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I am turning 63 shortly. I have been trying to educate myself. This channel is awesome. Thank you for explaining things in such detail. Everyone should subscribe to this channel. Thank you
Amazing commentary, I recommend you to everyone! I am on the G Plan and I love it. Would rather pay a bit more than have any hidden surprises. Thanks for your clarity and communication skills!
I wish I had seen this when I turned 65 nearly four years ago. The supplements seemed like so much more money, I just opted for the regular A & B. But this year, I got bladder cancer. Now, all of a sudden, I have the potential for huge bills, despite Medicare. I picked up a Plan N this month, which will help a lot, for the price of $193.50 a month. I sure wish I lived in a sane country with good medical care.
@@sidney4329 That's the reason. Since NY doesn't allow for medical underwriting to join or switch Supplements, the insurance companies charge much higher premiums because they have to accept everybody, which raises their risk pool. On the other side, you are VERY fortunate you were able to join a Supplement after your diagnosis. Most other folks in the country (46 or so states) would have been subject to underwriting and probably denied.
this is the reason i subscribe to this channel.turning 65 november 2024 and i need to learn as much as i can before my time comes to enroll.thank you sir.can i get any cost information for my state?
My parents had F-plan for years but switched to a MAPD on an advice our agent gave us during the annual enrollment last year. After viewing your video, I am thinking that we made a mistake. Please advise if it is potable to roll them back to the supplemental plan ( maybe a G-plan) without having to go through the underwriting since it has not been a year yet? Thank you.
It depends on when you made this change. You should be able to switch back if it's under 1 years. Called the trial right period. But they would have to go back to the same exact plan they were on prior. You can give the carrier a call!
What can you share about how fast the premiums for G vs N go up over time. Which plan would have the healthier pool? Are premiums the same for a 65 y/o vs an 80 y/o?
I’m not sure if you’ve already done this, but I don’t see it yet: can you please compare costs of a hypothetical disease or accident across both the advantage plans and medical plans? I’ve seen you discuss how much we might have to pay for various things if on an advantage plan, but as I’m listening to those videos, I’m thinking, “Yeah, but how much would I pay for that of if I had a medi gap plan?” I’d like to see a side by side comparison for a given disease or accident. Is there a MOOP if on a medigap plan? Thank you.
Assuming all claims are deemed medically necessary by Medicare: Total Costs for Plan G holders: 1) Part B premium (monthly) - 174.70 2) Premium for Plan G (monthly)- depends on insurance company and zip code 3) Part B deductible (Annual) - 240.00 100% coverage after this Total Costs for Plan N (holders): (1)-(3) - Same as above, but the Premium for Plan N typically is lower 4) Copays for Office Visits - up to $20 per visit (no maximum) 5) Copays for ER visits not resulting in admitting - up to $50 per occurrence (no maximum) 6) Excess charges - up to 15% above Medicare reimbursement (rare, prohibited in some states) Total Costs for "High Deductible" Plan G: (1)-(3) - Same as above 4) Deductible before Supplement pays - $2800 100% coverage after this
What I don’t get though, is if there is no out of pocket max, doesn’t that mean, they can charge you millions? Is there a limit to what they cover? I like the idea of a max because you know you won’t be spending more than the max… but if there’s no max, they can keep charging you and saying you’re responsible for this or that… right?
@@candleabra1837 Please go back and read my answer, where I explain the G, N, and High Deductible G. The G and High Deductible G have maximums, as I discussed. The G plan's maximum is the $240 Part B deductible, the High Deductible G's is $2800, and the N has none. With the N, you could pay a co-pay every time you see the doctor or visit the ER.
My part c is almost identical to my former employer's plan. I don't think I will max my oop every year. I have a wide network in JoCo, as you know. Please state the cost of gap plans at age 85. If I pay gap plans $2000/ a year for 15 years, going to the Dr. Twice a year, and max my part c twice, I have saved😊
Costs for a supplement plan at that age can vary widely depending on your location. We’d be more than happy to review and compare those costs with your current Advantage plan. Feel free to call our office at 1-800-864-8890-we’d love to help!
@@cinematicuniversenews1295Then go with advantage. Better than nothing if you think you can have the cash on hand to pay all the co-pays and co-insurance costs, which by the way start all over again at the beginning of each year. Pretty sure when you get serious sick you will have wished you would have paid the measly premium for G or N compared to what you will pay out of pocket with an advantage plan. But hey, it is your choice. We all will get sick as we get older and there are no freebees and shortcuts so don't just assume you can skirt by with advantage and can just change to a supplement later, especially if you get sick, you will be denied and stuck with advantage.
You pay the $174 per month whether you stay on original or do the advantage plan. If you add a supplement G or N you pay a monthly premium for but you get seriously sick you will be thankful you chose the supplement over the advantage if you choose a supplemental plan. My income has dropped drastically now however I don't think I can afford not to have a plan N supplement. But that is just how I see it.
I believe so. I have a G plan this year and am switching to an N plan for 2024, staying with the same provider. I have to submit a form to the ins provider stating that I want to make the change but that's it. I think you can change back and forth between G and N depending on if you know something is coming up in your health situation and you want the extra coverage.
Excess fees are an uncomfortable risk for me. People never know what doctors they might need in the future for something like emergency surgery (for example) or for a diagnosis that requires specialists (who are sometimes in short supply). Also, with rising healthcare costs, it's quite possible that more and more doctors will charge excess fees in the future. Medicare reimbursements in the future might not keep up with what doctors feel they are due for their services. With Plan G, a person will not be as limited in what doctor or surgeon they get, which might mean getting to use a doctor or specialist with greater expertise.
Social security pays for A and b plan Then automatically Set up direct withdrawal from bank account for g plan through anthem blue crossing blue shield. To avoid an advantage plan that would convert to medicaid and take everything.
I do not understand how the gap of Part B copays under N is stated by medicare.gov to be 0 on an N plan but you say there are still other Dr and ER co-pays. N should have 2 gaps which are the Part B premium and the Excess 15%. Where did these other mysterious co-pays come from?
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✅ To get 1 on 1 Help from our Team, Schedule a Call Here: go.medicareschool.com/vsl-2023
I am turning 63 shortly. I have been trying to educate myself. This channel is awesome. Thank you for explaining things in such detail. Everyone should subscribe to this channel. Thank you
I work in healthcare imaging. Advantage plans play doctor and deny medical procedures left and right. I would not have an advantage plan at all.
Thank you for the insight!
Amazing commentary, I recommend you to everyone! I am on the G Plan and I love it. Would rather pay a bit more than have any hidden surprises. Thanks for your clarity and communication skills!
Glad you enjoy it!
I wish I had seen this when I turned 65 nearly four years ago. The supplements seemed like so much more money, I just opted for the regular A & B. But this year, I got bladder cancer. Now, all of a sudden, I have the potential for huge bills, despite Medicare. I picked up a Plan N this month, which will help a lot, for the price of $193.50 a month. I sure wish I lived in a sane country with good medical care.
Do you live in one of the 4 Northeastern states that don't require medical underwriting?
@@brentgindelberger8851 I'm in New York.
@@sidney4329 That's the reason. Since NY doesn't allow for medical underwriting to join or switch Supplements, the insurance companies charge much higher premiums because they have to accept everybody, which raises their risk pool. On the other side, you are VERY fortunate you were able to join a Supplement after your diagnosis. Most other folks in the country (46 or so states) would have been subject to underwriting and probably denied.
this is the reason i subscribe to this channel.turning 65 november 2024 and i need to learn as much as i can before my time comes to enroll.thank you sir.can i get any cost information for my state?
My parents had F-plan for years but switched to a MAPD on an advice our agent gave us during the annual enrollment last year. After viewing your video, I am thinking that we made a mistake. Please advise if it is potable to roll them back to the supplemental plan ( maybe a G-plan) without having to go through the underwriting since it has not been a year yet? Thank you.
It depends on when you made this change. You should be able to switch back if it's under 1 years. Called the trial right period. But they would have to go back to the same exact plan they were on prior. You can give the carrier a call!
A in-patient
B out-patient
---
Supplement (AKA Medigap)
Or
C Advantage (
Plus
D drug
19:40
If one selects the N plan and a few years later goes to the G plan, does that person have to go thru underwriting?
Yes
Usually. However, it truly depends on the insurance company and the state's rules (if any)
@@brentgindelberger8851 Thanks, good to know - going with the G and be done with it 🧐.
Thank you! You've made it easier to undestand.
What can you share about how fast the premiums for G vs N go up over time. Which plan would have the healthier pool? Are premiums the same for a 65 y/o vs an 80 y/o?
You can avoid the excess charge by going on Medicare website and seeing if the doctors charge excess fees or not.
What happens if SSA pays for Medicare I only have A&B under them ?
I’m not sure if you’ve already done this, but I don’t see it yet: can you please compare costs of a hypothetical disease or accident across both the advantage plans and medical plans? I’ve seen you discuss how much we might have to pay for various things if on an advantage plan, but as I’m listening to those videos, I’m thinking, “Yeah, but how much would I pay for that of if I had a medi gap plan?” I’d like to see a side by side comparison for a given disease or accident. Is there a MOOP if on a medigap plan? Thank you.
Assuming all claims are deemed medically necessary by Medicare:
Total Costs for Plan G holders:
1) Part B premium (monthly) - 174.70
2) Premium for Plan G (monthly)- depends on insurance company and zip code
3) Part B deductible (Annual) - 240.00
100% coverage after this
Total Costs for Plan N (holders):
(1)-(3) - Same as above, but the Premium for Plan N typically is lower
4) Copays for Office Visits - up to $20 per visit (no maximum)
5) Copays for ER visits not resulting in admitting - up to $50 per occurrence (no maximum)
6) Excess charges - up to 15% above Medicare reimbursement (rare, prohibited in some states)
Total Costs for "High Deductible" Plan G:
(1)-(3) - Same as above
4) Deductible before Supplement pays - $2800
100% coverage after this
There are 10 Medigap plans , no MOOP on plan G , I can say because that the one I have.
What I don’t get though, is if there is no out of pocket max, doesn’t that mean, they can charge you millions? Is there a limit to what they cover? I like the idea of a max because you know you won’t be spending more than the max… but if there’s no max, they can keep charging you and saying you’re responsible for this or that… right?
@@candleabra1837 Please go back and read my answer, where I explain the G, N, and High Deductible G.
The G and High Deductible G have maximums, as I discussed.
The G plan's maximum is the $240 Part B deductible, the High Deductible G's is $2800, and the N has none. With the N, you could pay a co-pay every time you see the doctor or visit the ER.
My part c is almost identical to my former employer's plan. I don't think I will max my oop every year.
I have a wide network in JoCo, as you know. Please state the cost of gap plans at age 85. If I pay gap plans $2000/ a year for 15 years, going to the Dr. Twice a year, and max my part c twice, I have saved😊
Costs for a supplement plan at that age can vary widely depending on your location. We’d be more than happy to review and compare those costs with your current Advantage plan. Feel free to call our office at 1-800-864-8890-we’d love to help!
Are you saying that you pay 174 a month for B plan. If you want the G plan it would cost 125 extra a month? Thanks for your response.
Yes the G plan is an additional cost to the B Plan
@@stevenwirtz1673 that bs. what if your low income. people cant pay that. get the hell out here with that
@@cinematicuniversenews1295Then go with advantage. Better than nothing if you think you can have the cash on hand to pay all the co-pays and co-insurance costs, which by the way start all over again at the beginning of each year. Pretty sure when you get serious sick you will have wished you would have paid the measly premium for G or N compared to what you will pay out of pocket with an advantage plan. But hey, it is your choice. We all will get sick as we get older and there are no freebees and shortcuts so don't just assume you can skirt by with advantage and can just change to a supplement later, especially if you get sick, you will be denied and stuck with advantage.
You pay the $174 per month whether you stay on original or do the advantage plan. If you add a supplement G or N you pay a monthly premium for but you get seriously sick you will be thankful you chose the supplement over the advantage if you choose a supplemental plan. My income has dropped drastically now however I don't think I can afford not to have a plan N supplement. But that is just how I see it.
@@cinematicuniversenews1295 yea! thats $300 a month! my pension will be $285 a month. there goes my pension...
I know you'll to have to go through underwriting to switch from an C plan to an supplemental, but can you switch between G and N plans without issue?
I believe so. I have a G plan this year and am switching to an N plan for 2024, staying with the same provider. I have to submit a form to the ins provider stating that I want to make the change but that's it. I think you can change back and forth between G and N depending on if you know something is coming up in your health situation and you want the extra coverage.
Only if you go lower . Means you can switch from G to N but not from N to G without underwriting
@@Jazna1not in California. I have G and can go to N but if I want to go back to G I have to go trough underwriting. It isn’t guaranteed.
There is no universal answer. Depends on insurance company and the state's guaranteed issue rules (if any)
Excess fees are an uncomfortable risk for me. People never know what doctors they might need in the future for something like emergency surgery (for example) or for a diagnosis that requires specialists (who are sometimes in short supply). Also, with rising healthcare costs, it's quite possible that more and more doctors will charge excess fees in the future. Medicare reimbursements in the future might not keep up with what doctors feel they are due for their services. With Plan G, a person will not be as limited in what doctor or surgeon they get, which might mean getting to use a doctor or specialist with greater expertise.
now, if i choose the G plan, will i still have to pay the $175 for the B plan?
Yes. Part B deductible no matter which supp plan you choose.
The part B of Medicare has to always be paid regardless of what supplement plan you choose.
My prescription drug plan, that we are forced to buy by our dear government, more than doubled its premium from last year! Now that makes me sick!
Realize that you can shop for a new plan every year between Oct 15 and Dec 7
Can I have my Plan G monthly premium deducted directly from your Social Security payment or does it have to be deducted from my bank account?
I'm seeing answers both ways on this when researching. I'd contact your insurance company on this.
Social security pays for A and b plan Then automatically Set up direct withdrawal from bank account for g plan through anthem blue crossing blue shield. To avoid an advantage plan that would convert to medicaid and take everything.
I do not understand how the gap of Part B copays under N is stated by medicare.gov to be 0 on an N plan but you say there are still other Dr and ER co-pays. N should have 2 gaps which are the Part B premium and the Excess 15%. Where did these other mysterious co-pays come from?
My team would be happy to assist you. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com