2 жыл бұрын
@@markwilson4315 Those are good points ... thanks for taking the time to further explain Medicare Advantage.
@JellyBean-jr8xb
2 жыл бұрын
I’m on an advantage plan now for 8 years. I’m very grateful for my plan.
@kellikelli4413
Жыл бұрын
When you went back to original Medicare did you go thru the medical underwriting (as this man claims?)
@JohnDavis-yz9nq
Жыл бұрын
Evidently you have not have had to use it. When you have to use it you will be in for a big surprise and will be ungrateful for your plan. Hope that you own a bank because you are going to need a lot of money in the end. Sad part is you are stuck and cannot go back to the original Medicare.
@JohnDavis-yz9nq
Жыл бұрын
@@kellikelli4413 this person cannot go back to original Medicare once they choose Medicare Advantage. Their situation is very sad.
@kellikelli4413
Жыл бұрын
@@JohnDavis-yz9nq The original Medicare was RUINED anyway by the Bush43 regime when it passed that "forced" PART-D. The current (not the real original) Medicare system is a Rockefeller big pharmakea scam.
@JohnDavis-yz9nq
Жыл бұрын
Original Medicare is the only way to go unless you choose the Advantage and then you cannot go back to the original. Agree with you that Bush was a bad president as he tried to destroy social security. He was born with a silver spoon in his mouth and he doesn’t have a clue what the average American faces in everyday life. Other presidents born poor have forgotten where they came from. Even at best the original Medicare is not a good deal but it is the only thing that we have. The doctors that we have nowadays are awful. They are owned and controlled by the pharmaceutical companies and do not care about your well-being. What is sad is that some third world countries take better medical care of their people than the United States does. This man in this video is only telling part of the truth. For me he is a wolf at your back door just like the rest of them. Watch doctor David Belk on his videos the truth about Medicare supplements. That will surely wake you up. Good luck and I hope that you didn’t sign up with Medicare Advantage.
@dsa2591
Жыл бұрын
I have a PPO advantage plan and I have never been denied anything, and I've had many MRIs and expensive cardiac tests. Pre-approval for one test was done within 24 hours. However, my mother was on a supplemental plan and they denied her a life-saving surgery after already approving it. They didn't deny it until she was in the hospital, being prepped for surgery. She had no choice but to have the surgery and ended up paying THOUSANDS out of pocket. We had to sue that company to recoup her losses. Plus, supplemental plans cost so much in FL that as someone with low income, I could never afford them. You can push these plans all you want, but they are just as bad as any advantage plan. All insurance companies are crooked.
@gk_filer
10 ай бұрын
Most of our friends have a PPO and no issues so far
@GAderly-fn5ly
10 ай бұрын
Yep!
@patriciaberry4630
10 ай бұрын
@gk_filer That is because it is probably. You must live in a fairly wealthy area. That is why plans depend on your zip code. Average and lower income persons would not be offered plans offered in wealthy areas. They cannot afford them. So they get hmo plans. At least with Medicare it always pays 80% . Get reliable secondary insurance. With scripts if possible.
@GAderly-fn5ly
10 ай бұрын
@patriciaberry4630 You are wrong in so many ways. Original Medicare does NOT pay 80%! Figure it out! With what you pay for Medicare and with ALL the deductibles and no guarantee on max out of pocket, they pay no where near 80%! But please stay with Medicare.....you are one of those paying for my great MA plan. I live in a low income area.....where it's all a service area. With my MA plan I feel like I'm wealthy with them giving me money for groceries and OTC supplies and now even paying my utilitiy bills. Please folks STAY with original Medicare. I don't want ANY more folks going with MA plans as if too many go with MA we will lose our great benefits. I like hearing this guy tell you all those lies, he sounds like trump splaining! Just like trump telling folks how bad off they are. We've never had it so good in reality. Under trump the cost of Medicare went up every year but with our real President Biden everyone's Medicare costs have gone DOWN. I'm happy so many of you believe all these lies as it makes it so much better for the rest of us.
@patriciaberry4630
10 ай бұрын
@@GAderly-fn5ly Sorry you are the one that is wrong. I have had medicare since 2009. I have never paid a Co pay. A couple times paid small amounts. My secondary picks up what medicare does not pay. You are not very bright calling someone a liar. Opinions are okay. But not accusations. I have also done medical billing and coding and knowledge of patients imput. What do you have?
@bgregg55
2 жыл бұрын
My mother just passed at 96 1/2 & regular Medicare paid for literally all of her end-of-life care. I was amazed that we never got any medical bills. They even covered the helicopter transport to a larger hospital after a heart attack.
@MrElby100
2 жыл бұрын
When your mom was enrolled in Medicare it was a whole different plan than what is offered today. Her plan doesn’t exist anymore. I’m sorry for your loss.
@irinat9521
Жыл бұрын
If she was low income and medical everything would be free to her
@dorcasmcleod9439
Жыл бұрын
Sorry for your loss, but so great she had a long life, a blessing from God.
@janasher4940
Жыл бұрын
@@MrElby100 I'm finding that also. It seems all of this - insurance plans and medicare - keep cutting coverage and charging more. And refusing services to stall medical treatment.
@ninamc6116
2 жыл бұрын
I totally agree! I was a RN case manager for 5 years & frequently after a hospitalization the Medicare Advantage plans would not pay for skilled nursing facilities or long term care facilities. Everyone would talk about the great “dental & vision benefits”, but if you’re 85 & break your hip & can’t go to skilled nursing, you’re hosed.
@melindalicht6699
2 жыл бұрын
I broke my hip at 50and went home. What do they do at skilled nursing? I had a pt and my family helping. Did have pain sleeping on that side for years.
@MrDONTEATUS
Жыл бұрын
@@melindalicht6699 my friend that is 70 just had hip replacement and she didn't have anyone at home to help. Because she has a supplemental plan she was able to go to a rehab hospital for two weeks and then had home pt for a few weeks.
@amalias8888
Жыл бұрын
@@MrDONTEATUS It's not because she had a supplemental plan! She had original medicare along with a supplemental plan (which picks up the 20% medicare doesn't). Medicare Disadvantage is a ripoff.
@deedee_31
Жыл бұрын
well maybe the nurses were not skilled at the facility😂😂😂😂
@GAderly-fn5ly
Жыл бұрын
I know for a fact this stuff is untrue! My brother broke his hip when he was 89 and he lives in a very small town and they transported him to Sayre Pennsylvania to have the hip replacement and took care of all expenses including aftercare!
@nunyourbusiness2841
2 жыл бұрын
Being a Utilization management RN for a Florida based hospital for over 15 years, I totally agree with you. So often patients experience medical emergencies while on vacation and are limited to choices for care while away from home and “out of network.” I advise my friends and family to always invest in supplements and keep Medicare, steering them away from advantage or replacement plans. I think it’s a crime when I have to argue with advantage plans to authorize physician directed care after the acute health emergency has been addressed. Most folks don’t realize that once a patient is determined to be stable, their care is limited to what their advantage plan will allow, even while they remain hospitalized. Often their choices decrease significantly when they are discharged. Those who require home health or rehabilitation services post-hospitalization can be severely restricted and are usually required to return home to their local area for coverage. You are providing a great service with your videos. Keep it up!
@MedicareonVideo
2 жыл бұрын
Sure wish everyone could read your comment!
@TheCheryl57
2 жыл бұрын
Again, you have to consider your situation and many older people don’t travel so this would not be a problem. There are many things to consider on a personal level, it’s not one size fits all.
@efandmk3382
2 жыл бұрын
What you do is choose a provider that is ubiquitous. Meaning, they are everywhere. Kaiser, for example.
@lindahidalgo1804
2 жыл бұрын
@@TheCheryl57 I heard Advantage plans are more costly in the long run especially if you need a lot of medical care. Also, that those plans are more costly for the government, because those Advantage plans charge more for services because the middlemen/women and the in those companies need to make a profit.
@marleen6152
2 жыл бұрын
Thank you for this valuable information.
@jessicaalfonso5005
2 жыл бұрын
Thank you SOOOO much. You have answered questions for me that I have been asking for years! You made the information about choice of doctors and coverage area simple to understand without double talk that confused me. After listening to you I now understand the difference and I will always stay with Medicare.
@hisbigal
2 жыл бұрын
If Original Medicare would just cover dental, vision, and hearing services, there would be no need for Medicare Advantage plans at all. It would also help to lower the eligibility age to 60.
@thomasdreyer2389
2 жыл бұрын
It would also help if they gave free medical, dental, vision, transportation, food, clothing and entertainment free. Why not lower the eligibility to 30? That is called socialism. Medicare does cover some vision if it is medically necessary. I had cataract surgeries and macular pucker surgery, all covered by Medicare. In the video above, the agent mentions that Medicare gives the MA plan company about $1000 a month for them taking on the responsibility of and managing of your health needs. Think about that. That's $12,000 each year for each enrollee. That is a lot of money given to these companies. How can they do it? If the income is, for example, 100 enrollees x $12,000 equals $1,200,000. If you only have routine preventative services, then the MA company reaps big bucks profit. If you have serious health issues in a year, with the MA plans, then you could be out the MOOP (Maximum Out Of Pocket) for that plan, which could be $5-10,000 potentially and that could be done a nickel and a dime at a time, driving you mad trying to figure out what you have to pay and when you have to pay because of Co-pays, Co-insurance and deductibles, etc. You get some additional benefits with MA plans, but the trade offs are there lurking and you may or may not be ok with them when they jump out at you. The dental benefits included in the zero premium MA plans are typically preventative dental, not comprehensive. The vision would sometimes provide one or two eye exams annually, and typically included a set amount towards a frame (sometimes only every other year) and the prices on some of those frames were jacked up to make it look like you were getting a bargain. But remember there are tradeoffs. i.e. Friend of mine had main residence in Denver, part-time home in AZ. His MAPD, as all are, was geographically defined to the Denver metro area. Unless an emergency, when he needed medical care while in AZ, he had to fly back to Denver to get it or pay 100% out of his own pocket. And because his medical situation was such as it was, in Denver he could not switch to a Supplement, he wasn't medically eligible. But when he moved permanently to AZ, he was eligible with a guaranteed issue to get a supplement. But if he had only talked to a MA agent or the MA company, or just another MA company, I doubt they would have informed him that the Med Sup option was even available to him. The MA companies want to keep their enrollees, that's $12,000 a year for each one they sign up and keep. Not every agent is out there for you best interests, but it sounds like the gentleman above is. Having Original Medicare, a Med Sup and a stand-alone Part D isn't for everyone, neither is a MAPD plan for everyone. But before a person talks about specific plans, they should first understand concepts, options and choices.
@susiessoapstuff1459
2 жыл бұрын
They don't actually cover those things. You get a discount program.
@tonymanero5544
2 жыл бұрын
Your lifetime contributions and after 65 premiums do not cover the costs of healthcare. Taxpayers subsidize about $100,000 per person until they die. Adding more coverages means more subsidies by taxpayers.
@TheRealLaughingGravy
2 жыл бұрын
Yeah. Insurance for old people that doesn't cover dental, vision, and hearing - three of the most common problem areas for the elderly - is like car insurance that doesn't cover collisions. It's nuts. Lowering the age of eligibility would do two good things - it would remove the oldest population from private insurance (the age group that has the most health issues and makes the most claims) thus lowering private insurance costs for everyone else, and move them to Medicare, where they would be the youngest population, the age group that has the fewest health issues and makes the fewest claims, lowering Medicare costs for everyone. It would be a win-win. Gradually lowering the eligibility age to 50 (over say, a ten or fifteen year period) would make the transition easier for everyone.
@TheRealLaughingGravy
2 жыл бұрын
@@thomasdreyer2389 Nobody said anything about free transportation, food, clothing, or entertainment. Why did you? I think it's because you have no actual argument against Medicare covering dental, vision, and hearing services other than _Something something _*_SOCIALISM!!!_* It wouldn't be socialism, of course, but even if it were - so what? Three of the most common health problems older people have are with their teeth, their vision, and their hearing. Of course Medicare should cover these. Medicare covers *_maternity_* costs, for crying out loud. Why doesn't it pay for hearing aids?
@mosalim9315
2 жыл бұрын
As a physician I wholeheartedly agree with the points you made in this video. The worst I deal with is prior auth for rehab or SNF that are denied after many days being in the hospital waiting for auth, and then the peer to peer is rejected- the patient is not safe to go home but we must discharge them home because their insurance stopped paying for them to be in the hospital days prior and our ER is full of patients boarding waiting for beds in the hospital. Then they are readmitted in a few days/weeks from complications post discharge because they did not go to rehab.
@lynnebattaglia-triggs1042
2 жыл бұрын
Prior authorization and SNF issues are rampant with plain Medicare. I have seen this both as a provider (retired) and as Medicare adjudicator.
@juliemills6716
2 жыл бұрын
Medicare Advantage has to start at the exact same place as Traditional (Original) Medicare. Then, MA plans add extra benefits for example vision, hearing, no health deductible, gym membership, etc. The fact that a network is utilized mimics private under 65 health insurance. Medicare Advantage plans help the patient afford hospital stays so they don't get stuck with 20% of the total cost of staying in the hospital.
@lynnebattaglia-triggs1042
2 жыл бұрын
@@juliemills6716 Why are you telling me this? Not only am I a retired provider (and nearly all of my patients were on a Medicare Advantage plan), I have been on one myself for years now and am very satisfied.
@marceybull
2 жыл бұрын
This exact thing happened to my mother this past March! Every three days they reviewed her case, and about four times we had to appeal - soooo stressful living in limbo... At the 4th time, we lost the appeal. This is despite the recommendation of the doctor/therapists at her in-patient rehab ... However, Ive always been under the impression the Medicare + supplement route was for richer people who could pay a lot each month up front, and hence, the better coverage for the bigger on-going things down the road when they happen .... My mom was a life time social worker for the state until she retired -- an honorable job but not high paying (even with her Masters Degree, sigh).
@nancykaufmann3993
2 жыл бұрын
Been on Medicare + AARP/United Plan F for 7 years. Never needed a referral or had a problem with authorizations. Have paid zero for medical co-pays and minimal co-pays for drugs. Compared to my Medicare Advantage friends who are restricted to certain doctors, need referrals and pay co-pays for every doctor visit and hospital stay. One friend and I were both having problems after cataract surgery. I made an appointment for a second opinion at UM medical school. She couldn’t get approval from her Advantage plan. Yes, the supplement isn’t cheap but I budget for it and have complete control.
@melvinjames1077
5 ай бұрын
Its a damn shame the government doesn’t cover at the least our healthcare fully after a lifetime of working and paying taxes ! God says vengeance is mine !!! I would not want to turn away people from medical care and face god ! I wonder will he turn those people away from his help
@commonsense6967
2 жыл бұрын
The biggest problem with Medicare Advantage plans are that people don't understand that they, unlike Medicare Supplement Plans, are all DIFFERENT, from one plan to the next, and certainly different in quality, too. That is why, unlike Medicare Supplement Plans, CMS rated each one every year. But people continue to lump them all together, and assume that if they had problems with one, there must be problems with all of them. NOPE. But look at the star rating for each, because that is the most important factor. Steer clear of a 3 star or below.
@RedingtonPours
2 жыл бұрын
I'm an insurance agent, been selling med supps and advantage plans for years. The right thing to do is explain the pros and cons for each and let the client decide which is best for them. Be honest and learn how to present in such a way that they understand and CAN make an informed decision. There ARE cons to med supps. The price increases throughout the years can become more than a person on a fixed income can handle. And scaring them with tales of not getting service/approval is not helpful. I have hundreds of clients on mapds, and rarely get complaints about rejected services. HMOs are so different now than even 5 years ago, max out of pockets are better, networks are better, we even have plans with national networks.... There's a lot of advantages to mapds. I'll be honest, I didn't listen to the presentation, mostly because I've been doing this for years, and I know the details, but I had to comment because it's disengenuos to say one should "never" get an mapd. That's just as bad as saying mapds are the best option. Everyone is different and we need different solutions.
@faithgky
2 жыл бұрын
His advice is predicated entirely on the need for expensive supplement insurance, which assumes that you’re going to have a pricey hospitalization every year if the insurance is going to pay for itself. I have a relative who paid (5 yrs ago) over 10,000 a year in various premiums for him and his wife. They’re wealthy so afford the 20% for rare illness so it’s a stupid decision in my opinion. We switched to an Advantage plan because it provided a maximum out of pocket for protection in the event of a expensive illness. He also said out of network doctors can charge whatever they want because there’s no negotiated price but that’s not true in practice. There are usual and customary charges (a range) that doctors charge. I don’t agree with most of what he says.
@tinas.1089
2 жыл бұрын
I very much agree with you!
@vickibahls7587
2 жыл бұрын
Thank you Windi for your answer that both Advantage and Supplement plans need to be presented with pros and cons--we don't need someone telling us NOT to buy one or the other. I have been on an Advantage plan for years and have never experienced some of the things said in the video. I am a healthy person so far, so maybe that's why I've been happy. I love all the extras I get on my plan, most of all the GYM membership. I am on a PPO plan and all hospitals and doctors in my area are on the plan so that is not an issue. However, Most of my friends are on a supplement plan so I have been thinking about changing mainly due to my high out of pocket maximum if I would have to go out of network. But I weighed my costs and this video says your cost for a Medicare supplement is only the $233 deductible. That is false. In our area, the supplement plans are at least $100/month, so that has to be added to the $233 along with $10-$25/month for a pharmacy plan. My premiums are $0.00 and I get all those extra benefits, so a supplement plan for me is going to be way more expensive. BUT, it's like rolling the dice--if you do have a catastrophic illness, then a supplement is going to be better than the out of pocket maximum. VERY hard choice to make since we can't see whaT WILL happen in our future. Thanks for all the comments and the video.
@foreveryoung6797
2 жыл бұрын
My mother has been on a Medicare advantage plan and has never had a problem getting medical care.
@tampajim100
2 жыл бұрын
I'm an agent myself and his presentation is so one-sided it's ridiculous. He is not doing any of the consumers any favors by not providing all options.
@TrishBenedict
2 жыл бұрын
What you say may be true for some, but if you have a Kaiser HMO everything is different. I love Kaiser. I worked at Kaiser for years and I know it from the inside and out. When I hit 65 I opted for Kaiser‘s Medicare Senior Advantage. Nothing has changed for me except that I have more durable medical equipment options and things extended care and like that. My office visits cost $5 instead of $25. I did have to sign up for Plan B which I wouldn’t have had to if I just continued Kaiser, but I could see that it could become a big cost saver down the road when I get really old. But who knows what the future will bring? That’s the thing with any kind of insurance. It’s a crapshoot. And let’s face it, with medical care, the less you need it, the better. It’s much better to pay into it not use it then not have it when you do need it. And my Kaiser Senior Advantage is always there if I need it, something that as I get older is going to become more important. A lot of people like to bash Kaiser, but it’s the best HMO out there. I can tell you that if you need something, you will get it. For-profit insurance plans make money by doling expensive care. Kaiser is a not-for-profit and their goal is to keep you healthy so you don’t need the expensive care down the road. But if you do, it is there. My husband needed a heart transplant. He checked into Stanford Hospital and was billed the Kaiser hospital admission co-pay of $250. He walked out with no more charges. Zero. He had a heart transplant, something that cost anywhere from a $half million to over $1 million for $250. And despite the huge cost of the immunosuppressive drugs, he has only a $20 co-pay with no cap. Kaiser decided that there’s no point in paying for a heart transplant if they won’t pay for the drugs that you need to keep yourself alive. Most people can’t afford a couple thousand dollars a month for medicines. So we’re fans of Kaiser and I’m a fan of Senior Advantage. I kept my original benefits except that they’ve been expanded now.
@MedicareonVideo
2 жыл бұрын
Yes - glad you're happy. Unfortunately the vast majority are on plans that don't function very well.
@TrishBenedict
2 жыл бұрын
@@MedicareonVideo I have a dim view of most for-profit medical insurance, so that doesn’t surprise me.
@alysewitt3729
2 жыл бұрын
Sorry, but that is the Insurance plan I was on. They never told me my lung was collapsed....They took x rays twice. Never said a word after 2 surgeries. Changed insurance Companys and my new Dr. Sent me for an x ray and sent me straight to the hospital. I had to have a 3rd surgery at Cedar Sanai to fix the other 2 botched surgeries.
@TrishBenedict
2 жыл бұрын
@@alysewitt3729 Are we talking Senior Advantage or Kaiser here? I’ll just say that anyone can have a bad experience at any hospital with any health plan. It’s always the luck of the draw. Because Kaiser is a good deal. You get a lot of value for your money. They don’t ration or withhold care. Mistakes can happen and things can be missed. I’m glad you got your problem taken care of.
@tinas4946
2 жыл бұрын
My dad was on that plan and had a lot of health issues. It was the worst plan for him. His out of pocket monthly drug cost was $500 a month. A ER visit was $75 per visit. He had 25 ER visits in one year. His doctors had no clue how to help him and instead wasted our time in the ER. He was in assisted living and per the CA law had to call an ambulance in certain situations. It drove me crazy. My take was if you are healthy you’ll be fine if not it is harder. I had no idea there was original medicare.
@PhonolaEnean
2 ай бұрын
Didn't do it. Too much like a PPO and at the mercy of the medical provider. Opted for part B and G for supplement. No fuss no muss. No approval process, long billing delays, and games played by the health provider. As long as the doctor accepts medicare assignment (and most of them do) you are all set. If they don't go elsewhere. Easy peasy. Love it!!!!
@00wn
2 жыл бұрын
You also have to ask yourself " How much does peace of mind mean to me?" For me, it means a great deal. For that reason...and all the points Keith made, I choose original Medicare and Plan G and a drug plan. Thanks, Keith. Awesome explanation.
@MedicareonVideo
2 жыл бұрын
Thanks Joe!
@Ron4885
2 жыл бұрын
Couldn't agree more. (I picked Plan N) :)
@local_treasures815
2 жыл бұрын
How much does that cost you?
@darlahouston4670
2 жыл бұрын
@@local_treasures815 I’d like to know as well.
@billman6364
2 жыл бұрын
@@local_treasures815 couple hundred a month.
@alysewitt3729
2 жыл бұрын
I agree! I had a HMO and they sent me to a Surgeon who was training to learn how to remove my top lung. He didn't get it right and 3 days later had to open me back up for lung surgery #2. He left an air leak. I returned to work 2 months later, could not breathe. Xrays were taken twice. I worked for a year like that.No one said a word to me. I changed Insurance immediately found out my lung was collapsed and glued to my chest wall. Cedar Sinai fixed me as good as possible. My current lung Dr. said you can't leave a lung collapsed for a year. Now I'm stuck with 33% lung function. Get the best Doctor available. Don't let them send you to a surgeon in training. No HMO for me....
@MedicareonVideo
2 жыл бұрын
Sorry you had that experience :(
@alysewitt3729
2 жыл бұрын
I've been on Medicare and Plan F since 2008. It's worth the peace of mind.
@MaryBethMcCoy
2 жыл бұрын
@@alysewitt3729 I am so sorry to hear you went through such a horrible experience, and am glad you have a good supplement plan. I also have Original Medicare and a Plan N and you are absolutely right! The peace of mind is worth the cost.
@TheCheryl57
2 жыл бұрын
You do realize that can happen no matter what insurance you have. Sorry for health problems.
@alysewitt3729
2 жыл бұрын
@@TheCheryl57 I found out later that if I had gone to Cedar-Sinai to a true lung surgeon they would have made two tiny cuts instead of the 16 inch cut across my back that went into my breast. They would have got it right the first time. I would not have stayed one month in the hospital. You are right that anything can go wrong and it sure did. Leaving me with a collapsed lung knowing it was collapsed, is my biggest concern. I worked that way for an entire year.
@davidknaebe5123
2 жыл бұрын
What a great informative video. I just retired and had to dig through what you are describing without help. It can be so overwhelming hoping you are making the correct choice. I am 61 so I had to find insurance on the marketplace for myself. My wife is 70 so I had to figure out Medicare for her. Luckily, I chose original Medicare B with a Medigap (G) for her. Sounds like I made the right call. Wish I had found you before I went through all of the headaches. Thanks so much for this information!!
@MedicareonVideo
2 жыл бұрын
Good job!
@roberthoeller5516
2 жыл бұрын
I enroll people in Medicare advantage plans. 95% of the people I deal with survive just on their ssn, ssi, or ssdi benefits. If you can afford a Supplemental plan, I highly recommend it but you will have to purchase a standalone dental, vision, and/or hearing plan which could run another $100/mo. 75% of the people I help are C-SNP or D-SNP eligible.
@violetcat9116
2 жыл бұрын
I was in a unique situation because I got Medicare at age 64 due to disability. I chose a Medicare Advantage plan (Anthem). I had 2 surgeries, another procedure at the hospital that required general anesthesia and a lot of hospital based tests plus I am on several RX's. I paid nothing up front but by the end of the year, I had paid over $5000 in co-pays etc not counting RX copays. Plus it was a pain to followup on bills they disallowed. Thank goodness I found out I could change back to regular Medicare with a supplement at age 65 with no underwriter requirement or extra costs. This year has been a breeze compared to last year! I have had one surgery that required numerous trips to a wound care doctor specialist, an ER visit, starting PT and stopping PT several times, lots of expensive RX's, etc. I am going to have another major surgery next month too and know I will need one or 2 more next year. My uncovered medical costs out of pocket have been $150 for this year for a specialized medical device that Medicare will not cover. My RX cost have been a lot less too. The nice thing is I can go to any doctor that accepts Medicare!!! My first surgery this year was done in a Bon Secour hospital and the next surgery will be in a Riverside hospital. All covered!!!! I can research and find the best doctors in my area and not be restricted to one group. I also travel so no worried about being out of network. Last year while out of state, I ended up with a simple eye infection and it cost me over $250 for the doctor visit and RX that was not covered out of network. Yes, I pay extra but at $190.29 a month (supplement policy, a drug plan and a dental plan) I am still way ahead of last year. I need to say I got a high end drug plan because it equals less out of pocket for my drugs over the year. I also chose to do a dental plan with the dentist I have used for over 30 years at $29 a month. The Anthem plan only had dentist an hour away from me. I get my glasses at Costco or Sams so the cost is reasonable so no insurance needed. So $190.29 X 12 = $2283.48 for the year......a lot less than the over $5000 from last year. Even if I add the $150 that none of the insurances would cover I am less than the $5000! I am a retired math teacher so the numbers are my thing and I researched a lot of plans before I chose the right supplement plan for me. After months of searching I picked Mutual of Omaha for me. Then when I was almost confident in my research I stumbled on a EXCELLENT group that does it all for you and even helps you if problems come up. BOOMER BENEFITS. They were wonderful even months later when there was an issue with my drug plan. I was always informed during the process. I even did not have to run the figures to find the best drug plan, I just sent them a list of my regular RX's. Save yourself a lot of work and money and call them. No, I am not a rep or am I paid to say this. Just someone who put a lot of time and effort to get the best cost plan for myself only to find a free phone call could have saved me A LOT of time and work. And yes they do advise you on the Advantage plans if that is what you want. They take the time to find THE best plan for their clients and it is all FREE!
@keilana6
Жыл бұрын
Great if you have the income to afford the supplement. But why have Medicare coverage for only those who have been able to save thousands of $ for premiums? System needs to work for all income levels.
@jdenino6022
11 ай бұрын
If you live in NY State the rules for going onto a supplemental plan after an Advantage plan are different than most other states.
@wesleyc1029
2 жыл бұрын
Went on Medicare last year and went to a couple of advantage presentations and the sales pitch was a hard one. Kind of felt like I was talking to a car salesman. Being a retired RN I was already somewhat aware of the advantage problems and stuck with original Medicare plus a supplement. Your presentation is spot on and I think the clearest explanation of the differences I have heard thus far. Thank you so much for this great informative video!!!
@savannahsmiles1797
2 жыл бұрын
I dub them used people salesmen, and they have NO biz handling the medicare generation imho.
@bobbycoln5626
2 жыл бұрын
I see the Medicare advantage commercials on TV everyday and how they are misrepresented. They only point out the pros and never explain the cons. Being a past Chartered Life Underwriter, I am surprised the Insurance commissioner lets this slide.
@Harold710
2 жыл бұрын
To me they are a scam. Just look at how many tv commercials they run. (just like aspca, shriners, save the elephants, etc)
@rogwheel
2 жыл бұрын
Advantage plans make the insurance companies who write them a TON of profit. There’s a reason there are so many ads for them.
@dolores2716
2 жыл бұрын
I am suspicious of any product that advertises so heavily, but I was leaning to an advantage plan because of the limit on out-of-pocket. I now think I'll stick with Medicare and a supplement. Thanks for you comment. I like to hear from people who are not selling anything.
@troopermark6629
2 жыл бұрын
I agree with you 100%.. As my wife and I grow older, We have had serious medical issues. My wife had a heart murmer all her life, and at age 76 it turned into a valve replacement and a bypass all done at the same time. Within 30 days I was advised to have a pacemaker and it was done within a week. NO HMO for us, not ever!!!
@roberthoeller5516
2 жыл бұрын
Many advantage plans have PPO’s too. He failed to mention that!
@arthurstember6572
2 жыл бұрын
@@roberthoeller5516 PPO are NOT advantage plan and outside the scope of his comments.
@landiserla3668
Жыл бұрын
@@roberthoeller5516 PPO costs can rack up in the thousands for serious health problems. There is little advantage to "Medicare Advantage".
@roberthoeller5516
Жыл бұрын
@@landiserla3668 I had surgery in June, my bill was $21,794. I paid $464 out of that amount with my Advantage plan.
@landiserla3668
Жыл бұрын
@@roberthoeller5516 Medicare paid most of that. You would have paid $0 with a Medigap plan instead of advantage after meeting deductible.
@polinab.3594
Жыл бұрын
I have advantage in TN. I Don't understand what you're talking about. Max out of pocket 4.5K. Next year 3.5 K. I have Humana, which is accepted by most of the practices. Deasent cooayments. I had multiple procedures this year. Cooayments for outpatient surgeries and labs in a range of $30 to $200. Very low meds cooayments. Very satisfied.
@stevebrooks9493
2 жыл бұрын
I'm an agent and I enjoyed watching your video. I advise my clients in much the same way you do Keith. Go with a supplement out of the gate and stay with until it hurts. I laughinly say that I wish Broadway Joe and JJ had invested their money better back when they were bringing in the bucks and not having to pitch MA plans in their golden years. Bill Shatner sure doesn't need the dough.
@doyourbest7655
2 жыл бұрын
Amazing. Going on Medicare at 65 was incredibly confusing with tremendous conflicting statements. Could not understand the big picture. Now all the bs fed me makes sense. Clear presentation. Thanks
@MedicareonVideo
2 жыл бұрын
Thanks CT!
@carollabutay4654
2 жыл бұрын
A lot of doctors don't acceot original Medicare insurance . Doctors prefer Medicare advantage or PPO. Ask. Specialist they prefer Medicare advantage. Rather than original Medicare.
@myvenusheeler
2 жыл бұрын
@@carollabutay4654 Emm... I think you have this completely backwards.
@savannahsmiles1797
2 жыл бұрын
It is a maze and it is subject to changes...so try to keep on what is going on.
@savannahsmiles1797
2 жыл бұрын
@@carollabutay4654 It depends...
@jansonshine9082
2 жыл бұрын
As an MPH I so appreciate your open honesty. Corporate medicine is unconcerned with their patient outcomes. Their top priority is making management and shareholders happy- at any dire cost of life or quality of life for the patient.
@mmitchell6509
2 жыл бұрын
I worked for one of the biggest 4 profit corporations in the United States and abroad and I can attest to what you're saying it wasn't about patient care , it was about the profits and the stack holders. And of course I've also done some work for non profits and the same old thing there too!
@randyarnold7082
9 ай бұрын
That is sad, but true! The big medical insurance companies like bcbs are notorious for this! These companies open a book when someone gets sick, with price tags next to the illness! If it's kidneys or liver issues, there is a price next to it!!!!😢😢😢😢
@tooneboone3869
Жыл бұрын
I am 85 and had cancer at 61, had good insurance where I worked, was off work for a full year, and returned to work and retired at 67, got medicare and full supplement and the cancer returned 12 years later, got treatment and the cancer returned 7 years later and again 3 years later and still in treatments. I am not restricted anywhere or by any doctor or hospital. Where would I be on an ADVANTAGE PLAN??? I know I have indeed been blessed. I can pay my premiums, thanks goodness. I don't have any co-pays!
@lauralindquist3935
2 жыл бұрын
This is a great explanation. Signing up for Medicare was one of the most confusing things I have ever done. Based on this info, however, it seems I made the right choice to go with original Medicare.
@bobbycoln5626
2 жыл бұрын
You are right. Almost ALL Doctors and Hospital accept Medicare and the Supplements pay the same no matter which company you buy it from. Unless your primary care Physician, Hospital or specialists is in the Advantage network you pay out of network charges.
@yeppers7225
2 жыл бұрын
Laura, if you ONLY have Medicare, you will have to pay the 20% that Medicare doesn’t cover. A $100,000 hospital bill will cost you $20,000. You still keep Medicare whether you chose to use a supplement or a Medicare advantage plan. But they each cover that 20% for you to some degree. Call and ask an insurance agent that sells Medicare Supplements and Medicare Advantage plans to educate you about your choices. I sold both about 12 years ago. I took my dad off a supplement and put him on a MAPD, medicare advantage plan with prescription drug coverage. He saved $150/month by switching to the MAPD. Over the 10 years, he has saved over $9,000 in premiums to his supplement company. If the insurance person can’t explain everything and answer all your questions, find another one. It will cost you nothing to speak to someone.
@bobbycoln5626
2 жыл бұрын
@@yeppers7225 It is my understanding when you go to a Medicare Advantage plan, you go entirely to the plan. In other words the insurance company covers ALL of your medical expenses not just the 20%. That's why the Fed. Gov. pays them at least a $1,000 a month for every Senior they sign up. One can always go back to Medicare from an advantage plan for the 80% they pay but they would have to be underwritten for a Supplement plan and can be turned down and then have to pay that 20% themselves.
@yeppers7225
2 жыл бұрын
@@bobbycoln5626 that is incorrect. Medicare advantage participants and Medicare supplement participants still pay their part B premium. Most don’t know that because it comes out of their social security checks automatically. If either of these groups were “entirely on the plan” that would not be the case. Also, if you check Medicare.gov, it clearly explains both groups remain on original Medicare. That’s why these plans are called “gap” plans, both Medicare supplements and advantage plans fill the “gaps” original Medicare doesn’t cover. As a side note, I sold both supplements and advantage plans many years ago. I was able to write policies with any company in the US. In order to get the same coverage with most advantage plans, you must pick one of the most expensive plans in the supplements. That used to be plan F, as it was the most comprehensive coverage available for supplements. Plan N is fairly close as well, but doesn’t cover everything plan F does. Regardless of which option you choose, the worst thing to do is choose neither and have no extra coverage since original Medicare only covers 80% of the costs which leaves you paying the remaining 20%.
@bobbycoln5626
2 жыл бұрын
@@yeppers7225 Yes, you continue to pay the part B premium but the Federal Government pays the Insurance company a monthly costs of around $1,000 to cover ALL of the insured's claims. The Federal Gov. or Medicare pays nothing if you own an Advantage plan. Some companies even refund the part B premium when you purchase a Advantage plan.
@redwoods7370
2 жыл бұрын
Kaiser Permanente Senior Advantage Medicare plan is the exception though. It is excellent. I pay only $15 a month for it.
@maryg1338
2 жыл бұрын
I worked for doctors for a vvvery long time. And everyone of them told me “if you can afford it, never give up your Medicare”.
@ozarksfarmerhansen8782
2 жыл бұрын
He is not taking about giving up Medicare, Medicare advantage isn't Medicare. its a supplement if its a zero plan its worthless.
@maryg1338
2 жыл бұрын
@@ozarksfarmerhansen8782 I understand. I was agreeing with him.
@mwconservative
2 жыл бұрын
because Drs make more that wy
@miguelservetus9534
2 жыл бұрын
@@mwconservative Not really. It’s much more complex than that.
@haviettelibertin8914
2 жыл бұрын
I've read that Medicare covers only 80% of medical costs, so if you have a very expensive hospitalization or medical condition, the 20% you pay can go into multiple thousands of dollars. I've always had either a Medicare PPO or Advantage plan in order to avoid these costs, and now I hear that this course of action isn't the best way to go. As a senior on a fixed income, I get Medicaid Extra Help from the state of Colorado, which pays my Medicare premium, and also helps pay other expenses. I've been happy with it so far. How can I be on just regular Medicare, without paying extra for the supplement programs you mentioned? With inflation climbing more every day, and with the new rent increase from my landlord, I can't pay a penny more for my health coverage. I live in a small town in Otero county, Colorado, 68 miles away from Pueblo, the nearest big city, where the medical specialists are located.
@dianemelasouvanna6928
6 ай бұрын
Advantage plans have PPOs that do not require you to see your primary care first to get to a specialist.
@kudzu01
2 жыл бұрын
I’ve had Advantage Plans with three different companies, never had any problems with any of them. All my medical needs have been met with very low out-of-pocket costs. Maybe I’ve been really lucky with the insurance companies I’ve dealt with, but I’m sticking with my current plan.
@MedicareonVideo
2 жыл бұрын
That's great.
@carolynwheeler2739
2 жыл бұрын
I have an advantage plan and I get more for my money. I find the extra supplement you have to buy with original medicare is too expensive for me. Look that I dont have to buy a drug plan too. My meds are $0. Just love the extras and my deductible is 4900 Which is cheaper than original medicare! I'm happy with mine.
@Kim-dm4yb
2 жыл бұрын
@@carolynwheeler2739 $4,900??? Is that annually? So you have to pay that until they pay for anything? Maybe I'm not understanding. Is our country so brainwashed that they think thousands to pay is okay? I wish everyone would start protesting and learning that we are the only country that does this, the rest of the civilized world believes healthcare is a right and not a profit system. I always thought Medicare was great and virtually free for disabled and seniors since we pay into it for so long. Never realized what a scam it is! Wow! I wish I never became sick! Ugh!
@richardmccombs617
2 жыл бұрын
Just went through this with my 96 year old mother. Advantage plan fought with doctors recommend care and we had to go to arbitration. It worked out but if we were not available to help her , she would not have understood what was going on. Easy way to understand difference. Regular Medicare , doctors control your health care. Medicare advantage , underwriting controls your health care.
@MedicareonVideo
2 жыл бұрын
Hi Richard, Unfortunately I've heard that story too many times. Happy that it worked out for her but many times it does not. Hope she is doing better.
@richardmccombs617
2 жыл бұрын
@@MedicareonVideo thanks yes she is at 96 still very alert and on the mend.
@riadanabtawi5880
2 жыл бұрын
I am 76 and my phone has been ringing all day since last Thanksgiving with different people from different states trying to.sell me Medicare Advantage. I am happy to hear what you've said.
@MedicareonVideo
2 жыл бұрын
@@riadanabtawi5880 It really is a shame that it has to be that way
@tcpUtube1
2 жыл бұрын
Medicare doesn’t always pay for what doctors recommend. I had to have minor oral surgery to remove a growth from my pallet for biopsy and Medicare refused to pay anything. Never got an explanation why. Because Medicare refused to cover the biopsy my supplemental insurance refused to pay anything. I got stuck for the entire cost. Submitted Medicare a review petition. Called several times after the date Medicare was obligated to respond. I was repeatedly told my petition was still under review. Medicare never responded to my petition. It just disappeared. Never rely on Medicare.
@cameronmeers8096
2 жыл бұрын
I’m a Medicare agent, and there is definitely good argument to go with original Medicare and a supplement, but only about half of what you say is true about the Medicare advantage plan. Just saying!
@codydriver6413
2 жыл бұрын
I agree. Im an agent that handles every Medicare plan thats offered. MAPD, Supplements, and PDP. MAPD plans can work great for some people. Every single person is different and this video is misleading.
@barnardcarbajal8506
2 жыл бұрын
@@codydriver6413 Cody MEDADV is "Dubya" scam in an attempt to Privatize all of Medicare like prefunding the Postal Workers Pension for 75 years in '06 was a plan to torpedo the Postal Service prematurely. Privatyze! Cody
@TinaTom
2 жыл бұрын
@@marya4717 I don't have any hassles with my MADP with Humana. I have a really good Medicare agent who looks for the best plan for me with the least costs and most benefits. I don't pay anything for them and pay very little for my meds and Dr. I get $200/yr for vision and $1000/yr for dental. I have the Humana app on my phone and get $220/3 months for OTC items that would have cost me to buy them in a store. That has been a major help. Please talk to an agent and check out an advantage plan to save you those monthly costs you are paying.
@lindahidalgo1804
2 жыл бұрын
What is NOT true...just asking.
@sarahdee374
2 жыл бұрын
@@codydriver6413 I agree, my first year I went with Original, just fine. Second year I decided to try an Advantage. With the one I was leaning towards all my current docs are in network, my two meds are covered at $2 per refill, and in addition they also give me $40 quarterly in over the counter meds, a paid in full annual vision exam, $100 towards frames, 2 annual dental exams, and if needed it they will pay some towards hearing aides. All this for the (current) $170 Pt B premium. Now, I am healthy and the situation might change if something medical occurs. But so far (second year in) I'm very satisfied with my Advantage plan.
@Katsem
2 жыл бұрын
You are 100% correct. I have plan F, which I chose because I had a serious illness shortly before I became Medicare eligible. It was an easy decision because I knew I was going to be seeing specialists, having tests, procedures etc. and did not want to be in a network. Also, the benefits for each Medicare supplements are clearly spelled out , while the Advantage plans are murky. I have had tons of imaging, bloodwork, see lots of specialists (who I did not have to get a referral to see), have had surgeries and have NEVER got a bill. I know that not everything is covered , and eventually I might need something Medicare does not fully cover. But I ALWAYS ask if it’s covered by Medicare, and so far have never found anything a doctor ordered to not be covered. So, the supplement picks up the rest. Plan F is excellent.
@debhelms4106
11 ай бұрын
I’m going on plan F he said I would have copays every time I go to the dr!! Wonder why you don’t have copayments?
@maytrang671
11 ай бұрын
@@debhelms4106 You need to check your plan. Plan F cover all deductible copay.
@neilwhiteaker53
11 ай бұрын
@@debhelms4106 Plan F and Plan G have no office visit or ER fees at all. Ever. Make sure of what you are signing up for. You want a Medigap Supplement, not Medicare Advantage.
@sadie4me2
10 ай бұрын
Plant F is very very expensive. If you have a pre-existing condition such as cancer, they won’t even ensure you.
@joannejohnson85
2 ай бұрын
Mcare covers pretty much everthing with no preauthoriztion required. There are only about 30+ procedures they started requiring PA for about 3-4 yrs ago
@commonsense6967
2 жыл бұрын
I've had my Medicare Advantage Plan for 5 years now and I like it! But it's a 5 star plan (top rated by CMS) and ratings matter more than anything else when considering these plans.. And yes, it's an HMO that has been in existence now since 1982. I was also covered under the same HMO as a state worker years ago, so I was somewhat familiar. I've had doctors tell me my insurance was excellent!
@MedicareonVideo
2 жыл бұрын
Sounds like a lot of common sense!
@adventuresfloridatothailan5217
2 жыл бұрын
what plan do you have? I was thinking of Humana Gold.
@lindas.3791
2 жыл бұрын
Hubby has CalPERS insurance. We have Kaiser now. Thinking of Kaiser Senior Advantage. I’m 64, so I need to educate myself.
@SOZO_xo
2 жыл бұрын
My mom has UnitedHealth and has never had any issues.
@genebrenner855
2 жыл бұрын
How much have used your health care plan? Do you have a chronic condition like diabetes or high blood pressure?
@lelandcarlson1668
2 жыл бұрын
Wow! An insurance salesman with a conscience. Kudos to you for doing what's right for your clients, even though you could be making more money.
@MedicareonVideo
2 жыл бұрын
Thanks Leland - best to believe in what you sell!
@carlsnyder4833
2 жыл бұрын
He’s doing just fine on money. Those supplements he’s selling make him just as much as Advantage plans.
@MedicareonVideo
2 жыл бұрын
@@Jess_2025 Hi G2 - I have just about everything Medicare on my channel. If you look in the description of this video you can download my book and sign up for my Medicare Mini Course. All free. And yes - Medicare supplements are what I do. Feel free to give a call when time. 877-885-3484
@thegreatestbassist
2 жыл бұрын
AMEN....
@memories511
2 жыл бұрын
not
@PatB2023
2 жыл бұрын
Basically, you are going to pay! Make getting healty YOUR FULL TIME JOB! Dont get sick.
@billarroo1
2 жыл бұрын
I'm 75 and don't need medication or doctors very often, But I'm glad you explained all of this. Thanks
@islandgirl8199
2 жыл бұрын
So what plan do you have now sir?
@manuelguzmanjr6622
2 жыл бұрын
I am a licensed agent since 2006 and have clients on both Medigaps and Advantage Plans. It's our duty and obligation to give each client to do a thorough presentation and give them their options. Medigap plans are excellent but not all can budget a Medigap plan which increase every year and when it's a husband and wife the expense can really be a hardship. Then they have to pay separate for their part D and separate for dental insurance and so on. On the other hand, my parents and in-laws with medical issues like cancer and diabetes have done very well with advantage plans and still continue up to this day. Not to mention some clients may also qualify for Low-income Subsidies and Medicaid programs from their state so truly they are covered even 100% for all Medicare costs. Although they are managed care plans there are many professional physicians who participate in these advantage plans and the referral process is not a headache. There are not a one size fits all plan. Every client has unique situations, lifestyles, income and so forth. So, at the end of the day give your clients the option because if you don't do a good job explaining their options as discussed on Medicare and You handbook, another agent will come along and enroll them in a managed care plan.
@rodbutler4054
2 жыл бұрын
Spoken like a true insurance salesman!
@cvtremaglio
2 жыл бұрын
@@rodbutler4054 and how do insurance salesmen make money?
@davidcampo2902
2 жыл бұрын
Everything you said is spot on! I I don’t understand how this guy can generalize something as broad as a medicare into a little 16 minute video. There’s so many other reasons why somebody would choose a Medicare Advantage plan as opposed to a supplement plan. Aside from your part B why would you pay a monthly premium for some thing that keeps going up for the most part every single year plus pay a separate premium for your part D drug plan plus pay copayment on top of that.You mentioned low income subsidy there’s also state Medicaid and that comes along with a bunch of other benefits.
@roberthoeller5516
2 жыл бұрын
I too sell both and agree with you 110%.
@crand20033
Жыл бұрын
Would you recommend an advantage plan to someone who is really sick like a quadriplegic, cancer patient, heart patient, chronically ill, etc?
@pamelaconaty6878
2 жыл бұрын
When we first got on medicare we got a part G for 150 for me and 175 (and it went up every year after 3 years was paying over 225) for my husband a month plus RX another 50 for both and app $5 per RX (another 20 a month plus and one time ). Yearly just under $6000 even if we never see a doctor. We are now on an advantage plan 0 per month RX 0. Last year my husband started bleeding internally...was taken to the hospital by ambulance spent 15 hours in ER given 5 liters of blood 5 days in hospital and given more test than I can count...total cost 225!!! Out of pocket for the 2 of us last year was right around 1100. Our plan does cover dr all over the US. We pay 0 for our RX and 0 to see our pc doctor and 20 to see a specialist. And we get over the counter ...cold , pain reliver ect... of 50 a month. Our doctors are great and I really do feel we have much better coverage than when I was working and paying insurance. We had part G for almost 5 years because we didn't know better and our agent use the same scare tactic on us. Been on Kelsey Advantage for 3 years and it is great. AND NO WAITING IN DOCTORS OFFICES!
@virginiamoss7045
2 жыл бұрын
No waiting? I do not believe that. Wait times even for appointments is weeks to months. I've never seen a doctor without waiting up front or, worse, in an exam room. Never.
@craigharris702
Жыл бұрын
Hello 👋 Pamela how are you doing today?
@pamelaconaty6878
Жыл бұрын
@@craigharris702 great...thank you!
@pamelaconaty6878
Жыл бұрын
@@virginiamoss7045 We are still on KCA and still love it. It could take weeks to get an appointment for routine appointments but emergency right away. They even have Home visits for just $25 (not the once a year wellness exam that most plans do) if you feel to sick to go in that usually takes 24-48 to see, video anointment within 2hours and only 20 to go to urgent care. We do a lot of traveling and have used it in most part of the country (to be honest most parts are Oh NJ and FL are the only states we had to use it) with no problems. I'm sure my plan is NOT the only one out there. When looking start with 5star plans in your state.
@foreverthirtyone2189
23 күн бұрын
Thanks for the comment, it is VERY helpful. I will take Advantage plan !!
@deefromtx5530
Жыл бұрын
I have Medicare Advantage and love it! No monthly premium, no co-pays except $25 co pay for a specialist. Nothing for my monthly meds. I’ve had countless tests, a few surgical procedures and have had incredible care and the best of the best drs. I chose my specialists which are all 5 star in the Houston area. I’ve never been happier with my healthcare. Everything is amazing and I’ll never have anything else. Nothing in here you’re speaking of happened to me.
@patriciaguzman3996
Жыл бұрын
What Medicare advantage plan are you on
@newtron9
Жыл бұрын
His out of pocket of 7,500 is very rare. I am now debating on going with Summacare where the max. out of pocket is 3,800
@craigharris702
Жыл бұрын
Hello Dee how are you doing today?
@judyleach7116
Ай бұрын
@@patriciaguzman3996 Which Insurance company are you with?
@cornycorny2952
2 жыл бұрын
We have been on a 5 star Advantage plan since turning 65 12 years ago. Our plan is a non profit coop managed by medical professionals. Even though we had one major surgery, I find this plan to provide great coverage at a modest cost. Highly recommend our Martin's Point plan which is only available in the state of Maine. If you can find a similar plan in you area it will save you a bundle. The only way I can see that the supplement plans will pay is if you have multiple severe morbidities where you are spending most of your time in the hospital or doctor's office with a lot of expensive drugs. For the average normal person the advantage plans are a good alternative.
@Garth2011
2 жыл бұрын
The average normal person is about 50% of the public that rarely see a doc and the other half who are in the doctors office quite often.
@connieefurulee
2 жыл бұрын
Thanks for the thorough explanation. I’ve been asking Medicare questions well before the requirement age of 65. And now 6 years later. I am just as confused. To top it off, I worked at an agency that did not pay into social security. Which means I have to pay a larger Medicare premium. Nobody has given an explanation like this about the differences in this Overwhelmingly confusing process. I subscribed.
@MedicareonVideo
2 жыл бұрын
Thanks Connie! Sorry you'll have to pay more than you should.
@lilyang4282
2 жыл бұрын
@@MedicareonVideo ka n
@rmhalili
2 жыл бұрын
There are some employers (read school districts) that don't contribute to Social Security, however, there is a separate line item for Medicare. I would check you paystub. If there is a medicare line with a dollar amount, and it has been paid for 40 quarters or more then you will get no premium Part A. Part B cost $170.10/month for most middle class
@Kim-dm4yb
2 жыл бұрын
Its so uneccesarily difficult to understand. I still don't know what to do!! I live in Manhattan, NY , just got approved for disability and I feel there are no options that I can afford .
@illuminaughty2929
Жыл бұрын
I needed knee replacement, HMO gave me a cane.
@johnventura1637
Жыл бұрын
I have never heard of a supplemental plan to Medicare that only cost $100/month. The cheapest I've seen are about $300/month.
@susanm764
Жыл бұрын
Anthem 132. California g plan
@clubmogambo3214
2 жыл бұрын
7 years on a Med Advantage plan (for several years was on United Healthcare, but have since switched to Aetna), and I've had virtually no problems, with perhaps the one exception of sometimes having to wait a bit extra for an appointment with my PCP. No problems at all when having to visit specialists. Super and I mean super low cost - in fact, virtually no cost to Advantage. Not arguing with this gentleman, but I'm fine with my plan.
@JoyofRVing
2 жыл бұрын
When you’re younger it’s OK, but when you need to get post Acute services they suck. They denied Acute rehab for a patient of mine who had a hip fracture. They also denied skilled nursing for her. She ended up going home with home PT twice a week.
@MerkinMuffly
2 жыл бұрын
Sure, Medicare Advantage employee, but I think I'll pass.
@clubmogambo3214
2 жыл бұрын
@@MerkinMuffly What are you in high school? Who gives AF what medical plan you choose.
@roberthoeller5516
2 жыл бұрын
I enroll people in Medicare advantage plans. 95% of the people I deal with survive just on their ssn, ssi, or ssdi benefits. If you can afford a Supplemental plan, I highly recommend it but you will have to purchase a standalone dental, vision, and/or hearing plan which could run another $100/mo. 75% of the people I help are C-SNP or D-SNP eligible.
@darlenewells3309
2 жыл бұрын
Club Mogambo...agree..I have a lot of health issues. No problem at all with my Advantage plan. Even had 3 surgeries...I do have some med co pays but not bad...can see any Dr as well!
@mmitchell6509
2 жыл бұрын
I’ve been in the healthcare industry for over 30 years and I totally agree with you!
@pamelabrown7368
2 жыл бұрын
Me too!
@deadeyedi9833
9 ай бұрын
Me too. Family did this switch somehow. Mom didn’t want.
@WingChunGungFu
Жыл бұрын
Remember folks, Medicare Advantage isn’t bad, it depends upon a Medicare beneficiaries budget and needs. For some people a Med Supplement is better, for others, a Med Advantage plan is better. A good agent will offer both and let the beneficiary decide what is best for themselves. Do not take an agent seriously if they bash one or the other too much.
@watchmenonthewall9002
2 жыл бұрын
Thank you so much for speaking out about this! I’m 75 yrs old & I’m so tired of Medicare trying to push this Advantage down my throat! It is a rip off & the care is terrible! Thank you so much for speaking up about the travesty of Medicare Advantage!
@MedicareonVideo
2 жыл бұрын
Glad it was helpful!
@Rickm505
2 жыл бұрын
It's not a rip off and the care is fantastic. I've had advantage for 5 years now, and absolutely love it.
@MrStewbee
2 жыл бұрын
@@Rickm505 Yep I agree, great plan. I don't get the complaint this guy has in the least.
@carieyounginsurance
2 жыл бұрын
They have gotten excellent- someone who has trouble affording 200/300 a month for a supplement living on 1500 social security or less need to use the advantage plan and they are good! Do your own research with someone who has both options
@sassy0010
2 жыл бұрын
@@carieyounginsurance Yes................ Just don't get sick.
@mikerose7100
2 жыл бұрын
Not been my experience with Medicare Advantage Plan. No referral needed for specialist. All of my doctors are in the plan. Most hospital stays limited to paying 3 days at $300. I haven't had to use the traveling across the US benefit, but I think I would want the emergency treated and then return home for the ongoing care.
@nottthereyet4872
2 жыл бұрын
We LOVE our Medicare Advantage PPO Plan! So many extra benefits, too.
@Summersunshinemylove
2 жыл бұрын
Which one do you have? If you don’t mind me asking. I have two elderly parents and I’m having a hard time deciding which one to enroll them with
@nottthereyet4872
2 жыл бұрын
@@Summersunshinemylove AARP
@nottthereyet4872
2 жыл бұрын
@@Summersunshinemylove Now both my husband and I started with AARP right away at 65 - so we did enter at a good rate. It might be that the rate goes up depending on what age your parents start the Advantage Plan. But I really did my research and multiple phone calls, etc. and this was the best plan that covered everything we needed. Along with peace of mind. Highly recommend calling AARP for more information. Please feel free to ask any other questions if I'm able to help. I understand how daunting this process can be. 🍃
@Summersunshinemylove
2 жыл бұрын
@@nottthereyet4872 thanks a million. I’ll check it out
@SuperSushidog
2 жыл бұрын
We are full time RVers who are retired and travel the country in our motorhome. We have a Medicare Advantage PPO plan in our state of Domicile, Louisiana, which we haven't visited in over 2 years. We have used network doctors from AZ to NC and haven't had to go out of network yet. We paid $100 out of pocket last year for the initial visit at a dermatologist. That was it, for the entire year. However, we save $130 every month as a give back from our Medicare part B premiums. That's $1,560 a year in savings! Even with the $100 out of pocket last year (nothing the year before) we still saved $1,460. That's huge for us retirees.
@xtbum3339
2 жыл бұрын
As a retiree Medicare eligible soon, I've been swamped with offers of Medicare Advantage plans for nearly a year. Not fully understanding the options, your video enlightened me plenty. Am glad to see you doing the right thing now.
@MedicareonVideo
2 жыл бұрын
That's great! You'll get a lot more mail and phone calls the closer to 65 :(
@catbee1452
2 жыл бұрын
Wonderful it works in your favor. I'm of the opinion that Kaiser can be great if your medical problems are not complicated and things are stable. And it also depends on the choice of practitioners at the particular Kaiser you join. I've seen top notch physicians, specialists and nurses at some Kaisers, and other Kaisers where I wouldn't send my Yorkie to.
@savannahsmiles1797
2 жыл бұрын
@@catbee1452 my mom had Kaiser thru her union, it was fine until they said she needed a pacemaker. Then she subjected her to 3 surgeries installing faulty pacemakers. In her area, Kaiser was a teaching hospital and she was the guinea pig. I got IN THEIR FACE and said enough I don't want these experimental new contraptions. I did research and DEMANDED a well known unit and she FINALLY was fine. But then I knew how to navigate the broken system as a LICENSED AGENT and I went to the insurance commissioner and demanded they stop experimenting on her. I was an advocate as well having volunteered in hospital for decades. I knew the cages to rattle to get results, and I went after them ALL like a pit bull and got my mom the care she deserved. Kaiser can be good or seriously iffy.
@catbee1452
2 жыл бұрын
@@savannahsmiles1797 As a nurse for 43 years, I've seen a lot of "iffy" in different health care settings. To navigate the "iffy", one must know enough about the system to jump through the required hoops.
@churchofpos2279
2 жыл бұрын
@@catbee1452 I used to work at Kaiser. If you have minimial health problems. Kaiser will work for you. I always caution people that if you have expensive chronic medical problems, then there system is not so good. You have to learn how to work their system to get what you want/need.
@slaallday188
2 жыл бұрын
With Med Supp you have 3 premiums; medicare part B, the cost of the supplement and the cost of your part D premium. The deterrent to joining a Med supp plan is the large monthly premium. United Healthcare and Aetna have the best Medicare Advantage plans hands down.
@alansach8437
2 жыл бұрын
It all depends on how much peace of mind is worth to you. Basically, in many ways, it's a "pay me now (with controlled, known premium payments), or pay me later, (with unknown amounts looming). I know exactly how much my premiums are (yes, like everything else, they go up a little every year). I can budget for them. But if you have an advantage plan with big deductibles, copays and unknowns, you can take a big hit all at once.
@Gwen-joyful-light
2 жыл бұрын
My mother has AARP United Healthcare, Medicare advantage PPO, and so far its been great, I know someone else who has the same plan and he loves it too, I turn 65 this year so I plan on getting thd same plan three months ahead of my birthday.
@AG-iu9lv
2 жыл бұрын
@@Gwen-joyful-light good plan! My parents are both on med advantage and love it, same with my Medicare clients. Advantage isn't for everyone, and I have some clients on supplements because that is their preference and they can afford the premiums, but the vast majority are happily on advantage PPOs with huge networks & solid care. I have also seen older folks paying $700 plus total monthly for part B, med supplement, and drug plan because they're stuck in an obsolete med supplement and can't qualify for another one, and are scared to move because of videos like this.
@karen3876
2 жыл бұрын
In my area Humana’s is best. My deductible is thousands less than either of these two. However since being on MA now for my third year I would NOT suggest to anyone to take a med advantage plan. If you are in the hospital you will end up paying it out of pocket.
@Melanie-ix4nq
2 жыл бұрын
Yeah, and when there is 2 of you it is even more expensive.
@danielgranda896
2 жыл бұрын
I would say there are a few glaring omissions in this presentation. First is that the premium prices for Medicare Supplements differ GREATLY by state and demographics. It is in your best interest to get an OBJECTIVE view of what best suits your particular situation by comparing Original Medicare with a Supplement and Medicare Advantage in your area. It may be that in your area MAPD plans are few or are not competitive. However, I live in an area where the annual premiums for Medicare Supplements are more than the out-of-pocket maximums for the HMO plans. There was also no mention of ancillary benefits like; Vision, Dental, Chiropractic, Fitness, Acupuncture, quarterly coupons for Vitamins, etc. Medicare Advantage DOES cover and Original Medicare does not. I have clients in two states and they could not be more different. It is great that you love Original Medicare but if you do the analysis Medicare Advantage can be much better for people depending on their health and finances. If you life in a rural area Original Medicare is usually the best option if the Supplement and Drug plan are not cost prohibitive. Providers are fewer so networks are more restrictive. In an Urban area the opposite tends to be true. Hundreds of providers and many Medicare Advantage Carriers are competing for business and that brings loads of benefits and LOW out of pockets costs. Yes, you are restricted to the Plan’s network, and on most plans will need referrals, but Referrals should take the same amount of time as it take for your doctor to send a script to the pharmacy. For man things you can also see the Primary Dr virtually to obtain a referral. A broker will show you comparable options available in your area, not just the one they like…
@tomm5897
2 жыл бұрын
There are plenty of highly rated PPO Advantage plans which do not require referrals.
@barbaracruisemartin9806
2 жыл бұрын
I have just started PPO Blue Cross advantage . So far so good. Under $8 month. Do you know any drawbacks.?
@savannahsmiles1797
2 жыл бұрын
@@barbaracruisemartin9806 that is not a generic question as the plans differ in different states and counties. I enroll in Blue and have 6 states and no two plans are exactly a like. My best advice is find an agent you can trust and go over your concerns with them. Just so you know, there are multi PPO plans under Blue.
@mattgreen267
2 жыл бұрын
Daniel, I completely agree!!! As a licensed independent health insurance agent for almost 15 years, I can tell you there is some serious "truth twisting" in this video. He is basically taking the worst HMO product and the worst MA features and casting a blanket about all MA's across the county. In our area, we have highly rated PPO (Non-referral) plans with huge premium savings and extra benefits compared to Medigap plans. If you want the absolute best coverage and are willing to pay the huge premiums, go ahead and get a Medicare Supplement plan but if you are healthy and want to act as your own insurance company (by keeping those premium savings in your pocket) the MA plans are a VERY good option!
@jar407
2 жыл бұрын
@@mattgreen267 i bet he used the same type of presentation when he was selling hmo. not downloading his book but i wonder what's getting sold i will say my mom had the ppo advantage from fl blue, and the one the corrupt aarp pushes . and i had fl blue hmo 2 yrs with o care, 2 yrs advantage hno, this year they offered ppo same cost but i estimate it will cost me about 150 ded on meds . all but 1 of dr my mom used and hes a very specialize eye dr. he takes ppo . at most took 2 days to get appt with specialist . fl blues a not for profit i recommend it . if you have one home a person like who spend all winter in fl it would not be good
@judyriel3463
2 жыл бұрын
So glad I came across this video, I am in the process of signing up for Medicare and was so confused with all the info regarding advantage plans. This was very informative. Thank you very much for (in a nut shell explanation) going with regular medicare.
@yt12363
2 жыл бұрын
There is no out-of-pocket limit. Are you aware of that?
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