I appreciate your feedback - lately Advantage plans do seem to be more heavily advertised and even the Medicare and You guide seems to be skewed in that direction.
@@AbtInsuranceAgency - Yes. Sadly my friend had awful experience getting treatment with his advantage plan. Too much red tape and "approval" hassles ... Regular Medicare he would very likely be fine. Thanks for your videos 👌
CMS actually hates Advantage plans because healthier people tend to sign up for them and this increases the cost sharing for those who remain on traditional Medicare who are usually in poorer health. CMS has no choice in this matter though because the Balanced Budget Act of 1998 that was passed by Congress is what created Advantage plans.
There has to be a cost savings and/or risk reduction for the government to push advantage plans. Considering the restrictions involved with advantage (approvals for services, staying within networks, potential high deductible), I don't see the benefit for a relatively slight increase in cost contrasted with traditional Medicare and Medigap policy. Anyway I want to travel and if I need medical services on a trip I can't be worrying about staying within network and getting approval for services. -- Ms. Abt does a great job explaining this stuff.
Very good, clear info on a very COMPLICATED topic. Medicare is VERY EXPENSIVE with all the premiums, deductibles, 20% out of pocket, supplemental plan premiums, maximum out of pocket expenses, high RX drug prices, 15% EXTRA doctors can charge. MORE EXPENSIVE MONTHLY PREMIUM COSTS, for LESS COVERAGE, compared to ACA AFFORDABLE health insurance plans. How are seniors on FIXED INCOMES expected to afford Medicare EXPENSES and LIMITED coverage?? Seems like fleecing SENIORS on FIXED INCOMES and highway robbery charging $170.00 MONTHLY !!!!
Seniors retired with a 401k plan and/or pension plan and other financial streams (that take care of Part A and Part B) are very happy with traditional Medicare. No networks, no worries about coverage in other areas of the country, no referrals for specialists. Simple, worry-free, uncluttered; which is the way it should be for EVERY American, senior or not. Especially if you're recovering from a serious illness or accident. You shouldn't have to be stressed out and worried about bills and coverage... Stress and health recovery don't mix. So yeah, these seniors have been very happy with traditional Medicare.
@@8sun52 Agree completely. Prior to reaching 65 I was paying ~$1000/month (no ongoing health concerns) for BC/BS. At 65 went on Medicare A, B and medigap N. My total premiums (part B and N) were ~$320/month for as good and likely better coverage. My medigap N premiums have increased by a total of ~$10/month over five years. You won't catch me whinging about Medicare.
@@MikeNaples Thanks for your feedback. Yes. Medicare has about 3% administrative costs. Health insurance companies can typically have around 10% to 20% administrative costs, not including criminal-in-nature CEO salaries, which is unconscionable; people having to choose high deductible plans (underinsured), people with stripped down health insurance (underinsured), people who have to organize GoFundMe campaigns when they max out their health insurance due to a serious accident or illness. Medical bankruptcies. On and on it goes... People should check out the CEO salaries. It's public record. Then think about that. Really let that sink in. Really, really let that sink in. Very unpatriotic and ethically and morally perverted. Everybody's feeding at the trough selling Medigap Plans, Medicare Advantage Plans etc. This is part of the problem. They don't want to see this gravy train end. But they can find other business opportunities that do not contribute to the very fragmented, expensive, inefficient unpredictable, unstable healthcare non-system that it is...AARP, too, feeding at the trough. I will never, ever have anything to do with AARP. Medicare has been in place for decades. The structure is already there to easily build upon and modify a little bit...contrary to what "special interests" (that have a lot to lose), would have us believe. Everybody In, Nobody Out! Improved and enhanced Medicare For All WEBSITE: Physicians for a National Health Program
Speaking of AARP, can't find their info on AARP's stance re: GOP plans to sunset Medicare and Social Security. I thought AARP was the advocacy group for seniors (?)
Hello Stephanie. I’m an Account Executive for Medicare with a local plan in my area. Great explanation regarding pros and cons of Medicare Advantage plans vs Original Medicare. Loved your presentation. Succinct and easy to understand. Thank you for sharing this knowledge here. Love to do something like this some day for the Hispanic community. Blessings.😁😁😁😁👍🏼👍🏼👍🏼👍🏼
My medicare advantage provider will, literally, not talk to me when I'm outside my home state. They won't talk on the phone or provide tele-health services. They also block access to their website when I'm outside the country. I can't review test results or make future appointments for when I get home. Considering that I have given up my original part A and B coverage it's gotten scary to travel. A lot of seniors want to travel. This should be a consideration when choosing an advantage plan.
Thanks for covering this information! People need to hear the pros and the cons of advantage plans. Advantage plans have a bad reputation, but they can be great for some people!
My 90-year-old mom has had and advantage plan for many years and they have covered all her cancer treatments, her doctors and her preferred hospital or in network so I’m very happy that she went that route
That was so good and the fact that she did a no nonsense Pro and Con piece was most reassuring , she’s obviously not trying to hide anything, bravo, very clear and well presented.
I like Medicare Advantage ALL IN ONE Plan , one card , full coverage. I don`t mind getting referrals for specialists and tests. Some Medicare Advantage plans have Low Out of pocket limits too.
Excellent video. I appreciate that you give a balanced overview of the pros and cons of Advantage plans. Some of the TH-cam videos on this topic seem pretty lopsided.
thanks for your professional advice on a very confusing subject. The advantage plans are being pushed so hard by the insurance companies its seems that is all your hear about. I really appreciate your advice and help in choosing a supplement plan.
I have been researching and listening to various TH-cam videos. Your videos and explanations are very understandable and relatable. Thank you for sharing your experience on TH-cam. Also, I called your 888 # and received a timely call back and the person was extremely helpful. I do plan on using your company when I plan on retiring.
I've been poring over brochures and researching the Internet and I've been overwhelmed with all the options. Your videos have made my options so much clearer. Many thanks.
A very good and straightforward presentation. I think that it is important to note that the “set amount” that the insurer receives from the government (a policy termed “capitation”) depends on the projected health of the insured population. This creates a perverse incentive for insurers to encourage doctors to add diagnoses to patient records that are either only remote possibilities our outright false (a practice known as “upcoding”). It also creates an incentive for insurers to defer or deny care. It would have also been nice to see a more in-depth explanation of the perils of receiving medical services from out-of-network providers. This can occur not only in obvious situations like travel, but in more insidious cases like surgeries, where, for example, the anesthesiologist may be out of network and performs their work without the patient having a say in the matter. This can lead to horrendous charges that aren’t covered.
Clear explanation on pros, cons, and myths on Medicare Advantage plans. I think it's best to set down with an agent. I have an supplement plan and my significant other has an Advantage plan. Your financial, heath, and location will depend on which plan will be right for you..
Thanks for your knowledge. As a retired man who turned 65 last Dec. I decided to get my Life/Health license in Florida (215) and was appointed by pretty much all of the different companies with the idea I could put folks where they "fit" vs. trying to 'sell" them on any one particular plan, It is highly FRUSTRATING dealing with these companies...my experience is they want you to go through their PORTALS and it reminds me of the 3 STOOGES there is SO MUCH BRAIN DAMAGE....they want you to change your password pretty much EVERY TIME you sign in...HELP!!! Your supplemental video was EXCELLENT...and most of the sales people simply tell their customers "Supps are what your parents had"?? And they move on to their sales pitch ...however I am looking way more closely at Supps..and I have received more education from you than any other source so THANK YOU in advance!! I wish you were my boss.
Thank you so much for helping me to understand the real difference between supplemental insurance and the advantage choice. There is a difference and really did not understand the difference. You really are excellent at explaining the medical choices!!! Again, thank you so very much!!!
If you must have zero risk than buy a medigap plan but zero risk comes at a cost. I'm more worried about nursing home costs . We use our savings from Medicare Advantage plan to pay for long term care insurance
I just happened to stumble across your videos and they are coming at a great time. I plan on retiring in about 3 years at the age of 66, and just started reading about Medicare and all that goes with it. Your videos are straight to the point and very good. Will hang onto your phone number for when the time comes. Thank you and keep up the good work!! :)
It depends on several factors. If you have any major pre existing conditions, you may be better off keeping your existing Plan F rather than trying to switch to another lower cost plan. Medical underwriting could potentially disqualify you. I hope this helps!
I am late to the party here on this subject as I just turned 65 in April of 2022. I took a Medicare Advantage Plan here in northeast Pennsylvania thru Highmark. I choose this because I could NOT afford original Medicare because I could not afford the extra plans you have to get with original Medicare such as Medigap, Part D, etc. that adds up to a lot of money per month which I do not have or afford. I still work but only part-time and it is a struggle each month. My Highmark plan pays 22 a month towards my Part B so I only pay $148.10 a month instead of the $170.00 per month. Yes you have co-pays, yes they want you to stay "in-network". I have dental, vision, hearing, prescription with this plan. No referrals as this is a PPO and not an HMO. Is is perfect nope far from it but nothing is. I have a 0 co-pay for family dr., $30 for a specialist and $90 for the E.R. Again nothing is perfect.
I hear you. I am totally screwed. I am 70 and my husband left, with all of our money, kicked me off his health insurance and refuses to give me my share of our savings. I am trying to get on Part B but they are going to charge me $80 a month as a punishment for not selecting Part B when I was 65. No kidding. I have no money, went back to work and I am working with an agency to help me sort this out.
It seems the only real advantage to advantage plans is the lower cost of the monthly premium. Advantage in my area is the same as Part B = $165, basically. But a Plan G or N would be an additional $95 to $140 along with the A & B cost of $165. Sad when you are on a very tight and fixed income. My Doctor is on some advantage plans approved provider list but his clinic is not. He warns about the red tape, waiting for approvals, limitations within the Advantage Plans, etc. Also they don't always cover everything that a Plan G or N would cover, for example. From what I have gleaned I don't want an Advantage Plan.
Stephanie, assume a person has an Advantage plan with a $6,900 MOOP. With a few weeks left in the Annual Enrollment Period, the person learns of a health problem that will require expensive treatment that extends well into the next year. There is another Advantage plan available with a $3,900 MOOP. All of the relevant providers are on both plans. Is there anything keeping the person from switching plans to save $3,000 in the following year?
No, not at all, since Medicare Advantage Plans are not medically underwritten. You can always change plans between Oct. 15th - Dec. 7th for the coming year.
Helpful info as usual. I know someone who is considering MA and thinks it will be totally free (part B deductible reference). It may be tempting at 65 for some but when a serious issue arises in your 70’s, it will be a trap. If one can afford it, a supplement is the safer route.
My husband’s plan is AARP Medicare Advantage Walgreens Plan 1 United Healthcare. This plan pays for unlimited time in hospital. Is it a good plan or we should change?
Can you switch between the letter plans easily? Say I get plan N and then the next I decide on plan G. Is that done without the medical questions or underwriting?
I'm in disability for a year now. I'm only 64 year old now but i be 65 in May. i know i can get Medicare soon but don't know what to do. i have insurance from COBRA that i keep from my job. I'm pay lots' money now but i do need it because my condition. I'm on Aetna insurgent . that say i need to cancel it. but Aetna has Medicare too. do i cancel and renew it or keep it? should i go somewhere else. i don't mine paying monthly payment but don't want to pay too mush. can you help me? I live in LEE COUNTY Florida
Yep. The US healthcare non-system is extremely wasteful, expensive, bureaucratic, inefficient and fragmented. Healthcare spending in the US is nearly twice as much as some industrialized European countries and we still leave millions uninsured and underinsured; one serious disease or accident away from bankruptcy and GoFundMe campaigns. And search what these health insurance CEOs are making annually and then think about that the next time you're stuck with a huge deductible or you max out your health insurance. Just let that sink in, let that really sink in. The health insurance CEOs are not there for your benefit but are only there to maximize returns for investment shareholders. Those are our healthcare dollars in one form or another being siphoned away from our healthcare. The US healthcare non-system is ethically and morally perverted.
I still don’t understand the need for a supplemental plan like N for example over just A&B with D. Can you guide me to resources that could help me understand the benefits of paying for extra coverage.
Original Medicare A and B doesn't offer 100% coverage at the doctor/hospital. You have deductibles and coinsurance that you're responsible for. The Medicare Supplement Plans (like Plan N) help to pay for the deductibles and coinsurance so that you have much lower potential out of pocket exposure. Click Here for more info --> th-cam.com/video/tIEF7dC9e3o/w-d-xo.html
drp5 * without a supplement , I believe the biggest risk lies in part B coinsurance being 20%. There is no limit or out-of-pocket maximum. So think about how much outpatient surgery/procedure/treatments could run.
Make sure your Advantage plan is a PPO. My plan has all my doctors, hospitals i'll ever need. If your provider is a major company coverage is available nationwide. The savings my wife and I have obtained over the years has paid for any possible futue max out of pocket several times.
D Lee typically Part D Plans and Medicare Advantage plans have network pharmacies, and then among those there are Preferred and Standard network pharmacies. Rx costs are lowest at Preferred network pharmacies. The plan can tell you which pharmacies are Preferred network pharmacies, and you can always reach out to us with questions too. I hope this helps!
We winter in the lower-48 and summer in Alaska. Therefore the advantage plan would be a poor fit for multi-state health insurance since "out of network" when out of state?
I love your energy and your wonderful smile!. You have done a great job explaining the pros and cons of both and this video has made me reconsider getting these "cheap" Medicare Advantage policies. The stability of the carrier should also be factor in mitigating large year-over-year premium increases.
@@CarlosGarcia-ls4hn Not always. Many of them are similar to coverage from work and have deductibles and copays. Especially on some big ticket items like cancer treatments and prescriptions. Remember there's no free lunch.
I'm on SSDI, 56 y/o and my 2 years to switch to Medicare is up in June this year. I am very confused on wether to go with original part a and b or advantage plan. I hear horror stories of advantage plans having you pay a higher out of pocket (20%) after negotiating the final bill with hospital than original medicare....very confusing even after doing a lot of research...
I have a question I have CALpers special power ofAttorney my client took a stroke August 22 this year and her current insurance does not cover and will not assist in the care she needs is the Medicare and health insurance tied in
Listening to this video, I suddenly realized that we seniors who are retired municipal workers are being exploited by the City of NY and our prior Union. This comes under the heading of SENIOR ABUSE. Why not add SENIOR ABUSE to our court case?
Do you often referred to state plan. If we are planning on moving or living partially in another state in the near future will a major companies advantage plan cover me nationally? I probably need to ask them what are their state specific restrictions
In most situations, you are locked into your Medicare Advantage Plan for the calendar year. You can make changes from Oct. 15th - Dec 7th for changes to go into effect Jan. 1st of the following year. If you have a life changing event you may qualify for a special enrollment period to change mid-year. I hope this helps!
Thank you. I am in the first year Medicare with KP advantage plan, Do I have to reapply for next year 2021; or, it's auto enroll to same Medicare with KP advantage plan coverage without doing anything?
Medicare Advantage Plans are calendar year plans, so your plan benefits may change each year. You'll receive a renewal packet outlining plan changes in the Fall, and you can either do nothing to continue with your plan's renewal, or you can shop Medicare Advantage Plans during the Annual Election Period from Oct. 15th - Dec. 7th.
Technically, I believe the terminology is "Medicare *_WITH_* Supplement Plan" as Original Medicare remains in effect. You have a Medicare Advantage Plan *_FROM_* KP. Medicare Advantage Plans REPLACE Original Medicare as Original Medicare is NO longer in effect.
Can you choose to go to Medicare Advantage plan...then once you’ve tried it and discover you don’t like it, go back to original Medicare A and B a subsequent year?
I heard that once you go off Medicare Advantage that when you re-apply for a medigap plan they now look into your past medical records to make a decision on cost ect.
@@DavidReo yes, thsts what underwriters do. If you have medical issues You WILL be denied. Each yr you are reviewed by your own plan...they may be able to 'dump' you if you cost too much. Its a risk! 😦
Do the Medicare Advantage insurance companies require Medicare to give out our private medical information since Medicare is paying those insurance companies?
Good information as always! Thanks. In researching my Medicare Insurance options I found that as a resident of New York State I am allowed to change my plan once each year between MediGap and Advantage Plans (and vice versa) as part of the EPIC Program in the Special Enrollment Period (SEP). I have not seen this mentioned in yours or any other insurance advisor's videos. Am I missing something?
Great video's, jealous of them. I don't understand any of your thumbs down from people other than trolls. I will recommend my clients to you outside of the states I represent. Best-Chris
I did the part D before it enrolled me in Aetna Medicare advantage, so does that kick my part D separate plan processing from Humana out, and leave the advantage plan alone? Typically also how long Would it take for a plan to enroll? I want to make sure that I’m ok with my advantage plan? I did the separate part D last Saturday and Aetna with me being suddenly approved took effect 7/1 but it never showed up until this Monday. So should I be ok with the advantage plan, or will it kick me off for that separate part D plan that was processed last Saturday?
Stephen, if you call my office at 888-465-9728 we can definitely help. Typically enrolling in an Advantage plan will cancel out your Part D coverage, and vice versa. The coverage that is going to “stick” will depend upon your enrollment dates, approval dates, and election period. I’d be happy to help you sort it out if you’d like.
For me when I lived near major cities the advantage plan was a no-brainer, great service and very low cost. Now living in the sticks that plan stinks on ice it is expensive and has spotty service.
@@druannpellegrini5661 let’s say for example that your doctor advised you to have 5 injections per year to help your arthritis. Your insurance carrier may only deem that up to 4 injections are necessary and could deny the 5th injection. Then you are responsible for the cost of the 5th injection if you receive it. This is not extremely common but could happen. I hope this helps.
Sure. Traditional Medicare is fine if you can afford 280 a month for plan G and 90 for plan D. MOST can't afford an extra 370 a month. Add THAT up over a year. The out of pocket for an advantage seems the better choice if you have a good network.
Networks change every year. The doctors you like and trust with your care will leave the plan when they can no longer stand the insurance co.'s pressure to scrimp on your health by no longer approving the better treatments. Medicare Advantage is like sausage - once you see how it is made you will lose your appetite for it. But it will be too late.
@@utuber1000 yep, my doctor just left and no available doctor available accepting Medicare. I have expensive advantage plan, but did find a new provider elsewhere. I rather pay than lose out.
Outside Dental insurance carriers like Physicians Mutual are a good alternative for Dental coverage. However, any major restorative work requires a 1 year waiting period, while preventive can be covered more quickly. I do not have any advice on outside Vision coverage, but your eye doctor may offer a plan or know of a plan to minimize your expenses.
Medicaid pays our Part B Premium. That's why we are staying with the traditional Medicare Supplement plan. Medicaid is our supplement plan. We also get extra help with our Part D (prescription coverage).
I guess it's these type of Advantage plans that people talk about when they say medicare advantage plans are so terrible They get really huffy about it. I work for a very large University employer and have chosen an advantage plan that is a $167 a month. (Plus Plan B). For this I get a plan that is similar, in fact is even better than the company health insurance I had. Copays and deductibles are not onerous. I consider myself very fortunate. Choosing an Advantage plan over the supplement plans for me was a no brainer. Too bad this isn't available to everyone.
All of the YT tutorials say the same thing about switching back to a medigap plan after you have been on an advantage plan past the trail period - that you will have to answer health questions and pass underwriting - but I don't hear anyone going into detail about this, specifically how hard is it to pass underwriting? I assume cancer or some other very serious condition will likely disqualify you but what about less serious conditions - enlarged prostate or pre-hypertension or even hypertension that you are medicating successfully, just for example. So, generally how hard is it to pass underwriting? Can you elaborate please? Happy to call you directly to pursue this if that is something you do. I'm 67, with the above mentioned conditions, currently on Humana Gold HMO MA in Va. Thank you so much Stephanie, if you could please comment! I'm sure many have this same question now that MA facts are coming to light. A plan N sure seems like the way I would like to go.
You keep A&B. In fact you HAVE to have parts A&B to have an advantage plan. Also. The part B buyback program is real, it's just not very often that it pays the entire part B premium. Usually, they will pay between $20 and $80 back of your part B premium. Plans that pay the full $148 are rare, but they do exist.
💨 It seems the government is pushing Advantage plans. I don't think they are very good and will stay away ...
I appreciate your feedback - lately Advantage plans do seem to be more heavily advertised and even the Medicare and You guide seems to be skewed in that direction.
@@AbtInsuranceAgency - Yes. Sadly my friend had awful experience getting treatment with his advantage plan. Too much red tape and "approval" hassles ...
Regular Medicare he would very likely be fine.
Thanks for your videos 👌
CMS actually hates Advantage plans because healthier people tend to sign up for them and this increases the cost sharing for those who remain on traditional Medicare who are usually in poorer health. CMS has no choice in this matter though because the Balanced Budget Act of 1998 that was passed by Congress is what created Advantage plans.
There has to be a cost savings and/or risk reduction for the government to push advantage plans. Considering the restrictions involved with advantage (approvals for services, staying within networks, potential high deductible), I don't see the benefit for a relatively slight increase in cost contrasted with traditional Medicare and Medigap policy. Anyway I want to travel and if I need medical services on a trip I can't be worrying about staying within network and getting approval for services.
-- Ms. Abt does a great job explaining this stuff.
It's is not the government that's pushing medicare advantage it's private insurance companies because they are making mega bucks from it.
we will be calling and asking what is the best for us
Very good, clear info on a very COMPLICATED topic.
Medicare is VERY EXPENSIVE with all the premiums, deductibles, 20% out of pocket, supplemental plan premiums, maximum out of pocket expenses, high RX drug prices, 15% EXTRA doctors can charge. MORE EXPENSIVE MONTHLY PREMIUM COSTS, for LESS COVERAGE, compared to ACA AFFORDABLE health insurance plans. How are seniors on FIXED INCOMES expected to afford Medicare EXPENSES and LIMITED coverage??
Seems like fleecing SENIORS on FIXED INCOMES and highway robbery charging $170.00 MONTHLY !!!!
Seniors retired with a 401k plan and/or pension plan and other financial streams (that take care of Part A and Part B) are very happy with traditional Medicare.
No networks, no worries about coverage in other areas of the country, no referrals for specialists.
Simple, worry-free, uncluttered; which is the way it should be for EVERY American, senior or not. Especially if you're recovering from a serious illness or accident. You shouldn't have to be stressed out and worried about bills and coverage... Stress and health recovery don't mix.
So yeah, these seniors have been very happy with traditional Medicare.
@@8sun52 Agree completely. Prior to reaching 65 I was paying ~$1000/month (no ongoing health concerns) for BC/BS. At 65 went on Medicare A, B and medigap N. My total premiums (part B and N) were ~$320/month for as good and likely better coverage. My medigap N premiums have increased by a total of ~$10/month over five years. You won't catch me whinging about Medicare.
@@MikeNaples Thanks for your feedback. Yes. Medicare has about 3% administrative costs. Health insurance companies can typically have around 10% to 20% administrative costs, not including criminal-in-nature CEO salaries, which is unconscionable; people having to choose high deductible plans (underinsured), people with stripped down health insurance (underinsured), people who have to organize GoFundMe campaigns when they max out their health insurance due to a serious accident or illness. Medical bankruptcies. On and on it goes... People should check out the CEO salaries. It's public record. Then think about that. Really let that sink in. Really, really let that sink in.
Very unpatriotic and ethically and morally perverted.
Everybody's feeding at the trough selling Medigap Plans, Medicare Advantage Plans etc. This is part of the problem. They don't want to see this gravy train end. But they can find other business opportunities that do not contribute to the very fragmented, expensive, inefficient unpredictable, unstable healthcare non-system that it is...AARP, too, feeding at the trough. I will never, ever have anything to do with AARP.
Medicare has been in place for decades. The structure is already there to easily build upon and modify a little bit...contrary to what "special interests" (that have a lot to lose), would have us believe.
Everybody In, Nobody Out!
Improved and enhanced Medicare For All
WEBSITE:
Physicians for a National Health Program
Speaking of AARP, can't find their info on AARP's stance re: GOP plans to sunset Medicare and Social Security.
I thought AARP was the advocacy group for seniors (?)
Hello Stephanie. I’m an Account Executive for Medicare with a local plan in my area. Great explanation regarding pros and cons of Medicare Advantage plans vs Original Medicare. Loved your presentation. Succinct and easy to understand. Thank you for sharing this knowledge here. Love to do something like this some day for the Hispanic community. Blessings.😁😁😁😁👍🏼👍🏼👍🏼👍🏼
Glad it was helpful!
That was excellent! Clear and concise... enumerated pros and cons. Perfect
My medicare advantage provider will, literally, not talk to me when I'm outside my home state. They won't talk on the phone or provide tele-health services. They also block access to their website when I'm outside the country. I can't review test results or make future appointments for when I get home. Considering that I have given up my original part A and B coverage it's gotten scary to travel. A lot of seniors want to travel. This should be a consideration when choosing an advantage plan.
This is a very good point to consider - thank you for sharing!
thank u for helping us those need your help the most mostly retired ,lonely .GOD bless u .
Thanks for covering this information! People need to hear the pros and the cons of advantage plans. Advantage plans have a bad reputation, but they can be great for some people!
They are the correct answer for 75% or more of the population.
My 90-year-old mom has had and advantage plan for many years and they have covered all her cancer treatments, her doctors and her preferred hospital or in network so I’m very happy that she went that route
@@lenalsheffield Yes, my mother and father are in their 90's.
They have no problems with their Advantage plans.
That was so good and the fact that she did a no nonsense Pro and Con piece was most reassuring , she’s obviously not trying to hide anything, bravo, very clear and well presented.
Thank you!
I like Medicare Advantage ALL IN ONE Plan , one card , full coverage. I don`t mind getting referrals for specialists and tests. Some Medicare Advantage plans have Low Out of pocket limits too.
yES.
Thank you Stephanie!!! I am a new agent and this vid explained Med Advantage better than any material I've come across thus far.
This is actually about to help me pass my Medicare supplement exam this week, I’m glad I found these videos!
Excellent video. I appreciate that you give a balanced overview of the pros and cons of Advantage plans. Some of the TH-cam videos on this topic seem pretty lopsided.
Thank you!
so pleasant, and easy to understand. presents information without drama and fearmongering.
jose martinez thank you so much for the kind words!
thanks for your professional advice on a very confusing subject. The advantage plans are being pushed so hard by the insurance companies its seems that is all your hear about. I really appreciate your advice and help in choosing a supplement plan.
Thanks for your feedback!
I have been researching and listening to various TH-cam videos. Your videos and explanations are very understandable and relatable. Thank you for sharing your experience on TH-cam. Also, I called your 888 # and received a timely call back and the person was extremely helpful. I do plan on using your company when I plan on retiring.
Thank you so much for this feedback!
You're the Best Stephanie !! I'm learning thanks to You 😊
I've been poring over brochures and researching the Internet and I've been overwhelmed with all the options. Your videos have made my options so much clearer. Many thanks.
I’m so happy to hear that!
Another very informative video. Thank you, Stephanie. 👍
I live in Oklahoma and cannot afford a medicare supplement plan. Is Community Care a good choice for a medicare advantage plan??? Thanks :)
A very good and straightforward presentation. I think that it is important to note that the “set amount” that the insurer receives from the government (a policy termed “capitation”) depends on the projected health of the insured population. This creates a perverse incentive for insurers to encourage doctors to add diagnoses to patient records that are either only remote possibilities our outright false (a practice known as “upcoding”). It also creates an incentive for insurers to defer or deny care.
It would have also been nice to see a more in-depth explanation of the perils of receiving medical services from out-of-network providers. This can occur not only in obvious situations like travel, but in more insidious cases like surgeries, where, for example, the anesthesiologist may be out of network and performs their work without the patient having a say in the matter. This can lead to horrendous charges that aren’t covered.
Thank you for adding this feedback!
Clear explanation on pros, cons, and myths on Medicare Advantage plans.
I think it's best to set down with an agent.
I have an supplement plan and my significant other has an Advantage plan.
Your financial, heath, and location will depend on which plan will be right for you..
Excellent points. Speaking with an independent broker is always best. 😉
@@AbtInsuranceAgency which gives better advices, broker or an agent? What’s the difference between these two? Thank you.
@@fatimagross1956 Typically a broker works for YOU and represents many different carriers, while a agent represents one insurance carrier.
Thanks for your knowledge. As a retired man who turned 65 last Dec. I decided to get my Life/Health license in Florida (215) and was appointed by pretty much all of the different companies with the idea I could put folks where they "fit" vs. trying to 'sell" them on any one particular plan, It is highly FRUSTRATING dealing with these companies...my experience is they want you to go through their PORTALS and it reminds me of the 3 STOOGES there is SO MUCH BRAIN DAMAGE....they want you to change your password pretty much EVERY TIME you sign in...HELP!!! Your supplemental video was EXCELLENT...and most of the sales people simply tell their customers "Supps are what your parents had"?? And they move on to their sales pitch ...however I am looking way more closely at Supps..and I have received more education from you than any other source so THANK YOU in advance!! I wish you were my boss.
Thank you so much for helping me to understand the real difference between supplemental insurance and the advantage choice. There is a difference and really did not understand the difference. You really are excellent at explaining the medical choices!!! Again, thank you so very much!!!
Stephanie, if a Medicare Advantage Plan has dental coverage, does it "coordinate" with other plans, such as Delta Dental?
Hello Carlos, How are you doing today?
a dental plan is a plus/.
Please keep in mind most dentists do not take MA plans dental, most do accept Delta in some form.
I like your video presentation. It is informative too, at the same time. Thanks a lot for your guidance!
Sorry for the previous comment about your video output. Your output is fine. I am having trouble with my audio drivers.
If you must have zero risk than buy a medigap plan but zero risk comes at a cost. I'm more worried about nursing home costs . We use our savings from Medicare Advantage plan to pay for long term care insurance
I just happened to stumble across your videos and they are coming at a great time. I plan on retiring in about 3 years at the age of 66, and just started reading about Medicare and all that goes with it. Your videos are straight to the point and very good. Will hang onto your phone number for when the time comes. Thank you and keep up the good work!! :)
Since Kaiser is not in every state , would it be wrong to go with them?
I have plan f. It is expensive here in Georgia but at 84 years old I dare not change. Is this correct and best choice for me.
It depends on several factors. If you have any major pre existing conditions, you may be better off keeping your existing Plan F rather than trying to switch to another lower cost plan. Medical underwriting could potentially disqualify you. I hope this helps!
I'm on Medicaid at the moment and start Medicare March 1st. If I still have Medicaid would I still need a supplemental plan ?
In most cases, no. And many Medicare Supplement companies won't sell you have a plan if you have full Medicaid benefits.
I am late to the party here on this subject as I just turned 65 in April of 2022. I took a Medicare Advantage Plan here in northeast Pennsylvania thru Highmark. I choose this because I could NOT afford original Medicare because I could not afford the extra plans you have to get with original Medicare such as Medigap, Part D, etc. that adds up to a lot of money per month which I do not have or afford. I still work but only part-time and it is a struggle each month. My Highmark plan pays 22 a month towards my Part B so I only pay $148.10 a month instead of the $170.00 per month. Yes you have co-pays, yes they want you to stay "in-network". I have dental, vision, hearing, prescription with this plan. No referrals as this is a PPO and not an HMO. Is is perfect nope far from it but nothing is. I have a 0 co-pay for family dr., $30 for a specialist and $90 for the E.R. Again nothing is perfect.
That's the best MA plan I've ever seen. You won't find a better one in the country.
I hear you. I am totally screwed. I am 70 and my husband left, with all of our money, kicked me off his health insurance and refuses to give me my share of our savings. I am trying to get on Part B but they are going to charge me $80 a month as a punishment for not selecting Part B when I was 65. No kidding. I have no money, went back to work and I am working with an agency to help me sort this out.
It seems the only real advantage to advantage plans is the lower cost of the monthly premium. Advantage in my area is the same as Part B = $165, basically. But a Plan G or N would be an additional $95 to $140 along with the A & B cost of $165. Sad when you are on a very tight and fixed income.
My Doctor is on some advantage plans approved provider list but his clinic is not. He warns about the red tape, waiting for approvals, limitations within the Advantage Plans, etc. Also they don't always cover everything that a Plan G or N would cover, for example.
From what I have gleaned I don't want an Advantage Plan.
Stephanie, assume a person has an Advantage plan with a $6,900 MOOP. With a few weeks left in the Annual Enrollment Period, the person learns of a health problem that will require expensive treatment that extends well into the next year. There is another Advantage plan available with a $3,900 MOOP. All of the relevant providers are on both plans. Is there anything keeping the person from switching plans to save $3,000 in the following year?
No, not at all, since Medicare Advantage Plans are not medically underwritten. You can always change plans between Oct. 15th - Dec. 7th for the coming year.
Helpful info as usual. I know someone who is considering MA and thinks it will be totally free (part B deductible reference). It may be tempting at 65 for some but when a serious issue arises in your 70’s, it will be a trap. If one can afford it, a supplement is the safer route.
Is this true? Please explain further. Thank you.
Wy would one switch from one medicare advantage plan to another advantage plan? I thiufht they were the same. TY
My husband’s plan is AARP Medicare Advantage Walgreens Plan 1 United Healthcare. This plan pays for unlimited time in hospital. Is it a good plan or we should change?
That depends on many factor. Please give us a call at 888-465-9728 if you would like to review!
Thank you for your update take care stay safe and stay healthy love to watch your videos god bless you and your family
Can you switch between the letter plans easily? Say I get plan N and then the next I decide on plan G. Is that done without the medical questions or underwriting?
In most states you will have to pass through underwriting to switch your Plan Letter, or to switch from one insurance company to another.
If the med advantage replaces part a and b, then why would you still have to pay for part B? Will you get any benefits out of making that payment?
I'm in disability for a year now. I'm only 64 year old now but i be 65 in May. i know i can get Medicare soon but don't know what to do. i have insurance from COBRA that i keep from my job. I'm pay lots' money now but i do need it because my condition. I'm on Aetna insurgent . that say i need to cancel it. but Aetna has Medicare too. do i cancel and renew it or keep it? should i go somewhere else. i don't mine paying monthly payment but don't want to pay too mush. can you help me? I live in LEE COUNTY Florida
We would be happy to help you review your situation! Please call us at 888-465-9728
I’m lucky to be under the Canadian health care. No concerns about choosing the wrong plan or not having the correct information.
Hilarious! Thanks for the laugh!
A lot simpler, eh?
Yep. The US healthcare non-system is extremely wasteful, expensive, bureaucratic, inefficient and fragmented.
Healthcare spending in the US is nearly twice as much as some industrialized European countries and we still leave millions uninsured and underinsured; one serious disease or accident away from bankruptcy and GoFundMe campaigns.
And search what these health insurance CEOs are making annually and then think about that the next time you're stuck with a huge deductible or you max out your health insurance. Just let that sink in, let that really sink in.
The health insurance CEOs are not there for your benefit but are only there to maximize returns for investment shareholders.
Those are our healthcare dollars in one form or another being siphoned away from our healthcare.
The US healthcare non-system is ethically and morally perverted.
I find it weird you're even watching these videos
Thinking about immigrating to Canada. I know prosthetic eyebrows are included in the Canadian plan but what about toupées?
I'm a new agent and I have been reviewing your videos for more knowledge. Thank you!
Best of luck to you!
@@AbtInsuranceAgency Thank you!
I still don’t understand the need for a supplemental plan like N for example over just A&B with D. Can you guide me to resources that could help me understand the benefits of paying for extra coverage.
Original Medicare A and B doesn't offer 100% coverage at the doctor/hospital. You have deductibles and coinsurance that you're responsible for. The Medicare Supplement Plans (like Plan N) help to pay for the deductibles and coinsurance so that you have much lower potential out of pocket exposure. Click Here for more info --> th-cam.com/video/tIEF7dC9e3o/w-d-xo.html
drp5 * without a supplement , I believe the biggest risk lies in part B coinsurance being 20%. There is no limit or out-of-pocket maximum. So think about how much outpatient surgery/procedure/treatments could run.
Ron Brown Thank you , starting to make sense now.
Make sure your Advantage plan is a PPO. My plan has all my doctors, hospitals i'll ever need. If your provider is a major company coverage is available nationwide. The savings my wife and I have obtained over the years has paid for any possible futue max out of pocket several times.
Do Medicare Advantage Rx plans have network pharmacies and require their members to use them?
D Lee typically Part D Plans and Medicare Advantage plans have network pharmacies, and then among those there are Preferred and Standard network pharmacies. Rx costs are lowest at Preferred network pharmacies. The plan can tell you which pharmacies are Preferred network pharmacies, and you can always reach out to us with questions too. I hope this helps!
This is awesome info
Anything wrong with my Blue Medicare Advantage PPO?
We winter in the lower-48 and summer in Alaska. Therefore the advantage plan would be a poor fit for multi-state health insurance since "out of network" when out of state?
Great informative videos
Thank you!
I love your energy and your wonderful smile!. You have done a great job explaining the pros and cons of both and this video has made me reconsider getting these "cheap" Medicare Advantage policies. The stability of the carrier should also be factor in mitigating large year-over-year premium increases.
Thank you Alex!
Thank you for this video. It really helps to understand what the options are.
Kevin Brinkman thanks for watching Kevin!
Stephanie, isn't another advantage with Advantage plans is that they pay the 20% that traditional Medicare does not cover?
@@CarlosGarcia-ls4hn Not always. Many of them are similar to coverage from work and have deductibles and copays. Especially on some big ticket items like cancer treatments and prescriptions. Remember there's no free lunch.
I'm on SSDI, 56 y/o and my 2 years to switch to Medicare is up in June this year. I am very confused on wether to go with original part a and b or advantage plan. I hear horror stories of advantage plans having you pay a higher out of pocket (20%) after negotiating the final bill with hospital than original medicare....very confusing even after doing a lot of research...
You are on SSDI
With medicare supplement plans what are some of questions asked during underwriting?
The most clear and honest explanation ! Great job Stephanie!
Really feel so lucky in Vancouver Canada as a senior. Live in both countries for years.
Thank you Michael, that means a lot!
Can I sell you some cheap twin towers' stock too?
I have a question I have CALpers special power ofAttorney my client took a stroke August 22 this year and her current insurance does not cover and will not assist in the care she needs is the Medicare and health insurance tied in
At the new Obamacare today about 10 minutes ago with Flexico
Very, very useful! Thank you
I see these adverts on tv that say "add $144 to your SSA benefits"Is this true or is it a scam?
I review that in more depth here - th-cam.com/video/dMy1JJvQwTs/w-d-xo.html
I have to get Part A and B to keep and continue my Tricare. Do you think I would need a supplement or advantage plan with Tricare?
No
No again
Listening to this video, I suddenly realized that we seniors who are retired municipal workers are being exploited by the City of NY and our prior Union. This comes under the heading of SENIOR ABUSE. Why not add SENIOR ABUSE to our court case?
Do you often referred to state plan. If we are planning on moving or living partially in another state in the near future will a major companies advantage plan cover me nationally? I probably need to ask them what are their state specific restrictions
If you move out of your Medicare Advantage Plan's service area you will have a "special enrollment period" to choose a new plan in your new area.
Does Advantage plan cost changes according to the income like Medigap? Also, can you switch from Advantage to Medigap plan any time?
Great video ! Guidance if you have Tricare For Life ?
Is the 1406$ fee you have to pay upfront for original medicare, still apply with medicare advantage plan?
Could my Medicare Advantage plan be change now in August?
In most situations, you are locked into your Medicare Advantage Plan for the calendar year. You can make changes from Oct. 15th - Dec 7th for changes to go into effect Jan. 1st of the following year. If you have a life changing event you may qualify for a special enrollment period to change mid-year. I hope this helps!
Great educational information, as always thanks
Steve Boose 🤓
Please discuss worldwide coverage Advantage vs Medigap
Could you tell me what is the monthly payments for getting a supplemental insurance for Medicare?
how many insurance we can have ? can we have Aetna medicare and Medicare Advantage to gether ?
You cannot have both a Medicare Supplement and a Medicare Advantage Plan.
Great job explaining
😀Very informative, thank you very much
Thank you. I am in the first year Medicare with KP advantage plan, Do I have to reapply for next year 2021; or, it's auto enroll to same Medicare with KP advantage plan coverage without doing anything?
Medicare Advantage Plans are calendar year plans, so your plan benefits may change each year. You'll receive a renewal packet outlining plan changes in the Fall, and you can either do nothing to continue with your plan's renewal, or you can shop Medicare Advantage Plans during the Annual Election Period from Oct. 15th - Dec. 7th.
Technically, I believe the terminology is "Medicare *_WITH_* Supplement Plan" as Original Medicare remains in effect. You have a Medicare Advantage Plan *_FROM_* KP. Medicare Advantage Plans REPLACE Original Medicare as Original Medicare is NO longer in effect.
Can you choose to go to Medicare Advantage plan...then once you’ve tried it and discover you don’t like it, go back to original Medicare A and B a subsequent year?
You have one year to try it out from when you initially get it.
I heard that once you go off Medicare Advantage that when you re-apply for a medigap plan they now look into your past medical records to make a decision on cost ect.
@@DavidReo yes, thsts what underwriters do. If you have medical issues You WILL be denied. Each yr you are reviewed by your own plan...they may be able to 'dump' you if you cost too much. Its a risk! 😦
What happens if you move to a different state/zip code?
A very clear explanation. Thank you!
Do the Medicare Advantage insurance companies require Medicare to give out our private medical information since Medicare is paying those insurance companies?
Good information as always! Thanks.
In researching my Medicare Insurance options I found that as a resident of New York State I am allowed to change my plan once each year between MediGap and Advantage Plans (and vice versa) as part of the EPIC Program in the Special Enrollment Period (SEP). I have not seen this mentioned in yours or any other insurance advisor's videos. Am I missing something?
New York has different rules regarding Medigap and guaranteed issue rights. I don’t have a video specific to NY yet, but I hope to soon!
How soon on NYS video?
Very informative,by the way which insurance company are you with right now??
I am an independent insurance broker, and represent many various insurance companies.
@@AbtInsuranceAgency Thanks A lot for your response...by the way can you please write down medicare script for part c and d??
medical underwriting is not required in NY
ok,head spinning now..........what plan do i need for this ?
Great video's, jealous of them. I don't understand any of your thumbs down from people other than trolls. I will recommend my clients to you outside of the states I represent. Best-Chris
Chris thank you SO much! I truly appreciate you watching and commenting :-)
You're a PAID troll, aren't you
I have tried several times to talk to somebody, to find out sweetable plan, but i could not conect any live person, only ad.
Are you referring to calling my office? If so that doesn’t track. We are real people, here to answer the phone and help seniors. 888-465-9728.
I have elected an advantage plan Aetna said I was denied so I did part D with Humana, my question is am I going to get kicked off the advantage plan?
I did the part D before it enrolled me in Aetna Medicare advantage, so does that kick my part D separate plan processing from Humana out, and leave the advantage plan alone? Typically also how long Would it take for a plan to enroll? I want to make sure that I’m ok with my advantage plan? I did the separate part D last Saturday and Aetna with me being suddenly approved took effect 7/1 but it never showed up until this Monday. So should I be ok with the advantage plan, or will it kick me off for that separate part D plan that was processed last Saturday?
Stephen, if you call my office at 888-465-9728 we can definitely help. Typically enrolling in an Advantage plan will cancel out your Part D coverage, and vice versa. The coverage that is going to “stick” will depend upon your enrollment dates, approval dates, and election period. I’d be happy to help you sort it out if you’d like.
They never kick anyone off just X 10 your premium, but You weren't kicked off! Haha😛
Great video. I loved the dog and cat :-)
For me when I lived near major cities the advantage plan was a no-brainer, great service and very low cost. Now living in the sticks that plan stinks on ice it is expensive and has spotty service.
This is often the case!
This was very helpful, I’m training to sell Medicare now and this helped me understand better than 5 days of training 😂
Can you give some examples of Con #2, unforeseen medical bills not covered by Medicare Advantage Plans? Thank you.
Medicare Advantage plans could deny certain services, in which case you could be responsible for the costs of these services.
@@AbtInsuranceAgency that was NOT giving an example...😕
@@druannpellegrini5661 let’s say for example that your doctor advised you to have 5 injections per year to help your arthritis. Your insurance carrier may only deem that up to 4 injections are necessary and could deny the 5th injection. Then you are responsible for the cost of the 5th injection if you receive it. This is not extremely common but could happen. I hope this helps.
Sure. Traditional Medicare is fine if you can afford 280 a month for plan G and 90 for plan D. MOST can't afford an extra 370 a month. Add THAT up over a year. The out of pocket for an advantage seems the better choice if you have a good network.
Exactly. Health First is excellent and accepted by most doctors here.
Networks change every year. The doctors you like and trust with your care will leave the plan when they can no longer stand the insurance co.'s pressure to scrimp on your health by no longer approving the better treatments. Medicare Advantage is like sausage - once you see how it is made you will lose your appetite for it. But it will be too late.
@@utuber1000 yep, my doctor just left and no available doctor available accepting Medicare. I have expensive advantage plan, but did find a new provider elsewhere. I rather pay than lose out.
Do not use Advantage. Fewer doctors with less coverage.
The question is can you afford the deductibles on an advantage plan
If I dont go with Advantage plan, what are my options for Dental and Vision if they are not covered by plan A and plan B?
Outside Dental insurance carriers like Physicians Mutual are a good alternative for Dental coverage. However, any major restorative work requires a 1 year waiting period, while preventive can be covered more quickly. I do not have any advice on outside Vision coverage, but your eye doctor may offer a plan or know of a plan to minimize your expenses.
Medicaid pays our Part B Premium. That's why we are staying with the traditional Medicare Supplement plan. Medicaid is our supplement plan. We also get extra help with our Part D (prescription coverage).
How'd you qualify for medicaid? What are the qualifications...$$??
Thank u good info. Mostly but u left some stuff out
EXCELLENT
I guess it's these type of Advantage plans that people talk about when they say medicare advantage plans are so terrible They get really huffy about it.
I work for a very large University employer and have chosen an advantage plan that is a $167 a month. (Plus Plan B). For this I get a plan that is similar, in fact is even better than the company health insurance I had. Copays and deductibles are not onerous.
I consider myself very fortunate. Choosing an Advantage plan over the supplement plans for me was a no brainer. Too bad this isn't available to everyone.
All of the YT tutorials say the same thing about switching back to a medigap plan after you have been on an advantage plan past the trail period - that you will have to answer health questions and pass underwriting - but I don't hear anyone going into detail about this, specifically how hard is it to pass underwriting? I assume cancer or some other very serious condition will likely disqualify you but what about less serious conditions - enlarged prostate or pre-hypertension or even hypertension that you are medicating successfully, just for example. So, generally how hard is it to pass underwriting? Can you elaborate please? Happy to call you directly to pursue this if that is something you do. I'm 67, with the above mentioned conditions, currently on Humana Gold HMO MA in Va. Thank you so much Stephanie, if you could please comment! I'm sure many have this same question now that MA facts are coming to light. A plan N sure seems like the way I would like to go.
I cover underwriting in more depth here - th-cam.com/video/XDXdPMMxlOo/w-d-xo.html. Call us, we would be happy to help. 888-465-9728
@@AbtInsuranceAgency thanks, that was exactly what I was looking for. I'll call in January.
If you still have to pay medicare premiuns what is the point of having an advantage plan really?
You keep A&B. In fact you HAVE to have parts A&B to have an advantage plan. Also. The part B buyback program is real, it's just not very often that it pays the entire part B premium. Usually, they will pay between $20 and $80 back of your part B premium. Plans that pay the full $148 are rare, but they do exist.
Yes! I cover the Part B giveback in more depth here - th-cam.com/video/dMy1JJvQwTs/w-d-xo.html
Isnt that dependent on your income?
i just enrolled yeaterday and ive changed my mind.how do i cancel?
Give us a call! We can help. 888-465-9728
How does Medicare work with TriCare for life.
www.tricare.mil/LifeEvents/Medicare
Good info!