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As I understand it, you don't get denied to switch to regular medicare. You only get denied access to those medigap private companies that don't like your answers to the underwriting questions. Because this presenter is an insurance agent, he isn't discussing going only to original medicare, and just paying the 20% co pay (and whatever else you gotta pay). That is what I did. Your options are 1. Original medicare 2. Any available advantage plan (no, just don't go there!) 3. Original medicare PLUS medigap 4. Any of the first three, plus part D to cover drugs. That is MY understanding, and I am not an expert, so double check everything I said. I had eye surgery AND heart surgery this year under regular medicare, absolutely no problems, no insurance company between me and my doctors, no delays or insurance company delays or approvals. I recommend option 1. This presenter is suggesting options 3 and 4, which are also a reasonable approach. Be very suspicious of any agent pushing "advantage". They look good at first, but as soon as your health issues start going downhill, they avoid approving procedures and they hope you will die before they approve the procedure that might keep you alive.
One thing that seems to be going on at present is that corporations that promised health care to their retirees are putting their retirees on MA, not providing a supplement as may have been promised. I know that in one case, New York City, a lawsuit is underway. My brother is a victim of this bait and switch.
Thank You !!! I have a supplement plan G and glad I do !!!! Watching your video that explains the qualifications to get out of an Advanced plan makes me glad I have it !!! NO HEALTH WORRIES DOWN THE ROAD !!!! THANKS AGAIN 😊😊😊😊😊😊
Very good and clear video. From watching this, I probably could transition from MA to original Medicare with supplement. My wife, with type 1 diabetes and rheumatoid arthritis could not. We both chose original Medicare with part G supplements during the open enrollment period (turning 65) so we do not have MA downsides to worry about.
Thank you, this was actually very helpful. My Mom is 90 and didn't know that when she switched to a Cost plan that she was switched out of regular Medicare. She can honestly answer no to all of those questions! I'll have to talk to her about this.
MA plans don't work with The Mayo Clinic and they are one of the best hospitals in the country. They accept MediGap. That tells you that MA plans are lousy.
@@douglasjensen8986 Ummm, if your Mayo physician gave you outpatient treatments or admitted you inpatient for care and it was not preauthorized by your MA plan, it could be a problem, especially if the outapatient or inpatient care center was not in the MA's network.
Thanks! I was just advised to have knee replacements on both knees. I'm not planning to do it, but I will need to wait at least a year to leave my Advantage plan.
It seems most MA plans are different. My mother had Aetna MA with our retirement system as do I. Mom had outstanding coverage. But she was very healthy, lived until almost 102. Covid did put her in the hospital for a week when she was 101. I am now 80 and have the same very good coverage....However I'm choosing to have a recently govt approved surgical procedure done in lieu of spinal fusion. My MA curently deem it not covered! They will review the procedure again 6/25. But the traditional Medicare A & B will cover....they have to....and a Supplemental (Medigap) will pay the rest of what Medicare doesn't. So I was just told by....United Healthcare......who now we all know hasn't a good reputation... I qualify for a supplemental plan even at my age. All my answers are no.
Great Videos. I was told i have 1 year from the time Part B started to switch and get a medigap policy without going thru underwriting. Also, if you have an employer plan you can always go back to standard Medicare with a supplemental without underwriting any time. Is this correct ?
That's correct. If you initially enroll in a Medicare Advantage plan, you have a one-year trial period during which you can switch to a Medigap plan with guaranteed issue rights, meaning no medical underwriting. However, if you only enroll in original Medicare (Parts A and B) without an additional plan, you have a six-month period from the start of your Part B coverage to enroll in a Medigap plan with guaranteed issue rights. In regards to returning back to work here is a video explaining how that would look th-cam.com/video/4GtRppYTHho/w-d-xo.html
We had a friend of the family insurance agent. He had us sign a paper to use him for our Medicare. Can we get rid of him or did we sign a binding contract???
Thank you for this helpful information! I qualify medically to switch from advantage plan to supplement and would like to switch prior to March 31st. My prescriptions are currently provided through my advantage plan. How do I get RX coverage if I switch?
I’ve got the advantage plan with Anthem And I’ve never had the first problem I actually went straight to a mri instead of always in the past you have to get a xray first then a CT scan and I’ve always gone to a immediate MRI within a week
This gentlemen presents misleading information in my experience/ opinion. My experience with an advantage plan has been similar to yours. My Aetna Medicare PPO Advantage plan has been tremendous. I have had a knee replacement, breast cancer surgery with radiation, and rotator cuff surgery the last 8 years with no hassles, no prior authorizations and very little out of pocket. It comes with hearing and dental benefits and a gym membership. No doctor has ever denied me coverage and the care has been excellent. I can’t figure out why anyone would not want an advantage plan! Perhaps the issue is where someone lives?
@@janetbetts5159 That's exactly what l am wondering after hearing all this.. my mother has had a hip replacement and knee replacements without an issue..
With respect to leav8ng and Advantage plan to supplemental, what about during the Trial Period? Also, what about if you move to another state? There seems to be information missing here.
Those are all special scenarios which we have other videos that discuss those scenarios. This is specifically for those that don't have a trial right period any more or don't plan to move.
I have lot more to learn. i thought it wl be easy. my husband is already going to 62. were not US citizens- but green card holder. really confuse with this healthcare system in US. i wl have to learn more. And I dont want to make a mistake .
I live in California and turned 65 last May 2024 and enrolled in Medicare A & B and Kaiser Permanente Advantage. During the current Open Enrollment Oct-Dec for year 2025 I want to enroll in Original Medicare + Plan G Medigap. Will I be subject to the 30 health questions and underwriting?
It depends on when your Part B started, you have a 6 month open enrollment from that date to get a supplement plan with no underwriting. So if your Part B started 5-1-2024, you have until the last day of this month to get a supplement with no underwriting. If you wait past that day you will have to go through underwriting. Give us a call we'd be happy to help, you can reach us at 1-800-864-8890.
I sure get a pile of mail every year during the enrollment period from companies who want to sell me a plan. They seem pretty eager for a company who secretly wants to deny the coverage.
Excellent video, but you may way to edit (if you can) the 17:15 mark as you say "getting an Advantage Plan", when you obviously meant "leaving an Advantage Plan".
And in his example about signing up on the bulletin board, he put a birthday of 3-15-59, which means your eligible for Medicare 3-15-25, not 3-15-24.. l find these things very confusing when listening!
@@RC-vv6nr good point. I am coming from $1000/mo. for small business plan insurance, so Traditional Medicare is cheap. But many had near free medical so these number look big.
Each carriers questions may vary. You can contact the carrier you are seeking and possibly ask for what their questionnaire includes. As they are not the same for all.
Tabaco use usually doesn't disqualify you when going through underwriting, you might pay a higher copay. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
If I have am on an Advantage Plan in Florida for 2 or 3 years, then move to Georgia, do I have to go through underwriting to get a Supplement (N or G) in the new State?
Since you are moving that would be GI (guaranteed issue) plan doesn't require underwriting. If you'd like a broker like us to help, we'd need to go through the underwriting process. Otherwise, you'll need to sign up directly with the carrier to avoid underwriting. If you have questions about this you can call our office as well at 1-800-864-8890.
Advantage plans have no issues making changes. The only thing is you have to make those changes during the annual enrollment period! If you'd like any assistance please call our office at 1-800-864-8890.
I chose an advantage plan. But the only thing l had to do to cancel it was go to Urgent care only to find out they did Not accept that plans coverage. Case and plan dismissed. AMEN
They cover any emergency in any emergency room but not an out of network urgent care, only in network urgent cares. Its a wonder you didnt have that information before you picked the urgent care to go to.
Just wondering about Plan G. I have been on an Advantage Plan with Medicaid and Medicare. I am now losing Medicaid. Would I qualify for Guaranteed Issue because of this. I do have the letter stating losing as of October 1? Any suggestions on what to do? Also, the Advantage Plan I have is for D-SNP they do not have any plans for not being D-SNP. I was told by one of your agents that I would have to call the insurance company to find out what they require for G-I. Sorry but I thought that was why we call you for help.
@@DiChitty I have heard many leaving Plan F because it's a closed plan since Jan 2020, and the prices are going up. The prices are going up, because they are unable to attract new 65 year old's, who often are healthier.
anneaugello Yes, you would still have to pay the 175.70 for your Part B plan,it would still be taken out of your social security check; and also, you would pay the Supplemental premium, and, if you wanted one, get and pay for a Part D plan (prescription drug) too.
Yes, if you are receiving social security the part B premium will be deducted from your social security check. if you're not receiving Social Security, you'll receive a bill for your Part B premium from Medicare. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
Yeah..this video is misleading, I have had a Medicare Advantage PPO plan for 9 years. I pay $77. Month in premiums and have had first class care for breast cancer, knee replacement and rotator cuff surgery. I pay $30 to see a specialist with no referral involved. I have never had a doctor refuse to see me and every time I have needed a special procedure (MRI, Ultrasound, CT scan, etc….i have gotten it without a referral and in a timely manner.). This video is misleading. Years ago I switched medical coverage during open enrollment….with no questionnaire involved. Open Enrollment is exactly that.
Yeah, they are great..until you have a serious health problem..then you are screwed. Great insurance right up until you need it…then you are SOL. I saw a friend wait nearly a year for a “pre-approval” for a procedure….the condition because much worse while waiting. Waited until the procedure was no longer a viable choice because the condition progressed.
@@Katiekatie948 an Advantage Plan can be either an HMO or a PPO….that’s what creates the issue of needing a referral. I have a PPO Plan and within a half hour of having a mammogram that indicated I needed further testing, i was given an ultrasound….an hour later I had a breast biopsy. Two days later it came back as a cancer diagnosis. But I chose a plan with a monthly co-pay not one with a zero payment….makes all the difference!
@@douglasjensen8986 Right.. my mother has had a hip replacement and two knee replacements on MA, without an issue.. maybe it depends on what state you are in??
In that scenario, you won’t have to go through underwriting as you’ll have a guaranteed issue right. However, there is usually a short window to make the change-typically 30-60 days-to get signed up with a new plan if your current plan is no longer available. If you have any questions or need assistance, feel free to reach out!
It depends on your situation. Some employers have very good health insurance plans. My wife and son don’t pay for their health insurance. Most countries with public health coverage pay for it with special tax levies, so it is not exactly “free”.
@@MrStan0630true…but…those countries do not have runaway price gouging by private equity. Health care is still NONPROFIT elsewhere. Here…pricing according to what the equity corporation wants to make in profit.
No, the Part B effective date is not necessarily the same as the Part A effective date. While many people enroll in both Part A and Part B at the same time, some individuals may delay enrollment in Part B if they have other health coverage, such as employer-sponsored insurance (20 employees or more) , it's crucial to coordinate your enrollment in both Part A and Part B according to your specific circumstances and needs. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
He was only reading questions from Section 4, these are the main questions that would determine if you qualify or not. So other questions wouldn't be as important in deciding if they accept you.
Save your money. Lots of people stuck on MA are there because at the time they started medicare, they didn't have enough money to start paying out a large insurance payment every month, so they just went with the polcy type that cost the least at the time, and hoped they wouldn't get seriously ill. Once stuck on MA, you would be permanently stuck, unless you win the lottery and can self insure.
@@d.e.b.b5788The captative agents, and those that push Advantage plans to get the biggest commission for life, never fully explain what the co-insurance or the deductibles really are for. They buy leads, and constantly call you, against CMS rules. They won't tell you what an advantage plan covers if you get cancer. They won't tell you their standard is to pay for lesser drugs and procedures first, even if it against your doctors orders. They won't tell you you will be kicked out of rehab at a certain day against your doctors orders, because they simply stop paying for it, making you 100% responsible after that. But they do say, Its 0 cost to you, and some say its free for you. they certainly love to brag about their perks. They never tell you if you want to switch to a medsup plan you are required to medically qualify after your IEP. I completely blame CMS for allowing all this to continue. There should never be commissions for life. Seniors are being preyed upon every single day.
It depends on when you are trying to add that on, after a certain age those plan also require underwriting. They aren't as intense as supplement underwriting, but if you qualify it can certainly be added on. Give us a call we'd be happy to help, you can reach us at 1-800-864-8890.
You can fast forward thru videos to the parts you want very easily in a couple different ways. I personally like watching the videos in it's entirety to understand the full explanation of what Marvin is conveying in all of his videos. That's just me but I'm sure that many others are the same way.
JoyGardner, you can increase/decrease the audio speed in TH-cam by one, two, three notches. I like Marvin's explanation. He sticks to his topic & often gives helpful background or context information related to his topic. Marvin speaks pretty quickly! 😂🎉
Please speak to Dr. Oz who may be in charge of Medicare under the Trump presidency. Dr. Oz thinks Advantage plans are the best. I've heard he will push for all retirees to join Medicare Advantage plans. We need a choice.
Time for single payer health care. Whats going to happen to the insurance industry when we all fail the qualifications for health, property and auto? We know what will happen to us customers.
@@jaggillar6680 A single payer health system is a terrible idea. You need competition to have decent prices, care and options. Do sone homework before you spout nonsense.
This country has the most incredibly screwed up system of medical care that anyone could ever imagine. I wish I lived in a civilized country that had medical care for all, or at least that didn't treat medical care as if it was a for-profit business (don't let the supposed non-profit, mostly church related plans fool you---they are there to make money for their church). We pay more for medicine, surgery, procedures than any other country. And the care isn't that great.
Question 1...I do not have a PCP and have not been to a dr in well over 2 years and will likely not see one before I am on Medicare next year. If I am understanding you correctly, I would then not have any, diagnosed, treated, etc. conditions. Everything would be no then on the time-specific questions, correct? I have no active scripts, nothing at all since 2022; and Question 2...If I do not have a PCP how would an underwriter "look into" anything? Thank you for taking the time to read/respond.
Since you are just turning 65, underwriting does not apply you to. You do not have to go through underwriting the first 6 months of starting Medicare Part B. So no one would be taking your health into consideration at the time you apply.
@@MedicareSchool I understand your response. I am asking, hypothetically, if a person selected an Advantage plan and then at the next OE, want to go to a Medigap plan, with no PCP, having not been treated for more than 3 years by any physician, how would an underwriter "look into" the answers to the 30 questions? and, Under that scenario, no dr/no treatment/diagnoses all answers would then be "no" since no dr visits, correct? If it's been 4 years since a person was at a dr and treated, that is outside the scope of the questions.
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Medicare School gets an A+ for its excellent financial and Medicare content. Well done, Medicare School. Teaching suits you well!
Wow, thank you!
I would be curious to know how many people try to switch to Regular Medicare and are denied.
As I understand it, you don't get denied to switch to regular medicare. You only get denied access to those medigap private companies that don't like your answers to the underwriting questions. Because this presenter is an insurance agent, he isn't discussing going only to original medicare, and just paying the 20% co pay (and whatever else you gotta pay). That is what I did. Your options are 1. Original medicare 2. Any available advantage plan (no, just don't go there!) 3. Original medicare PLUS medigap 4. Any of the first three, plus part D to cover drugs. That is MY understanding, and I am not an expert, so double check everything I said. I had eye surgery AND heart surgery this year under regular medicare, absolutely no problems, no insurance company between me and my doctors, no delays or insurance company delays or approvals. I recommend option 1. This presenter is suggesting options 3 and 4, which are also a reasonable approach. Be very suspicious of any agent pushing "advantage". They look good at first, but as soon as your health issues start going downhill, they avoid approving procedures and they hope you will die before they approve the procedure that might keep you alive.
One thing that seems to be going on at present is that corporations that promised health care to their retirees are putting their retirees on MA, not providing a supplement as may have been promised. I know that in one case, New York City, a lawsuit is underway. My brother is a victim of this bait and switch.
Thank You !!! I have a supplement plan G and glad I do !!!! Watching your video that explains the qualifications to get out of an Advanced plan makes me glad I have it !!! NO HEALTH WORRIES DOWN THE ROAD !!!! THANKS AGAIN 😊😊😊😊😊😊
Very good and clear video. From watching this, I probably could transition from MA to original Medicare with supplement. My wife, with type 1 diabetes and rheumatoid arthritis could not. We both chose original Medicare with part G supplements during the open enrollment period (turning 65) so we do not have MA downsides to worry about.
I’d like to get your take on Kaiser Senior Advantage. I know it’s not nation wide (I think) but I wonder about it. Thx, keep up the good work.
I’m going to share this information with friends. Thanks again.
Thanks for sharing!
Gerome saved me a lot of headaches and worry. So professional and knowledgeable! Absolutely the best service I’ve had in a long time.
That is wonderful to hear, thank you so much for sharing!
Thank you
I simply chose part a and FEP BCBS. I have had cancer and this combination was great for me.
Thank you, this was actually very helpful. My Mom is 90 and didn't know that when she switched to a Cost plan that she was switched out of regular Medicare. She can honestly answer no to all of those questions! I'll have to talk to her about this.
At 90 her premiums on medigap will be high.
Thank you so much for what you do you have answered all my questions. It’s so confusing and scary when you first have to pick some thing.
We understand, and are here to help! If you have any questions just give us a call! 800-864-8890.
Great Information! Thank you Marvin.
Glad it was helpful!
Excellent video!
I sure am happy that Medical Underwriting is not allowed in Massachusetts.
MA plans don't work with The Mayo Clinic and they are one of the best hospitals in the country. They accept MediGap. That tells you that MA plans are lousy.
It tells you they want to milk the Goverment for as much as they can.
Poor people are stuck with them.
My mom is on MA and she goes to Mayo Clinic exclusively 🤔
I went to the Mayo Clinic, and they said they don't bill my MA insurance company, instead I file a claim with my insurance company. No problem.
@@douglasjensen8986 Ummm, if your Mayo physician gave you outpatient treatments or admitted you inpatient for care and it was not preauthorized by your MA plan, it could be a problem, especially if the outapatient or inpatient care center was not in the MA's network.
Thank you for clarifying this
Thanks! I was just advised to have knee replacements on both knees. I'm not planning to do it, but I will need to wait at least a year to leave my Advantage plan.
If you have any questions about the matter, we're happy to help. Give us a call at 1-800-864-8890.
My mom just had both knees done on her Advantage plan.. why do you need to wait a year?
It seems most MA plans are different. My mother had Aetna MA with our retirement system as do I. Mom had outstanding coverage. But she was very healthy, lived until almost 102. Covid did put her in the hospital for a week when she was 101. I am now 80 and have the same very good coverage....However I'm choosing to have a recently govt approved surgical procedure done in lieu of spinal fusion. My MA curently deem it not covered! They will review the procedure again 6/25. But the traditional Medicare A & B will cover....they have to....and a Supplemental (Medigap) will pay the rest of what Medicare doesn't. So I was just told by....United Healthcare......who now we all know hasn't a good reputation... I qualify for a supplemental plan even at my age. All my answers are no.
Great Videos. I was told i have 1 year from the time Part B started to switch and get a medigap policy without going thru underwriting. Also, if you have an employer plan you can always go back to standard Medicare with a supplemental without underwriting any time. Is this correct ?
that is what I was told also, under 1 year, can't go past 1 year mark
That's correct. If you initially enroll in a Medicare Advantage plan, you have a one-year trial period during which you can switch to a Medigap plan with guaranteed issue rights, meaning no medical underwriting. However, if you only enroll in original Medicare (Parts A and B) without an additional plan, you have a six-month period from the start of your Part B coverage to enroll in a Medigap plan with guaranteed issue rights.
In regards to returning back to work here is a video explaining how that would look th-cam.com/video/4GtRppYTHho/w-d-xo.html
We had a friend of the family insurance agent. He had us sign a paper to use him for our Medicare. Can we get rid of him or did we sign a binding contract???
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
Thanks! and also I wonder how many resources and peoples' time is used on underwriting? We all pay for that. How does that improve our medical care?
Thank you for this helpful information! I qualify medically to switch from advantage plan to supplement and would like to switch prior to March 31st. My prescriptions are currently provided through my advantage plan. How do I get RX coverage if I switch?
You would have to get a separate Part "D" prescription drug plan in my opinion. Give them a call for details.
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
I’ve got the advantage plan with Anthem And I’ve never had the first problem I actually went straight to a mri instead of always in the past you have to get a xray first then a CT scan and I’ve always gone to a immediate MRI within a week
This gentlemen presents misleading information in my experience/ opinion. My experience with an advantage plan has been similar to yours. My Aetna Medicare PPO Advantage plan has been tremendous. I have had a knee replacement, breast cancer surgery with radiation, and rotator cuff surgery the last 8 years with no hassles, no prior authorizations and very little out of pocket. It comes with hearing and dental benefits and a gym membership. No doctor has ever denied me coverage and the care has been excellent. I can’t figure out why anyone would not want an advantage plan! Perhaps the issue is where someone lives?
@@janetbetts5159
That's exactly what l am wondering after hearing all this.. my mother has had a hip replacement and knee replacements without an issue..
@@janetbetts5159I wouldn’t be able to go to my top cancer hospital if I had an advantage plan..they don’t take it.
With respect to leav8ng and Advantage plan to supplemental, what about during the Trial Period? Also, what about if you move to another state? There seems to be information missing here.
Those are all special scenarios which we have other videos that discuss those scenarios. This is specifically for those that don't have a trial right period any more or don't plan to move.
I have lot more to learn. i thought it wl be easy.
my husband is already going to 62. were not US citizens- but green card holder.
really confuse with this healthcare system in US.
i wl have to learn more. And I dont want to make a mistake .
I live in California and turned 65 last May 2024 and enrolled in Medicare A & B and Kaiser Permanente Advantage. During the current Open Enrollment Oct-Dec for year 2025 I want to enroll in Original Medicare + Plan G Medigap. Will I be subject to the 30 health questions and underwriting?
It depends on when your Part B started, you have a 6 month open enrollment from that date to get a supplement plan with no underwriting. So if your Part B started 5-1-2024, you have until the last day of this month to get a supplement with no underwriting. If you wait past that day you will have to go through underwriting. Give us a call we'd be happy to help, you can reach us at 1-800-864-8890.
Good info!
Glad it was helpful!
What was the Part B ...before 2020 date time about?
I believe you are asking what the premium was before 2020.. in 2019 it was $135.50
I sure get a pile of mail every year during the enrollment period from companies who want to sell me a plan. They seem pretty eager for a company who secretly wants to deny the coverage.
Excellent video, but you may way to edit (if you can) the 17:15 mark as you say "getting an Advantage Plan", when you obviously meant "leaving an Advantage Plan".
And in his example about signing up on the bulletin board, he put a birthday of 3-15-59, which means your eligible for Medicare 3-15-25, not 3-15-24.. l find these things very confusing when listening!
If my MA plan is going out of business do I need to go into underwriting to get in a plan G?
The WORST thing is if you can’t afford your supplemental plan anymore but you get turned down for an advantage plan.
In NY you are allowed to switch without any underwriting by Law.
Yes, he mentioned it in the video.
You are lucky. As he mentioned only 4 states let you do that.
@@JBoy340a this is true however, the premium for the N plan is $242 and the G plan $306 monthly.
@@RC-vv6nr good point. I am coming from $1000/mo. for small business plan insurance, so Traditional Medicare is cheap. But many had near free medical so these number look big.
Title should be Most People cannot leave.
Are the MA plan insurance companies leaving the states that don't allow / require medical underwriting?
No they're still being offered in those states.
Where can you get copy of those questions?
Each carriers questions may vary. You can contact the carrier you are seeking and possibly ask for what their questionnaire includes. As they are not the same for all.
if you are a Tabacoo user with no respiratory condition, would that disqualify you from moving to supplement?
Tabaco use usually doesn't disqualify you when going through underwriting, you might pay a higher copay. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
If I have am on an Advantage Plan in Florida for 2 or 3 years, then move to Georgia, do I have to go through underwriting to get a Supplement (N or G) in the new State?
Since you are moving that would be GI (guaranteed issue) plan doesn't require underwriting. If you'd like a broker like us to help, we'd need to go through the underwriting process. Otherwise, you'll need to sign up directly with the carrier to avoid underwriting. If you have questions about this you can call our office as well at 1-800-864-8890.
Can I easily switch from one advantage plan to another?
Advantage plans have no issues making changes. The only thing is you have to make those changes during the annual enrollment period! If you'd like any assistance please call our office at 1-800-864-8890.
I chose an advantage plan. But the only thing l had to do to cancel it was go to
Urgent care only to find out they did Not accept that plans coverage. Case and plan dismissed. AMEN
They cover any emergency in any emergency room but not an out of network urgent care, only in network urgent cares. Its a wonder you didnt have that information before you picked the urgent care to go to.
Please teli about suppeimental plan F,,,
Just wondering about Plan G. I have been on an Advantage Plan with Medicaid and Medicare. I am now losing Medicaid. Would I qualify for Guaranteed Issue because of this. I do have the letter stating losing as of October 1? Any suggestions on what to do? Also, the Advantage Plan I have is for D-SNP they do not have any plans for not being D-SNP. I was told by one of your agents that I would have to call the insurance company to find out what they require for G-I. Sorry but I thought that was why we call you for help.
Some situations we aren't able to help, in this case since you have guaranteed issue rights we aren't able to assist unfortunately.
@@MedicareSchool Well it turns out I have to have Plan F due to date of starting Medicare. Surprisingly it's even better than Plan G.
@@DiChitty I have heard many leaving Plan F because it's a closed plan since Jan 2020, and the prices are going up. The prices are going up, because they are unable to attract new 65 year old's, who often are healthier.
If I have stage 3 chronic kidney disease would I be denied coverage
Unfortunately yes, unless you lived in one of those 4 GI states like NY, VT, CT, and MA.
With a supplemental plan I know you will have a monthly premium but do they still take the Medicare portion out of your social security check?
anneaugello Yes, you would still have to pay the 175.70 for your Part B plan,it would still be taken out of your social security check; and also, you would pay the Supplemental premium, and, if you wanted one, get and pay for a Part D plan (prescription drug) too.
All correct. My supplemental includes dental, drugs, vision. Great deal
Yes, if you are receiving social security the part B premium will be deducted from your social security check. if you're not receiving Social Security, you'll receive a bill for your Part B premium from Medicare. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
You also qualify to move from MA to Medigap when your MAvplan drops you, without any underwriting!
Yes, and some people are happy about it
My insurancw told me i can leave the advantage plan and go back to a ppo plan
PPO is an advantage plan, do you mean to a supplement?
The Advantage plan I chose has a $220/month premium, not $0. The "Pay as you go" amounts are very low.
Yeah..this video is misleading, I have had a Medicare Advantage PPO plan for 9 years. I pay $77. Month in premiums and have had first class care for breast cancer, knee replacement and rotator cuff surgery. I pay $30 to see a specialist with no referral involved. I have never had a doctor refuse to see me and every time I have needed a special procedure (MRI, Ultrasound, CT scan, etc….i have gotten it without a referral and in a timely manner.). This video is misleading. Years ago I switched medical coverage during open enrollment….with no questionnaire involved. Open Enrollment is exactly that.
Yeah, they are great..until you have a serious health problem..then you are screwed. Great insurance right up until you need it…then you are SOL. I saw a friend wait nearly a year for a “pre-approval” for a procedure….the condition because much worse while waiting. Waited until the procedure was no longer a viable choice because the condition progressed.
@@Katiekatie948 I have had multiple in-patient surgeries. In over 10 years, I never had a pre-approval delayed or denied.
@@Katiekatie948 an Advantage Plan can be either an HMO or a PPO….that’s what creates the issue of needing a referral. I have a PPO Plan and within a half hour of having a mammogram that indicated I needed further testing, i was given an ultrasound….an hour later I had a breast biopsy. Two days later it came back as a cancer diagnosis. But I chose a plan with a monthly co-pay not one with a zero payment….makes all the difference!
@@douglasjensen8986
Right.. my mother has had a hip replacement and two knee replacements on MA, without an issue.. maybe it depends on what state you are in??
What about if your Advantage plan leaves you? Can you then go to Supplemental without the 30 questions?
In that scenario, you won’t have to go through underwriting as you’ll have a guaranteed issue right. However, there is usually a short window to make the change-typically 30-60 days-to get signed up with a new plan if your current plan is no longer available.
If you have any questions or need assistance, feel free to reach out!
Don't you just love the USA medical system? Only the strong survive!
It depends on your situation. Some employers have very good health insurance plans. My wife and son don’t pay for their health insurance.
Most countries with public health coverage pay for it with special tax levies, so it is not exactly “free”.
@@MrStan0630true…but…those countries do not have runaway price gouging by private equity. Health care is still NONPROFIT elsewhere. Here…pricing according to what the equity corporation wants to make in profit.
@@MrStan0630 some people are what I call employee work slaves. They cannot leave their employer due to their medical coverage. Rather sad.
I left twice with no questions. You just have to change in open enrollment which happens every year in October 15-December 7 DDay.
Are you in any of the four states he mentioned?
If your Advantage plan is no longer available in your community can you go back to original medicare and get a supplement without underwriting?
If you are notified that your plan will no longer be offered then yes you can with no underwriting.
Is the B date the same as the A date?
No, the Part B effective date is not necessarily the same as the Part A effective date. While many people enroll in both Part A and Part B at the same time, some individuals may delay enrollment in Part B if they have other health coverage, such as employer-sponsored insurance (20 employees or more) , it's crucial to coordinate your enrollment in both Part A and Part B according to your specific circumstances and needs. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
I will choose wisely when I turn 65. I failed the quiz by having lymphoma 32 years ago.
Better choose the supplemental from the get go.
Same here. I'm on insulin.
Stay clear of advantage plans. They are not our friends.
I see jackycane answered my question. Thnx!
30Questions 11:11
I only count 16 questions - What about the other 14 ?
He was only reading questions from Section 4, these are the main questions that would determine if you qualify or not. So other questions wouldn't be as important in deciding if they accept you.
When I turn 65 no (dis) advantage for me.
Save your money. Lots of people stuck on MA are there because at the time they started medicare, they didn't have enough money to start paying out a large insurance payment every month, so they just went with the polcy type that cost the least at the time, and hoped they wouldn't get seriously ill. Once stuck on MA, you would be permanently stuck, unless you win the lottery and can self insure.
@@d.e.b.b5788The captative agents, and those that push Advantage plans to get the biggest commission for life, never fully explain what the co-insurance or the deductibles really are for. They buy leads, and constantly call you, against CMS rules. They won't tell you what an advantage plan covers if you get cancer. They won't tell you their standard is to pay for lesser drugs and procedures first, even if it against your doctors orders. They won't tell you you will be kicked out of rehab at a certain day against your doctors orders, because they simply stop paying for it, making you 100% responsible after that. But they do say, Its 0 cost to you, and some say its free for you. they certainly love to brag about their perks.
They never tell you if you want to switch to a medsup plan you are required to medically qualify after your IEP.
I completely blame CMS for allowing all this to continue. There should never be commissions for life. Seniors are being preyed upon every single day.
To bad Arthritis is a no go, almost everyone has it
If you get turned down when trying to move to a supplement plan, can you get a hospital plan to supplement your advantage plan?
It depends on when you are trying to add that on, after a certain age those plan also require underwriting. They aren't as intense as supplement underwriting, but if you qualify it can certainly be added on. Give us a call we'd be happy to help, you can reach us at 1-800-864-8890.
I enjoy your videos and it would be so helpful if you could get to the point quickly
You can fast forward thru videos to the parts you want very easily in a couple different ways. I personally like watching the videos in it's entirety to understand the full explanation of what Marvin is conveying in all of his videos. That's just me but I'm sure that many others are the same way.
JoyGardner, you can increase/decrease the audio speed in TH-cam by one, two, three notches. I like Marvin's explanation. He sticks to his topic & often gives helpful background or context information related to his topic. Marvin speaks pretty quickly! 😂🎉
Please speak to Dr. Oz who may be in charge of Medicare under the Trump presidency. Dr. Oz thinks Advantage plans are the best. I've heard he will push for all retirees to join Medicare Advantage plans. We need a choice.
You do have choices. Dr. Oz does not pick your medical plan. Advantage plans can be ok for some people.
I can never leave becsuse I need
an injection on my retina.
Could they have made the Medicare program any more confusing than it is lol ?
Time for single payer health care. Whats going to happen to the insurance industry when we all fail the qualifications for health, property and auto? We know what will happen to us customers.
@@jaggillar6680 A single payer health system is a terrible idea. You need competition to have decent prices, care and options. Do sone homework before you spout nonsense.
This country has the most incredibly screwed up system of medical care that anyone could ever imagine. I wish I lived in a civilized country that had medical care for all, or at least that didn't treat medical care as if it was a for-profit business (don't let the supposed non-profit, mostly church related plans fool you---they are there to make money for their church). We pay more for medicine, surgery, procedures than any other country. And the care isn't that great.
If only Bernie was in charge!!
Your like button does not work....again.
what is wrong with this country?
Question 1...I do not have a PCP and have not been to a dr in well over 2 years and will likely not see one before I am on Medicare next year. If I am understanding you correctly, I would then not have any, diagnosed, treated, etc. conditions. Everything would be no then on the time-specific questions, correct? I have no active scripts, nothing at all since 2022; and Question 2...If I do not have a PCP how would an underwriter "look into" anything? Thank you for taking the time to read/respond.
Since you are just turning 65, underwriting does not apply you to. You do not have to go through underwriting the first 6 months of starting Medicare Part B. So no one would be taking your health into consideration at the time you apply.
@@MedicareSchool I understand your response. I am asking, hypothetically, if a person selected an Advantage plan and then at the next OE, want to go to a Medigap plan, with no PCP, having not been treated for more than 3 years by any physician, how would an underwriter "look into" the answers to the 30 questions? and, Under that scenario, no dr/no treatment/diagnoses all answers would then be "no" since no dr visits, correct? If it's been 4 years since a person was at a dr and treated, that is outside the scope of the questions.
@@colleenwolf8014 Good question! I wonder what the answer is.
if you are a Tabacoo user with no respiratory condition, would that disqualify you from moving to supplement?
Depending on the rest of your health it wouldn't disqualify you from moving, it could potentially make your monthly premiums higher for tobacco use