I recently met with a Medicare specialist through my doctor's office. The meeting lasted 1 1/2 hours, and I was still not sure what was what. This 11 minute video makes it completely clear to me now. Thanks so much!
Watched another of your videos. You make everything so clear. You’re a great teacher/spokesperson for all us Seniors who have no clue to which path to choose. Thank you.
Excellent overview!! You made it simple and easy to understand and covered the important elements of the pluses and minuses of both Medicare Advantage and the Medicare supplement plan. Thank you!!!
I've been researching Medicare for my grandmother who turns 65 in October. I warned her against MA because of all the horror stories I read. Not once did I ever hear of a positive experience. The sad thing is you can't go back to original Medicare without underwriting if your initial open enrollment has passed. The main complaint I heard was they will deny every claim making the senior jump through hoops to get approved. Sounds like a nightmare.
Christine Did you mean Medicare Advantage will deny every claim making a senior go through hoops? Or, Medigap making seniors jump through hoops to sign up after the initial underwriting grace period?
I'm pretty sure you can always go back to Original Medicare (Parts A & B), but you may not be able to pass underwriting for a Med Supplement policy. You should call Medicare and ask them this question specifically- as that's what they told me. *You'd have to elect to return to Original Medicare during the Annual Election Period which starts Oct. 15th I believe....I'm a newly licensed insurance agent myself & learning everything I can about Medicare right now! I hope this helps :)
Thank you so very much. Trying to choose a Medicare plan is the hardest decision I think I’ve ever made. Very confusing with so many options and nothing really explains it very well. Then Finally I found your channel. You really describe well and make it so simple to understand. Thank you.
How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
Thanks for very elaborate information and removing my confusion. I didn’t know before the comparison with so much clarity. I am 66 and still working. I am now fully satisfied with my Medicare and BCBS supplemental plans. Thanks
You thank us for watching but the thanks goes to you for making these videos. I've never been so confused in my life as I am by all of this Medicare information.
I'm glad I choose you to be my independent Medicare agent. There is so much misinformation which seems to lean toward the advantage plans and very little information about the supplement plans its really difficult to make an informed decision. I appreciate your unbias information.
Thank you Stephanie. This is a great explanation on the differences between Supplement and Advantage. I am a military retiree and will turn 65 Feb 2022. I now feel informed and able to engage TRICARE and get to the bottom of my options!
I am in same VA boat as you albeit I will turn 65 in November 2023, some issues I see are make sure you register for Tricare For Life (TFL)? I will probably do Medicare A/B and idk maybe D for added ease of using a local pharmacy. I doubt I will do Advantage and assume the $7,550.00 out of pocket risk annually. Eye, hearing, and dental I will do out of my own pocket.
How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
After watching this video, I called your office and spoke with Samantha. She was very helpful. Thanks so much for the service you provide. I will likely be following up after I make a few business decisions.
Great job explaining the differences. As a retired independent health insurance broker, I would show clients how Advantage plans could save them significant amounts of money - as long as they stayed healthy. However, if they got sick or even needed a relatively common surgery such as surgical repair of a broken bone, their out of pocket expenses could far exceed those of a supplement. With a $7500 potential exposure annually, they can be financially crippling. And heaven forbid, you break that bone while going to a Christmas party. You could be responsible for that $7500 in December and then again the following year in the event of complications. Finally, EVERY Advantage plan is managed care in one form or another. EVERY managed care plan I ever reviewed included the definition of 'medically necessary' as meaning 'least aggressive, least expensive treatment available'. If I or my loved one has a dread disease, I want more aggressive treatments. Advantage plans lose their value as we age and have to use them more. And once you get really sick, you may not be able to qualify for a supplement.
How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
Thank you Roger. You hit the nail on the head for me. I'm 66, already enrolled in A & B and could not make up my mind between supplemental and advantage. Your explanation made it clear I need supplemental. I wish I could buy you a drink or cook you a steak. Thank you friend for taking the time and effort to help us out.
This was one of the best explanations I have seen anywhere on the differences between Advantage and Supplement (or Medigap) options. My husband turns 65 in 14 months but many of our friends have tried already to guide me to whichever choice they made. I will be covered by my employer well after age 65, but this clarified many items for me. I bookmarked your site and I will contact you in the autumn before his Jan birthday. Great information.
I am finding the same thig. In talking to friends who are on Medicare if you don't agree to do exactly the same thig as they did, they actually get mad. Do your own research and a cost/benefit analysis of how you will use Medicare and your own health history.
First time exploring and signing up for medicare and your video was very simple and easy to understand. Now comes the question of which one to pick and the cost etc..
Thank you Stephanie, I watched some of the other videos of some of the other agents they had their own personal choices and what they would do not keeing in mind the customer , but not you you keep in mind the customer and what’s going to work for them
The fact that they go via zip code means people get the crap end of the deal. How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
I have had a supplement plan N for a few years but they talked me into switching to an Advantage plan. I had it for four months and my out of pocket expenses were more than my premium for plan N. Needless to say I switched back. I do have medical issues, so take that into mind if you go with the Advantage Plan. The deductibles can quickly add up!
I have an F plan, which was the N + more of its day. Ever since the F was closed, I get mail almost every month from these nefarious agents , including my F Plan provider, touting the benefits of a cheaper Advantage plan. I guess they think we seniors lose our faculties as we age, and they hope we will have a senior moment and sign onto their new plans. Anyways, I can spot these mailings now so I just trash them unread. My F Plan is expensive, but am happy to pay forward for the unknown which will inevitably come.
How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
I have an older plan F, no longer offered to new applicants, prior had an advantage plan, Have looked at advantage plans but the closest providers are 65 miles away (would like to save a few dollars but my local hospital and providers are only 1 mile away). I was pleased with my advantage plan when I lived in two other states where they were and the cost. As I get older, I prefer to not mess around. Yes, it costs more up front but you could easily burn through that 5,000 to 7,500 a year on the back side of an advantage plan. Sort of like the old "pay me now or pay me later."
Hi Richard, I am a licensed agent and sell lots of Supplement. One thing that might help you on your premium is to try to switch to Plan G. The only difference in Plan F and Plan G is plan F pays your part b Deductible and G doesn't. Typically F is about $330 more a year than G, so by going to G and paying the Part B Deductible you could save over $100 a year.
If you are in good health then a Medicare Advantage plan may be perfect. If you have medical problems then I recommend a supplement plan to augment A & B and Part D. My suppliment costs $240 a month but I am so glad that I have it. I have many medical problems.
I agree that Medigap plus Original Medicare is the best way to go, but that is generally an option for those in middle to upper income -- folks usually with multiple retirement income streams, not just Social Security. It is not an option at all for folks under 65 on SSDI/Medicare. I mostly serve the disabled and low income retirement community. Even $150 a month for a Plan N plus a Part D plan is unrealistic for most folks. That is the difference between having enough to eat and their power bill being paid and that's just the way it is. As for MA being just for the healthy, that has basis in reality. I have hundreds disabled clients clients on MA (99% in PPOs), folks with serious chronic conditions, and they never have any problems getting any and all the care they need.
It is important to remember that all of these instructional videos are made by folks who make their living on commissions. I think Miss Stephanie was pretty even handed. My wife is in open enrollment and I think we are going to go with the "Cadillac plan" (part G or N) for her. I'm just on A+B for almost two years, just fine thank you, but I have zero health issues. OBTW nobody tells you that the penalty for signing up for part D late is miniscule. I am still looking for a medicare info channel that is not run by someone with skin in the game.
That part D penalty blew my mind. Totally crazy to pay a penalty to drug companies or government for the rest of my life. Obviously "payoff" to someone.
Thanks Stephanie for making these videos explaining in a simple, easy to follow way, all the information needed to understand what options are available and to make the right choices, even for a dummy like me before discovering your videos, had seemed like a very confusing Medicare subject.
I have an advantage plan and am very happy with it. It's cheap, and all of my favored providers are in the network, including a major medical teaching center.
WOW, I've never heard of this stuff, total newb, but I was able to understand everything she said. thank you for such a thorough, unbiased education! I'm excited to know about the Medicare Advantage plans!!
In my area it's easy. I have been insured through Kaiser's Advantage plan for 9 years. I pay Part B and basically that's it for fixed payments. Part D is covered. There are fees for procedures, which are modest. At the moment my meds are free as are lab tests. While this saves me a lot of money compared with supplemental plans, this is not the main reason why I like Kaiser. It is a unified system, so things don't slip through the cracks. You don't have to go round trying to find somebody to take Medicare (try to find an orthopod in LA who does) and the employees are salaried. No fee-for-service docs making unnecessary appointments or performing unnecessary procedures to make money.
Kaiser has the best healthcare delivery model, but really only works in high population metro areas due to the need for economies of scale. They are the highest rated insurer in every market they are in. I have them here in GA.
We live in Washington, and have had Kaiser for the last 5 years, they’ve taken good care of us. Trying to figure out if we want to go with an advantage plan with them, from all we’ve heard from our friends that’s not the way to go ( With an advantage plan no friend has Kaiser) at this point we’ve been away from our family doctor we’ve had for over 20 years now I and I am not sure if he’d take us back. Good to hear something good about Keizer ❤️
The point about medical underwriting is important. My husband decided to go back on regular Medicare and a gap plan after being on an Advantage plan. The advantage plan was very affordable but had a high deductible and out of pocket amount. When he applied for regular Medicare they looked at his health, and due to heart problems his monthly premium would be $379 plus another $33 for a Part D drug plan (plus the cost of Part B as well). The Advantage plan had been $65 a month and included Part D. We had quite a time figuring out which would be best.
@@AbtInsuranceAgency Really it's no problem if you're fortunate to have amassed extra thousands in bank. Need a truly citizen oriented system with equitable health care for all.
Thank you for being honest in your explanation of MAPD vs MedSup. I've been a broker for over 20 years and I am very objective when it comes to accessing a clients situation. Kudos to you.
I'm working in Medicare call center in pakistan and we are direct dealing with US citizens. But I want to start own my call center but I want loyal US license agent, we both can get good earning. Any one can contact me.
Biggest difference I found, none of my current doctors take an advantage plan! Plus finding specialist in the area was very hard. The supplemental was taken by all! So, for me, there was never a question on which I would choose. Central Florida area.
@@earlofmar7987 I have AARP United Health Supplemental and never had an issue seeing a specialist doc in the north Orlando area. Friends with Advantage plans have issues because of being in a network with limited docs. Other parts of the state may be different.
@@BuckshotPA1 Thanks BuckshotPA! These Medicare Agents try & talk you into this Advantage Plans. And they advertise them like there a "Catch All". Thanks for shinning a light on this for me. You are exactly right, each state and different parts of a state, have different Carriers and different coverage and cost different . I'm in a little town north of Houston, TX. I have Southern Guaranty - Aetna, as my Supplemental. Cost $120.00 They've covered everything 100% My Prescriptions I run thru United Health Care. It cost $85.00 for the plan. But they don't cover all of my prescriptions and I end up using GoodRX. And be careful, of some of the Med's that Medicare approves. They are made in China and are full of poison. Always ask your Pharmacist, where they are made.
More and more physicians and hospitals are no longer contracting with MedAdv carriers because they can’t get paid. It’s just not worth the hassle. Source: I work for a physician group.
I got a lot of valuable information from your overview! I try so hard to absorb all the information and appreciate you here! I love our seniors and I cannot wait to be fluently able to communicate this information as a broker easily and get to helping take care of our seniors very soon! Its a lot but I truly believe it will be all worth it in the end. Knowledge and a caring heart = a win win!
I’ve been paying into Medicare my entire working life. Now I am paying over $500 per month for my wife and I to be on Medicare and have a supplemental plan. That’s hardly socialism.
@@orwhat24 You must be kidding? If you were to purchase a similar policy for two without Federal government support the premiums would be over $40,000 per year. When you paid into Medicare that money went to others, it was not for your later benefit. . Be thankful for your socialized health care and for the Democrats.
When our supplemental policy got to over $500.00 per month (two of us combined) it was time for a change (increase premium each year - we are both 87). We are VERY happy after 2.5 years in our Advantage plan. Extra $500.00 per month in Discretionary savings/spending is a BIG deal.
Wow! Wish my plan would help me with food. Minimum expenses keep going up with no help from MC system. They are part of the rise in increasing cut into budget.
Thank you for all that information, I have been on Medicare Advantage in CA. for 8 years. It was easy I just paid my premiums to my union and was covered thru Kaiser including Rx. Now I have moved to South Carolina before open enrollment and it has become a big headache . Checking into supplemental with one company you have to qualify and the premiums are thru the roof, I will probably stick with a Advantage plan. Another thing that happens is once you inquire about plans the brokers pounce on you like you are fair game, there commission must be enormous.
A bit surprised you didn’t highlight that most, if not all, Advantage plans only pay up to 80% of the costs for chemotherapy and other Part B drugs, and even less if obtained out of network. As a volunteer Medicare counselor for a non-profit in Virginia, I always note that, which for many is a game changer. Also, we place emphasis the “guaranteed issue right” issue in terms of what path to take. As we like to say “you marry a Medigap plan, but date an Advantage plan”. Overall, great job of explaining things, really appreciate your videos.
Well, give that 50% of marriages end in divorce I'm not sure that is much of a selling point. Do you mean guaranteed issue or guaranteed renewable? With the exception of Dual, Nursing Home, C-SNP plans, you move out of service area, etc. I'm not aware of any MA plans that aren't both guaranteed issue or guaranteed renewable.
Thanks a lot David and ABT. You guys sent me back to square one. I don’t know what’s going on now. I thought that if you had original Medicare you would get that 80/20 split, but if you had a Medicare advantage they would pay 100% with you paying some kind of deductible. Now it looks like Medicare advantage is also doing the 80/20 split. Is that correct?
Found your post interesting to watch. I can't wait to see your post soon. Good Luck with the upcoming update. This video is very useful, interesting, and effective.
Madam can you please explain about HSA, HRA and FSA and your videos are awesome and you give a knowledge and awareness about traditional medicare and Medicare advantage plan and also for your service. Gods blessings , people blessings and Subscribers blessings are always there for you madam.
@@AbtInsuranceAgency Yes madam sure my name is Adam and i will call you regarding this topic madam and I am working in a billing office madam and Thankyou so much for your kind reply.
We have been on the Humana Advantage plan for years and are very happy with it. Co pays for office visits are low and the mail order prescription is very convenient and reasonable priced plus you receive a monthly allowance to purchase over the counter vitamins and such from a Humana catalog. Never had a problem finding a specialist but then we do live in a big city. in price. The only negative is it is a HMO so a primary care doctor writes a referral... Not a big deal but sometimes I forget to ask for one. Never had a problem finding a
I am still confused. I think if you would Show 3 columns 1) Standard Medicare 2) Medicare Advantage 3) Medicare supplement Then we would e able to compare more easily. I get all muddled up in the middle and have no idea what my coverage is. Explain it like I am a child.
When It Came Time For My Enrollment Into Medicare I Did My Own Research, And Then Contacted A Broker To Help Me Understand/Answer Questions I Had. The Broker Was Immensely Helpful. However, Two Points Were Never Brought Up In Their Initial Presentation Which I Had Listed As Needing Clarification, And Even Though I Have No Need (Or Help) For More Information I Still Watch Videos Such As This. I Have Yet To See Any Broker Or Professional Medicare Associate Mention These Items Which I Believe Would Help In Making An Informed Decision-1) That There Is An Annual Rate Increase For Medigap Plans And 2) Original Medicare Does Not Have Max Out-Of-Pocket Caps. I Always Wondered Why Those Were Never Mentioned.
Hi Michael, on your 2nd point that the Original Medicare have no max out of pocket cap, did you mean the patient can pay unlimited out of pocket? Thanks
@@SerenityEscape0823 Yes. A Medicare Patient Using Original Medicare Is Responsible For 20% Of The Part B Health Cost After A Small Deductible. Part A Is A Little Convoluted With Defined Coinsurance Based On Days In Hospital, But I Do Not Believe There Is A Max Out Of Pocket.
@@michaelbrooks133 Good to know. Thanks for the info, Michael. I watched a video from another channel and they way they put it sounded like the Original Medicare has no out of pocket other than a low deductibles because the Supplemental (MediGap) is supposed to cover the 20% that is not covered by the Original Med. Glad that I read your comments here. Thanks again.
@@SerenityEscape0823 You Are Welcome, However I Want To Make Sure I Am Not Misleading You And That I Fully Understand Your Original Question. My Response Was For Original Medicare Only. Supplemental Is A Policy Sold By Insurance Companies (With Strict Guidelines They Must Follow) That Will Pay Most (If Not All) That Medicare Does Not Pay For. Medigap/Supplemental Carries A Monthly Premium, But Is Considered Ideal For Those With High Health Care Costs And Can Afford The Premiums. Please Note For Both Plans A Separate Drug Policy Is Required, With Penalties If Not Followed.
@@SerenityEscape0823 from what I understand what's being described is Not having a medigap plan. Medicare part B alone will have an 80/20 split with you having 20% to pay and no cap that's why you buy a medigap supplement policy. The medigap takes care of the other 20% that's not included in the Medicare part B. They're supposedly a deductible on the supplement and then it pays the rest I believe that's the case I'm just learning myself. The problem is if you just have Medicare part A and part B there's No limit out of your pocket. Also of course get a part D or you'll have the penalty. But the whole purpose of the medigap policy is to cover that 20%.
Would suggest you identify that when you first are eligible for Medicare that if you do not take Part D there is a penalty for later enrollment ( should you take it in the future). Since many Medicare Advantage plans include Part D /drugs this would be covered, but not if you go the route of traditional Medicare. Best to get a plan D (even if you are not on any medication) and switch later (if another plan would better serve you) during the yearly open enrollment period to a different plan D. The penalty fee for taking Part D after the initial enrollment would be on top of the monthly premium for Part D. Overall a very concise and clear explanation of the two routes to Medicare coverage. Thanks.
Here in Palm Beach County Florida the Advantage plans are numerous and competitive and the largest plans have extensive Doctor participation, particularly Humana. The supplement plans become unaffordable as you age, once you are in your upper 70’s or 80 years old or more, you can be paying $500 a month, plus drug plan etc. I see most folks cannot maintain them as they get old and really need them. Nightmare!
Issued age supplements are way to go but people miss that because they are usually 10-20$ more expensive than group supplements and attained age supplements
Good explaination of Medicare options! My only suggestion would be to better explain "medical underwriting" i.e. what questions about your health will disqulaify you from purchasing a medicare supplament plan if you miss the initial open period. This extreamly important if and when you want to change form an Advantage Plan to supplament plan.
Good presentation! To the point, easy to understand and clear. The only a bit misleading point is that it's not necessarily "true"(always) that a Medicare eligible person would have to pay for "Part B premium". Depending on what state they live in and if their income does not exceed certain limits, they may qualify por programs that will pay in full or partially for the part B premium. Greetings
As a couple that are considered average, she has her Medicare part B taken out of her monthly SS payment. Being that I have a government pension and paid into SS for 9.5 years, I would likely not get a penny of SS even if I went back to work for a half year. I pay my quarterly Medicare part B by mail. Thank you for sharing that some folks need and are possible beneficiaries of some form of assistance. That's great for many to know, just as there are programs to help some afford medication if the individual qualifies. Thank you!
The fact that they go via zip code means people get the crap end of the deal. How much do Medicare Advantage plans receive from the government? How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021 What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
It seems to me that if you go with traditional Medicare part A and B you pretty much have to buy Part D for prescriptions and Medigap insurance for other things . And so now you are paying three premiums and you still do not have coverage for dental and maybe vision ?? It seems very expensive and you do not have full coverage ?? Why would anyone do that ?? Does not seem like a good way to go ???
Richard Warren I have an older plan F, no longer offered to new applicants, prior had an advantage plan, Have looked at advantage plans but the closest providers are 65 miles away (would like to save a few dollars but my local hospital and providers are only 1 mile away). I was pleased with my advantage plan when I lived in two other states where they were and the cost. As I get older, I prefer to not mess around. Apologize for the double post. Internet hiccup.
I watched this video because American health care is a mystery to me. American health care is very confusing. I'm just glad we have a universal healthcare system in Canada even with its faults still is not confusing. You go to the doctor or hospital and your province reimburses the doctor, health provider or hospital for that visit. Yes, you cannot get an MRI for everything you want because those are rationed in a public system however there are ways to get scans done sooner if there is a need. Sometimes people will travel to the US for healthcare which isn't available in Canada but that isn't often. It would need to be something super rare and unheard off still beats no coverage or the patchwork systems in the US
Ok, so $130/mo for supp, +$50/mo for dental/vision/hearing + $50/mo part d, is about $230/mo more. For that cost you get to use every provider instead of a network, have lower out of pocket max (what is typical?) Ok, what else am i missing in which supplement would be better? How are all of the copays and percentages different?
As a medical biller myself, majority of the pt doesn’t even know that they have a medicare advantage. They would still come in at the office giving out their medicare ID and only to figure out during verification that there is a medicare advantage. Not sure if that is a brokers fault. One thing as well is majority of the providers are out of network with MA. So if pt have PPO, that means higher pt responsibility on their bill even if you stated they pay less for premium while for HMO, no network coverage plus referral is needed. So if you don’t need too much perks, as a billers advise, go with the traditional and get a supplement period. I wont advise an MA because you will end up confused and arguing with the provider’s billing department. That’s my take. I’ve seen several pt regret getting the Medicare Advantage.
Thank you for the info, it was very informative and will probably give you a shout before fall. Sounds like Medicare supplemental plan is the way to go but should be done ASAP before my health takes a dive, LOL
What I ran into was nobody to tell me the best way to go, and while social security signs you up, they don't know anything or act that away. I think this process was written up to purposely confuse the participants. Why different prices depending on where you live, and why the mailbox full of ads and hundreds of phone calls, I viewed it as all a big scam so i chose the best I could.
Old adage, if it sounds too good to be true, it probably is. MA plans look cheap but in the long term this is usually not the case. Unfortunately, some people cannot afford the full supplement plan route. Still, I personally would not touch a MA plan with a ten foot pole.
I enrolled in the Advantage plan Nov 1, 2021after 7 years with a traditional supplement. Supposedly you can “unenroll” the Advantage plan if you do it by March 31st. I called to unenroll, which I could do by filling out an online form. My previous traditional supplement company told me they could reinstate my policy with a written request. Here is the problem… If I un-enrolled my Advantage plan when my old was reinstated, I would lose my Part D, prescription drug coverage. I called my old Part D provider & they said they couldn’t reinstate it because it was past the enrollment period. I just gave up & stayed with the Advantage even though I was happier with my old traditional supplement plan.
The Part D provider was incorrect. You can enroll in a Part D plan through March 31st using the Medicare Advantage Open Enrollment Period “special election” reason. You could also use your “Trial Right” to get re-enrolled in Part D. I would advise calling 1-800-MEDICARE(633-4227) and they should be able to help!
In Kansas, to get the full benefits of Medicare with a Supplement the Doctor must accept or be in network with Medicare. If Dr isn't in network the supplemental insurance can and often does deny the claim. So yes, you can choose your doctor but always ask if they are in network with Medicare to get full benefits available.
Hello there, recently new to Medicare as a licensed agent and I’m in supplement sales but for some reason advantage appears to dominate, I think largely due to the little to no cost monthly, but still believe in my heart that supplement is a more comprehensive and overall better plan, but I’m torn.
Thank you for this explanation. One thing not really explained are the extra benefits like coverage fir dental vision & the over the counter free bees . Why don’t those who pay a monthly supplement premium get an over the counter free bee card?
The State of Texas pays my $148 a month premium because my only income is $1150 social security and I have an advantage plan because the supplemental plans are very expensive and who cares about the 20% they don't pay, I don't. What are they going to do, ruin my credit? I'm 71 and broke, my credit rating has been in the toilet for years. I have 3 sons but none of them are rich, hard working boys who have families of their own to worry about. I worked hard all my life but only white collar thieves get rich. Work your fingers to the bone you get bony fingers.
I think allot of these TH-cam advisors who say supplements are always the most appropriate solution are motivated by commissions. If I sell someone a supplement I will get $585 plus a $50 bonus for a total of $635 in commission on the intial sale and $585 on renewal. If I sell an Advantage plan I will get $585 if this is a brand new person to medicare and $287 a year on all renewals. The premium numbers she quotes are also totally bogus, at least in NY State. Premiums in NY State range between $270 a month to $648 a month. Virtually every company writing Advantage plans has ZERO premium plans. So you can pay $4,000 to $6,000 or zero, it is your choice. She deliberately avoided mentioning PPO plans where yo can go to any doctor you want.
I recently met with a Medicare specialist through my doctor's office. The meeting lasted 1 1/2 hours, and I was still not sure what was what. This 11 minute video makes it completely clear to me now. Thanks so much!
You are so welcome! Call me anytime for free assistance. 888-465-9728.
I did the same. The presentation looked an invasion plan. All I got out of it was a headache.
@@weirdshibainu 😆😅
Watched another of your videos. You make everything so clear. You’re a great teacher/spokesperson for all us Seniors who have no clue to which path to choose. Thank you.
Wow, thank you!
Excellent overview!! You made it simple and easy to understand and covered the important elements of the pluses and minuses of both Medicare Advantage and the Medicare supplement plan. Thank you!!!
About time I find someone who explains the differences for me. I have looked and looked for someone to explain these with no help. Thank you so much.
I've been researching Medicare for my grandmother who turns 65 in October. I warned her against MA because of all the horror stories I read. Not once did I ever hear of a positive experience. The sad thing is you can't go back to original Medicare without underwriting if your initial open enrollment has passed. The main complaint I heard was they will deny every claim making the senior jump through hoops to get approved. Sounds like a nightmare.
Christine
Did you mean Medicare Advantage will deny every claim making a senior go through hoops? Or, Medigap making seniors jump through hoops to sign up after the initial underwriting grace period?
I'm pretty sure you can always go back to Original Medicare (Parts A & B), but you may not be able to pass underwriting for a Med Supplement policy. You should call Medicare and ask them this question specifically- as that's what they told me. *You'd have to elect to return to Original Medicare during the Annual Election Period which starts Oct. 15th I believe....I'm a newly licensed insurance agent myself & learning everything I can about Medicare right now! I hope this helps :)
Both plans are adequately explained by you, Stephanie. Thank you for the shared knowledge and your time.
Thank you so very much. Trying to choose a Medicare plan is the hardest decision I think I’ve ever made. Very confusing with so many options and nothing really explains it very well. Then Finally I found your channel. You really describe well and make it so simple to understand. Thank you.
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
Thanks for very elaborate information and removing my confusion. I didn’t know before the comparison with so much clarity. I am 66 and still working. I am now fully satisfied with my Medicare and BCBS supplemental plans. Thanks
This process is ultra confusing and your overview was very informative and understandable. I will be calling!
You thank us for watching but the thanks goes to you for making these videos. I've never been so confused in my life as I am by all of this Medicare information.
Call us with questions at any time!
I'm glad I choose you to be my independent Medicare agent. There is so much misinformation which seems to lean toward the advantage plans and very little information about the supplement plans its really difficult to make an informed decision. I appreciate your unbias information.
Gary I’m so grateful to have you as a client! 🙂
Very Good. Thanks
you know how to explain, very beautifully explained
@@usman_ali23 thank you!
Thank you Stephanie. This is a great explanation on the differences between Supplement and Advantage. I am a military retiree and will turn 65 Feb 2022. I now feel informed and able to engage TRICARE and get to the bottom of my options!
I am in same VA boat as you albeit I will turn 65 in November 2023, some issues I see are make sure you register for Tricare For Life (TFL)? I will probably do Medicare A/B and idk maybe D for added ease of using a local pharmacy. I doubt I will do Advantage and assume the $7,550.00 out of pocket risk annually. Eye, hearing, and dental I will do out of my own pocket.
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
After watching this video, I called your office and spoke with Samantha. She was very helpful. Thanks so much for the service you provide. I will likely be following up after I make a few business decisions.
Looking forward to it!
Great job explaining the differences. As a retired independent health insurance broker, I would show clients how Advantage plans could save them significant amounts of money - as long as they stayed healthy. However, if they got sick or even needed a relatively common surgery such as surgical repair of a broken bone, their out of pocket expenses could far exceed those of a supplement. With a $7500 potential exposure annually, they can be financially crippling. And heaven forbid, you break that bone while going to a Christmas party. You could be responsible for that $7500 in December and then again the following year in the event of complications. Finally, EVERY Advantage plan is managed care in one form or another. EVERY managed care plan I ever reviewed included the definition of 'medically necessary' as meaning 'least aggressive, least expensive treatment available'. If I or my loved one has a dread disease, I want more aggressive treatments. Advantage plans lose their value as we age and have to use them more. And once you get really sick, you may not be able to qualify for a supplement.
Very excellent points!
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
Florida has Moop at $1500 with Part B give back - and for those on Medicaid what ?
Thank you Roger. You hit the nail on the head for me. I'm 66, already enrolled in A & B and could not make up my mind between supplemental and advantage. Your explanation made it clear I need supplemental. I wish I could buy you a drink or cook you a steak. Thank you friend for taking the time and effort to help us out.
@@carolinacoins My pleasure. Glad I could help. Hope health insurance is the biggest waste of money in your life 🙂
Stephanie,. YOU are AMAZING!!! This Video was So Helpful.
Continued Success to YOU and Yours.
Warmly,
Kelly Chase
Thank you!!
This was one of the best explanations I have seen anywhere on the differences between Advantage and Supplement (or Medigap) options. My husband turns 65 in 14 months but many of our friends have tried already to guide me to whichever choice they made. I will be covered by my employer well after age 65, but this clarified many items for me. I bookmarked your site and I will contact you in the autumn before his Jan birthday. Great information.
I am finding the same thig. In talking to friends who are on Medicare if you don't agree to do exactly the same thig as they did, they actually get mad. Do your own research and a cost/benefit analysis of how you will use Medicare and your own health history.
First time exploring and signing up for medicare and your video was very simple and easy to understand. Now comes the question of which one to pick and the cost etc..
That’s what we can help with! Free service. 888-465-9728 😊
Thank you Stephanie, I watched some of the other videos of some of the other agents they had their own personal choices and what they would do not keeing in mind the customer , but not you you keep in mind the customer and what’s going to work for them
Thank you for that compliment, it means a lot! That's exactly what I aim to do.
Perfect, finally someone explained everything clearly. Thank you.
The fact that they go via zip code means people get the crap end of the deal.
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
I have had a supplement plan N for a few years but they talked me into switching to an Advantage plan. I had it for four months and my out of pocket expenses were more than my premium for plan N. Needless to say I switched back. I do have medical issues, so take that into mind if you go with the Advantage Plan. The deductibles can quickly add up!
Great point!
I have an F plan, which was the N + more of its day. Ever since the F was closed, I get mail almost every month from these nefarious agents , including my F Plan provider, touting the benefits of a cheaper Advantage plan.
I guess they think we seniors lose our faculties as we age, and they hope we will have a senior moment and sign onto their new plans.
Anyways, I can spot these mailings now so I just trash them unread.
My F Plan is expensive, but am happy to pay forward for the unknown which will inevitably come.
@@ashenaura exactly my friend. Live and learn applies! Thanks for your reply!
@@ashenaura
Thank you for sharing this information..🙏
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
I have an older plan F, no longer offered to new applicants, prior had an advantage plan, Have looked at advantage plans but the closest providers are 65 miles away (would like to save a few dollars but my local hospital and providers are only 1 mile away). I was pleased with my advantage plan when I lived in two other states where they were and the cost. As I get older, I prefer to not mess around. Yes, it costs more up front but you could easily burn through that 5,000 to 7,500 a year on the back side of an advantage plan. Sort of like the old "pay me now or pay me later."
Hi Richard, I am a licensed agent and sell lots of Supplement. One thing that might help you on your premium is to try to switch to Plan G. The only difference in Plan F and Plan G is plan F pays your part b Deductible and G doesn't. Typically F is about $330 more a year than G, so by going to G and paying the Part B Deductible you could save over $100 a year.
If you are in good health then a Medicare Advantage plan may be perfect. If you have medical problems then I recommend a supplement plan to augment A & B and Part D. My suppliment costs $240 a month but I am so glad that I have it. I have many medical problems.
I agree that Medigap plus Original Medicare is the best way to go, but that is generally an option for those in middle to upper income -- folks usually with multiple retirement income streams, not just Social Security. It is not an option at all for folks under 65 on SSDI/Medicare. I mostly serve the disabled and low income retirement community. Even $150 a month for a Plan N plus a Part D plan is unrealistic for most folks. That is the difference between having enough to eat and their power bill being paid and that's just the way it is. As for MA being just for the healthy, that has basis in reality. I have hundreds disabled clients clients on MA (99% in PPOs), folks with serious chronic conditions, and they never have any problems getting any and all the care they need.
It is important to remember that all of these instructional videos are made by folks who make their living on commissions. I think Miss Stephanie was pretty even handed. My wife is in open enrollment and I think we are going to go with the "Cadillac plan" (part G or N) for her. I'm just on A+B for almost two years, just fine thank you, but I have zero health issues. OBTW nobody tells you that the penalty for signing up for part D late is miniscule. I am still looking for a medicare info channel that is not run by someone with skin in the game.
We work very hard to be as unbiased as possible with the information we provide. Thanks for watching!
That part D penalty blew my mind. Totally crazy to pay a penalty to drug companies or government for the rest of my life. Obviously "payoff" to someone.
Thanks Stephanie for making these videos explaining in a simple, easy to follow way, all the information needed to understand what options are available and to make the right choices, even for a dummy like me before discovering your videos, had seemed like a very confusing Medicare subject.
Thank you so much for taking the time to leave this feedback! I am so glad the videos have helped you. Please call us anytime (888) 465-9728 :-)
I have an advantage plan and am very happy with it. It's cheap, and all of my favored providers are in the network, including a major medical teaching center.
Hello 👋 Helene m.. How are you doing today? And happy 😀 weekend to you over there 🤗
Don’t tease us like that Helene. Tell us what city and state you live in! Thanks
@@kevincolvin5205 Pennsylvania.
Wow!. You live in a good place.
@@keilana6 This is available to all Medicare recipients.
Excellent video. Thank you!
Glad it was helpful!
WOW, I've never heard of this stuff, total newb, but I was able to understand everything she said. thank you for such a thorough, unbiased education! I'm excited to know about the Medicare Advantage plans!!
Please interview your physician and hospital billers. They know more than anyone which carriers pay and which screw over you and your providers.
In my area it's easy. I have been insured through Kaiser's Advantage plan for 9 years. I pay Part B and basically that's it for fixed payments. Part D is covered. There are fees for procedures, which are modest. At the moment my meds are free as are lab tests. While this saves me a lot of money compared with supplemental plans, this is not the main reason why I like Kaiser. It is a unified system, so things don't slip through the cracks. You don't have to go round trying to find somebody to take Medicare (try to find an orthopod in LA who does) and the employees are salaried. No fee-for-service docs making unnecessary appointments or performing unnecessary procedures to make money.
Kaiser has the best healthcare delivery model, but really only works in high population metro areas due to the need for economies of scale. They are the highest rated insurer in every market they are in. I have them here in GA.
We live in Washington, and have had Kaiser for the last 5 years, they’ve taken good care of us. Trying to figure out if we want to go with an advantage plan with them, from all we’ve heard from our friends that’s not the way to go ( With an advantage plan no friend has Kaiser) at this point we’ve been away from our family doctor we’ve had for over 20 years now I and I am not sure if he’d take us back. Good to hear something good about Keizer ❤️
Great job Stephanie! I taught and counseled clients on Medicare for 15 years and this is a very good summary.
Thank you!
The point about medical underwriting is important. My husband decided to go back on regular Medicare and a gap plan after being on an Advantage plan.
The advantage plan was very affordable but had a high deductible and out of pocket amount. When he applied for regular Medicare they looked at his health,
and due to heart problems his monthly premium would be $379 plus another $33 for a Part D drug plan (plus the cost of Part B as well).
The Advantage plan had been $65 a month and included Part D. We had quite a time figuring out which would be best.
So important to remember. Thank you for sharing.
@@AbtInsuranceAgency Really it's no problem if you're fortunate to have amassed extra thousands in bank. Need a truly citizen oriented system with equitable health care for all.
I am 62 and starting to pay attention to this…thank you
Thanks so much for the clarity of this video. I have been struggling for a clear understanding. I must say you were spot on. Great job.
Thank you for the video!!! We learn a lot with you! Thank you!
My pleasure! ☺
Thank you for being honest in your explanation of MAPD vs MedSup. I've been a broker for over 20 years and I am very objective when it comes to accessing a clients situation. Kudos to you.
Thank you, that means a lot!
I'm working in Medicare call center in pakistan and we are direct dealing with US citizens. But I want to start own my call center but I want loyal US license agent, we both can get good earning. Any one can contact me.
Biggest difference I found, none of my current doctors take an advantage plan! Plus finding specialist in the area was very hard. The supplemental was taken by all! So, for me, there was never a question on which I would choose. Central Florida area.
My neighbor elderly father lives in Florida and has a difficult time getting in just to see the doctor. Have you experienced this?
@@earlofmar7987 I have AARP United Health Supplemental and never had an issue seeing a specialist doc in the north Orlando area. Friends with Advantage plans have issues because of being in a network with limited docs. Other parts of the state may be different.
@@BuckshotPA1 Thanks BuckshotPA! These Medicare Agents try & talk you into this Advantage Plans. And they advertise them like there a "Catch All". Thanks for shinning a light on this for me. You are exactly right, each state and different parts of a state, have different Carriers and different coverage and cost different . I'm in a little town north of Houston, TX. I have Southern Guaranty - Aetna, as my Supplemental. Cost $120.00 They've covered everything 100% My Prescriptions I run thru United Health Care. It cost $85.00 for the plan. But they don't cover all of my prescriptions and I end up using GoodRX. And be careful, of some of the Med's that Medicare approves. They are made in China and are full of poison. Always ask your Pharmacist, where they are made.
More and more physicians and hospitals are no longer contracting with MedAdv carriers because they can’t get paid. It’s just not worth the hassle. Source: I work for a physician group.
@@earlofmar7987 " They are made in China and are full of poison." You got proof?
Being a medical biller, Its a good info.for sending claims.
a big TY from 🇵🇰
Thank you for sharing this information, very helpful and informative. Your awesome!!
Great Video Stephanie!
Thank you!
I got a lot of valuable information from your overview! I try so hard to absorb all the information and appreciate you here! I love our seniors and I cannot wait to be fluently able to communicate this information as a broker easily and get to helping take care of our seniors very soon! Its a lot but I truly believe it will be all worth it in the end. Knowledge and a caring heart = a win win!
Absolutely!
Thanks for the sage adviise. You are Informed and trust worthy. ^5
Smile 😊
Hello 👋 Jamie.. How are you doing today? And happy 😀 weekend to you over there 🤗
I just turned 65. Socialized medicine is great. Why not give this benefit to everyone in America?
I’ve been paying into Medicare my entire working life. Now I am paying over $500 per month for my wife and I to be on Medicare and have a supplemental plan.
That’s hardly socialism.
@@orwhat24 You must be kidding? If you were to purchase a similar policy for two without Federal government support the premiums would be over $40,000 per year. When you paid into Medicare that money went to others, it was not for your later benefit. . Be thankful for your socialized health care and for the Democrats.
@@orwhat24 You are blessed to be able to afford that.
Thank you so much Stephanie these video's are so very helpful.
When our supplemental policy got to over $500.00 per month (two of us combined) it was time for a change (increase premium each year - we are both 87). We are VERY happy after 2.5 years in our Advantage plan. Extra $500.00 per month in Discretionary savings/spending is a BIG deal.
Wow! Wish my plan would help me with food. Minimum expenses keep going up with no help from MC system. They are part of the rise in increasing cut into budget.
Good job, making it easy as possible to understand,
Thank you for all that information, I have been on Medicare Advantage in CA. for 8 years. It was easy I just paid my premiums to my union and was covered thru Kaiser including Rx. Now I have
moved to South Carolina before open enrollment and it has become a big headache . Checking into supplemental with one company you have to qualify and the premiums are thru the roof, I will
probably stick with a Advantage plan. Another thing that happens is once you inquire about plans the brokers pounce on you like you are fair game, there commission must be enormous.
Made sense thank you for explaining it
A bit surprised you didn’t highlight that most, if not all, Advantage plans only pay up to 80% of the costs for chemotherapy and other Part B drugs, and even less if obtained out of network. As a volunteer Medicare counselor for a non-profit in Virginia, I always note that, which for many is a game changer. Also, we place emphasis the “guaranteed issue right” issue in terms of what path to take. As we like to say “you marry a Medigap plan, but date an Advantage plan”. Overall, great job of explaining things, really appreciate your videos.
The 20% on chemo and Part B drugs with Medicare Advantage is an important factor to consider, absolutely. Thank you for watching!
Independen 65
Well, give that 50% of marriages end in divorce I'm not sure that is much of a selling point. Do you mean guaranteed issue or guaranteed renewable? With the exception of Dual, Nursing Home, C-SNP plans, you move out of service area, etc. I'm not aware of any MA plans that aren't both guaranteed issue or guaranteed renewable.
Thanks a lot David and ABT. You guys sent me back to square one. I don’t know what’s going on now. I thought that if you had original Medicare you would get that 80/20 split, but if you had a Medicare advantage they would pay 100% with you paying some kind of deductible. Now it looks like Medicare advantage is also doing the 80/20 split. Is that correct?
Excellent commentary. Brava!
Great job explaining this topic. As a financial advisor I run into this. I'm sharing with a client.
Found your post interesting to watch. I can't wait to see your post soon. Good Luck with the upcoming update. This video is very useful, interesting, and effective.
Madam can you please explain about HSA, HRA and FSA and your videos are awesome and you give a knowledge and awareness about traditional medicare and Medicare advantage plan and also for your service. Gods blessings , people blessings and Subscribers blessings are always there for you madam.
Please give us a call anytime at (888) 465-9728. I will take notes on some future video topics as well :-)
@@AbtInsuranceAgency Yes madam sure my name is Adam and i will call you regarding this topic madam and I am working in a billing office madam and Thankyou so much for your kind reply.
Thank you. I was tottally confused and now feel I understand it better.
Thanks for these very important informations.
Glad it was helpful!
Appreciate you breaking this down for us stephanie! Thanks ☺️
Always a great video filled with valuable and unbiased information
We have been on the Humana Advantage plan for years and are very happy with it. Co pays for office visits are low and the mail order prescription is very convenient and reasonable priced plus you receive a monthly allowance to purchase over the counter vitamins and such from a Humana catalog.
Never had a problem finding a specialist but then we do live in a big city.
in price. The only negative is it is a HMO so a primary care doctor writes a referral... Not a big deal but sometimes I forget to ask for one. Never had a problem finding a
I am still confused. I think if you would Show 3 columns 1) Standard Medicare 2) Medicare Advantage 3) Medicare supplement Then we would e able to compare more easily. I get all muddled up in the middle and have no idea what my coverage is. Explain it like I am a child.
We will continue to work hard to make our videos as simple and accurate as possible!
When It Came Time For My Enrollment Into Medicare I Did My Own Research, And Then Contacted A Broker To Help Me Understand/Answer Questions I Had. The Broker Was Immensely Helpful. However, Two Points Were Never Brought Up In Their Initial Presentation Which I Had Listed As Needing Clarification, And Even Though I Have No Need (Or Help) For More Information I Still Watch Videos Such As This. I Have Yet To See Any Broker Or Professional Medicare Associate Mention These Items Which I Believe Would Help In Making An Informed Decision-1) That There Is An Annual Rate Increase For Medigap Plans And 2) Original Medicare Does Not Have Max Out-Of-Pocket Caps. I Always Wondered Why Those Were Never Mentioned.
Hi Michael, on your 2nd point that the Original Medicare have no max out of pocket cap, did you mean the patient can pay unlimited out of pocket? Thanks
@@SerenityEscape0823 Yes. A Medicare Patient Using Original Medicare Is Responsible For 20% Of The Part B Health Cost After A Small Deductible. Part A Is A Little Convoluted With Defined Coinsurance Based On Days In Hospital, But I Do Not Believe There Is A Max Out Of Pocket.
@@michaelbrooks133 Good to know. Thanks for the info, Michael. I watched a video from another channel and they way they put it sounded like the Original Medicare has no out of pocket other than a low deductibles because the Supplemental (MediGap) is supposed to cover the 20% that is not covered by the Original Med. Glad that I read your comments here. Thanks again.
@@SerenityEscape0823 You Are Welcome, However I Want To Make Sure I Am Not Misleading You And That I Fully Understand Your Original Question. My Response Was For Original Medicare Only. Supplemental Is A Policy Sold By Insurance Companies (With Strict Guidelines They Must Follow) That Will Pay Most (If Not All) That Medicare Does Not Pay For. Medigap/Supplemental Carries A Monthly Premium, But Is Considered Ideal For Those With High Health Care Costs And Can Afford The Premiums. Please Note For Both Plans A Separate Drug Policy Is Required, With Penalties If Not Followed.
@@SerenityEscape0823 from what I understand what's being described is Not having a medigap plan. Medicare part B alone will have an 80/20 split with you having 20% to pay and no cap that's why you buy a medigap supplement policy. The medigap takes care of the other 20% that's not included in the Medicare part B. They're supposedly a deductible on the supplement and then it pays the rest I believe that's the case I'm just learning myself. The problem is if you just have Medicare part A and part B there's No limit out of your pocket. Also of course get a part D or you'll have the penalty. But the whole purpose of the medigap policy is to cover that 20%.
Would suggest you identify that when you first are eligible for Medicare that if you do not take Part D there is a penalty for later enrollment ( should you take it in the future). Since many Medicare Advantage plans include Part D /drugs this would be covered, but not if you go the route of traditional Medicare. Best to get a plan D (even if you are not on any medication) and switch later (if another plan would better serve you) during the yearly open enrollment period to a different plan D. The penalty fee for taking Part D after the initial enrollment would be on top of the monthly premium for Part D. Overall a very concise and clear explanation of the two routes to Medicare coverage. Thanks.
Thank you! We do cover that information in many of our other videos.
It is crazy & I will NEVER understand the lifetime penalty. Sure willing to pay a penalty for late sign up but for whole life?
Your welcome Jamie! I know you have a hard job and Medicare rules are constantly changing. Good luck to you&your clients.
This was a fantastic overview! YOU have made things so clear for me. Thank you so much!
Simple and clear explanation thank you will be calling
I just want to say thank you for your videos! They are very helpful!!!
I'm now 66. This medicare makes me cry. I still cannot make a decision. I'm so confused .
We help people just like you everyday, and our service is 100% free. Call us at 888-465-9728.
Here in Palm Beach County Florida the Advantage plans are numerous and competitive and the largest plans have extensive Doctor participation, particularly Humana. The supplement plans become unaffordable as you age, once you are in your upper 70’s or 80 years old or more, you can be paying $500 a month, plus drug plan etc. I see most folks cannot maintain them as they get old and really need them. Nightmare!
Issued age supplements are way to go but people miss that because they are usually 10-20$ more expensive than group supplements and attained age supplements
Good explaination of Medicare options! My only suggestion would be to better explain "medical underwriting" i.e. what questions about your health will disqulaify you from purchasing a medicare supplament plan if you miss the initial open period. This extreamly important if and when you want to change form an Advantage Plan to supplament plan.
Good presentation! To the point, easy to understand and clear. The only a bit misleading point is that it's not necessarily "true"(always) that a Medicare eligible person would have to pay for "Part B premium". Depending on what state they live in and if their income does not exceed certain limits, they may qualify por programs that will pay in full or partially for the part B premium.
Greetings
As a couple that are considered average, she has her Medicare part B taken out of her monthly SS payment. Being that I have a government pension and paid into SS for 9.5 years, I would likely not get a penny of SS even if I went back to work for a half year. I pay my quarterly Medicare part B by mail. Thank you for sharing that some folks need and are possible beneficiaries of some form of assistance. That's great for many to know, just as there are programs to help some afford medication if the individual qualifies. Thank you!
That’s true, medicaid can help to pay their part B premiums if they qualify income wise.
So what kind of income do we need to have to qualify for the Medicaid assistance for the part B you guys are talking about? Specifically California.
The fact that they go via zip code means people get the crap end of the deal.
How much do Medicare Advantage plans receive from the government?
How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.Sep 21, 2021
What makes me so mad is that most Social Security do not receive a $1,000. dollars for a monthly payment. So no wonder all of those commercials trying to sign people up from the insurance companies. Talk about corrupt and the draining of Social security/Medicare so it will fail. Get off paying the insurance our money at a fat profit.
It seems to me that if you go with traditional Medicare part A and B you pretty much have to buy Part D for prescriptions and Medigap insurance for other things . And so now you are paying three premiums and you still do not have coverage for dental and maybe vision ?? It seems very expensive and you do not have full coverage ?? Why would anyone do that ?? Does not seem like a good way to go ???
SO incredibly helpful. MANY THANKS!
Smile 😊
Hello 👋 Vera... How are you doing today? And happy 😀 weekend to you over there 🤗
As a 20yr agent I see this as a fairly good description by comparison of the 2 kinds of supplements.
Well done explanation, Stephanie. Thank you.
I did not read the Medicare book because I am not a rocket scientist.I picked Blue cross blue shield as here in Illinois they are a great brand.
Richard Warren
I have an older plan F, no longer offered to new applicants, prior had an advantage plan, Have looked at advantage plans but the closest providers are 65 miles away (would like to save a few dollars but my local hospital and providers are only 1 mile away). I was pleased with my advantage plan when I lived in two other states where they were and the cost. As I get older, I prefer to not mess around. Apologize for the double post. Internet hiccup.
Thanks for this input! Plan F definitely gives you comprehensive coverage and provider freedom.
I watched this video because American health care is a mystery to me. American health care is very confusing. I'm just glad we have a universal healthcare system in Canada even with its faults still is not confusing. You go to the doctor or hospital and your province reimburses the doctor, health provider or hospital for that visit. Yes, you cannot get an MRI for everything you want because those are rationed in a public system however there are ways to get scans done sooner if there is a need. Sometimes people will travel to the US for healthcare which isn't available in Canada but that isn't often. It would need to be something super rare and unheard off still beats no coverage or the patchwork systems in the US
Ok, so $130/mo for supp, +$50/mo for dental/vision/hearing + $50/mo part d, is about $230/mo more. For that cost you get to use every provider instead of a network, have lower out of pocket max (what is typical?) Ok, what else am i missing in which supplement would be better? How are all of the copays and percentages different?
I have had an advantage plan and I will be moving to another one come open enrollment. A advantage plan is good if you are in good health.
I am verifier it's information very helpfull for me for customers convince thank you mam
As a medical biller myself, majority of the pt doesn’t even know that they have a medicare advantage. They would still come in at the office giving out their medicare ID and only to figure out during verification that there is a medicare advantage. Not sure if that is a brokers fault. One thing as well is majority of the providers are out of network with MA. So if pt have PPO, that means higher pt responsibility on their bill even if you stated they pay less for premium while for HMO, no network coverage plus referral is needed. So if you don’t need too much perks, as a billers advise, go with the traditional and get a supplement period. I wont advise an MA because you will end up confused and arguing with the provider’s billing department. That’s my take. I’ve seen several pt regret getting the Medicare Advantage.
I can confirm as I worked as a case manager for a health insurance company and I spoke with many frustrated members about receiving denials.
Thanks
Thank you for the information
Great video .... thank you! Referred to all my senior friends.
Thank you for the info, it was very informative and will probably give you a shout before fall. Sounds like Medicare supplemental plan is the way to go but should be done ASAP before my health takes a dive, LOL
We look forward to speaking with you!
What I ran into was nobody to tell me the best way to go, and while social security signs you up, they don't know anything or act that away. I think this process was written up to purposely confuse the participants. Why different prices depending on where you live, and why the mailbox full of ads and hundreds of phone calls, I viewed it as all a big scam so i chose the best I could.
Thank you so much, this was very very helpful.
Old adage, if it sounds too good to be true, it probably is. MA plans look cheap but in the long term this is usually not the case. Unfortunately, some people cannot afford the full supplement plan route. Still, I personally would not touch a MA plan with a ten foot pole.
Canada and The U.K have free healthcare for all, Maybe one day we will too in America...
Better understanding. Thanks so much.
Your explanation is very clear thank you
I enrolled in the Advantage plan Nov 1, 2021after 7 years with a traditional supplement. Supposedly you can “unenroll” the Advantage plan if you do it by March 31st. I called to unenroll, which I could do by filling out an online form. My previous traditional supplement company told me they could reinstate my policy with a written request. Here is the problem… If I un-enrolled my Advantage plan when my old was reinstated, I would lose my Part D, prescription drug coverage. I called my old Part D provider & they said they couldn’t reinstate it because it was past the enrollment period. I just gave up & stayed with the Advantage even though I was happier with my old traditional supplement plan.
The Part D provider was incorrect. You can enroll in a Part D plan through March 31st using the Medicare Advantage Open Enrollment Period “special election” reason. You could also use your “Trial Right” to get re-enrolled in Part D. I would advise calling 1-800-MEDICARE(633-4227) and they should be able to help!
FINALLY!!!... Understand it!! THANK YOU!
In Kansas, to get the full benefits of Medicare with a Supplement the Doctor must accept or be in network with Medicare. If Dr isn't in network the supplemental insurance can and often does deny the claim. So yes, you can choose your doctor but always ask if they are in network with Medicare to get full benefits available.
Hello there, recently new to Medicare as a licensed agent and I’m in supplement sales but for some reason advantage appears to dominate, I think largely due to the little to no cost monthly, but still believe in my heart that supplement is a more comprehensive and overall better plan, but I’m torn.
Thank you for this explanation. One thing not really explained are the extra benefits like coverage fir dental vision & the over the counter free bees . Why don’t those who pay a monthly supplement premium get an over the counter free bee card?
The State of Texas pays my $148 a month premium because my only income is $1150 social security and I have an advantage plan because the supplemental plans are very expensive and who cares about the 20% they don't pay, I don't. What are they going to do, ruin my credit? I'm 71 and broke, my credit rating has been in the toilet for years. I have 3 sons but none of them are rich, hard working boys who have families of their own to worry about. I worked hard all my life but only white collar thieves get rich. Work your fingers to the bone you get bony fingers.
Wish I lived in Texas. Would really help to have help paying Part B premium. Our SS incomes are similar.
I think allot of these TH-cam advisors who say supplements are always the most appropriate solution are motivated by commissions. If I sell someone a supplement I will get $585 plus a $50 bonus for a total of $635 in commission on the intial sale and $585 on renewal. If I sell an Advantage plan I will get $585 if this is a brand new person to medicare and $287 a year on all renewals. The premium numbers she quotes are also totally bogus, at least in NY State. Premiums in NY State range between $270 a month to $648 a month. Virtually every company writing Advantage plans has ZERO premium plans. So you can pay $4,000 to $6,000 or zero, it is your choice. She deliberately avoided mentioning PPO plans where yo can go to any doctor you want.
You are the best!!! Thank you, Thank you, Thank you.
Great information and well presented! Thank you!
Amazing video!!! Great teacher!
Thank you Gillian 🙏🏼
PS on below meant to print, sure wish we could have a medical plan like Canada.
I like your videos
Thank you!