Thank You. This was the easiest breakdown I have found on TH-cam. I am lost on all this. I have always had insurance through my employer. I had a stroke due to an injury. I have not been able to get released to go back to work. I am currently on a private Blue/Cross My blue HMO. plan which has cheap monthly rates and low deductible etc. I will be forced in a few months since I am on SSDI to take the switch? So if I am hearing correctly I will only be allowed either Part A&B or The Advantage plan?
@@justink87371 If you are new to Medicare you will have a 180-day period from the start of Medicare Part B to get any supplement plan available to you. However, under 65 is not easy in all states. there is no Federal mandate to offer supplements to people under 65 on SSDI. We can help look for you. that said, in your Medicare welcome packet you should have an "Opt Out" card to opt out of Part B and keep your private coverage, but you may face penalties if you do that. medigapseminars.org/contact-us/
@@MedigapSeminars Ok thank you for the Info. I think it's still a few months away before that package will be sent to me. I just don't like that there is no Out of Pocket Max On Medicare.
I had Medicare and Medicaid with D for years. Here is the deal. I saw a flex card ad on fb. Thinking it was a government program I went to that page. I was called by the company. I’m still thinking this government program. They started a spill and said yes I was eligible. They did not tell me I was leaving regular Medicare at all. So now I am on Medicare Advantage Gold which I totally don’t want. I will go back to original Medicare plan in October. You need warn people like me about the tactic of using flex cards to draw Seniors into their plan. I am 72 and they are crooks and deceivers. They think I am stupid but you have convinced me I am making the right decision. You have shown a video I can understand. Please warn other uninformed Seniors about what they are doing. Top of the day to you
I have a niece who worked for one of the largest MA provider in the US. She worked in several finance sections prior to working in the dept that reviews and approves/denies surgery, procedures, tests, prescription drugs etc. She resigned shortly after discovering the tactics that the company employed through their denials and how they treated their customer's by denying the necessary treatments that doctors had ordered. She said it was the most depressing experience in her life to follow company protocols that she knew were killing people prematurely. She couldnt handle it and is now an outspoken critic of the industry.
@@peacefreedom4930 if you are old enough for Medicare, you are old enough for a supplement. If you are on Medicare and under 65 you can get a supplement depending on your state laws. If you would like clarification, feel free to call us at 800-8 47-9680.
Matthew is probably the most informed and objective source for Medicare insurance information. The relentless advertising and promotion of advantage plans to the uninformed General Public is unfortunate. Keep up the great work Matthew!!
Excellent! Finally a straight shooter who tells it like it is. I am a physician and I can tell you we hate the administrative red tape The Advantage Plans put us through. That is why we are dropping our participation in these plans. They are not worth the trouble or added administratve payroll that is required of us to provide care. Good luck with your new doctor you had to switch over too be cause you chose advantage plan.
I was a Medicare sales agent with an FMO and I almost was brainwashed against Medicare Supplements. Thanks to your videos and others that tell the truth about medicare advantage plans, the damage done by that company was reversed. Before I left that company, we were told that they would no longer be offering supplements. That disturbed me but I was still under the spell of the lies, I eventually left the company due to health reasons and now I am glad that I did. The more that I learn the less I am willing to go back to companies that enforce advantage plans and leave out information about supplements. If I could find a company that tells the whole truth about Medicare plans, I would go back into the sales field. I live in Florida and so far I have not found such a creature. So, I have to rely on you for the "truth" because I will be going on Medicare in July. I will be getting a supplement!! Thank you for your honesty. I have learned so much.
In the year leading up to turning 65, I researched this topic and discovered Matthew's videos, and I'm SO glad I did. I chose traditional Medicare with a Plan N supplement. The more I learn about the topic, and there's a lot to learn, the more I confident that I made the right choice for me. Thank you, Matthew!
It’s crazy now that I am a senior my hard earn money is going to feed the insurance companies no matter which one I choose wether is advantage or original I have to pay the only way is been poor and getting both Medicare and Medicaid now This is am devastated
I've had a Medicare plan and a Medicare supplement plan for about 8 years. And the supplement plan pays whatever Medicare doesn't. Minus whatever deductible you choose. Monthly premium has gone up over the years. In some years I may have paid more for the plan than I got in services, but there have been years when it's literally saved me thousands of dollars. So over the time frame I've had it. It's definitely paid for itself not only financially but in not having to worry about having a procedure done. And not needing a pre-authorization. If my doctor says go I go I can go to any doctor. I want anywhere in the nation. Medicare advantage plans are basically private insurance. High deductibles, high rejection of coverage. Pre-qualifications. Looks cheaper on the front end but you're going to lose on the back end. So listen to this man
Absolutely agree with you and my Husband and I did the same thing and not sorry, we went with Supplement G plan. I had to have an emergency major surgery three years ago, spent seven days in hospital and I only had to cover about $200.00 dollars!!!
NEVER take advice from someone that makes money from the choices they recommend, like this guy. I have a degree in Economics specializing in social insurance, and an MBA. I've had Supplemental and Advantage insurance plans. I prefer Advantage plans in my area. Zero premium, zero cost family doctor, every medical profession in my city are in network, I've never had any surgery or treatment turned down, my medications are all free except for one high cost brand and that costs me $45 per month, free dental care, free eye exams and glasses, free hearing and discounted hearing aids. They have a national network of doctors.
@@samuelbutterworth4303I have Medicare Advantage ppo 2 and it seems like it covers a lot but I’ve still gotten bills for tests and doctor bills for procedures or hospital care.
Don't forget the bigger concern with chronic conditions and surgical needs. Quality of care. This is overlooked by almost everyone that signs up for Advantage Plans. They love the cost vs a supp plan until they need care. Seniors are dying prematurely every day because of these Advantage Plans.
Pretty much have decided on original Medicare (A&B) plus N and Part D, whenever I decide to retire. The cost and "perks" of an Advantage plan sound appealing, but not worth the risk of possible out of pocket expenses compared to original Medicare with a supplement plan. Health conditions can change quickly and with us in the over 65 crowd, that's a huge consideration at least in my opinion. And i want my medical decisions to be made between me and my doctor, not an insurance company.
One point I cut out of this video to keep it from being too long is that a recent study by Medicare showed that about 90% of Advantage plan companies advertise their plans by drawing attention to the extra benefits (I call shiny objects). They do so to take the focus off the healthcare benefits so people assume they are as good as Original Medicare.
Fortunately for me the Medicare Advantage Plan I was on was discontinued by my provider and I was able to go back to original Medicare with a supplement. You have explained excellently just how this system works and I am personally so very fortunate that I was able to ditch a Medicare Advantage Plan (which is an advantage for insurers). Your video is so educational regarding the pitfalls of Medicare Advantage and should be viewed by all those just going onto Medicare. Thank you for your excellent knowledge of Medicare.
Thank you for explaining this. When I get mailings soliciting my participation in a medical insurance plan, it’s ALWAYS for an advantage plan. Until I watched your video, I didn’t know why there are so many advantage plans looking to hook me up. They talk about free gymn membership, vision and hearing test coverage…all kinds of tempting offerings. But I suspected, and your video confirmed this, there is big money to be made by companies offering advantage plans. Money for them, not medical coverage for me. I just toss these mailings. I have a Medicare Supplement plan, and I’m keeping it!
Thank you. I have Medicare and a supplement. Never really understood the difference and was curious about the Advantage plan. You did a great job explaining that and I appreciate you.
Thank you. I just met with a Medicare broker yesterday. He tried to tell me original Medicare with a supplement required pre authorizations just like advantage plans and he didn’t know of any of his clients who had delayed or denied procedures. I said I had to review the plans before making a decision. But what I did is make an appointment with a different Medicare agent
Of course, you could call us. That is what we do for a living. I can assure you, I have more experience and knowledge that any local broker you can find. medigapseminars.org/contact-us/ 800-847-9680 Even more, my team is trained to help you after the sale when you may have issues with billing or whatever can come up between your doctor and Medicare.
Thank you Matt for your clear, concise, medicare explanation, that has been grotesquely obscured by the insurance companies. I am totally amazed at all the young insurance representatives of advantage plans pitching them to Costco and Sam's Club seniors. The few I have discussed medicare with truly have no idea what the basics are and what is at stake for the senior. They promise a free gym membership while not explaining the alternatives of opting out/and opting into an advantage plan, apparently concentrating on the amount of money they will receive when they sign someone up for their advantage plan. I'm a lucky and happy medicare participant with a healthy supplement plan I can afford. I do not have to worry about the cost of that supplemental plan, or worry about not having the right coverage to make "my" own medical decisions based on "my" doctor's recommendations.
As a recent retiree and new to the Medicare and Medicare Advantage systems, your video was just what I needed to inform me of my actual options. I was actually uninformed and I knowledgeable of this whole process. However, your video was well informative so that I now understand and know which option is right for me. Thank you ever so much for this video!
Matthew enjoy listening to your videos as they have helped me navigate the Medicare world, which I entered into early 2023. I am so glad I selected a Medicare Supplement N plan as I have had some unique and life threating illness come up over the past six month. Had no issue in finding a doctor and getting the necessary treatments which have placed me on the road to recovery.
Excellent video. I chose an Advantage Plan when I turned 65 and had no issues with it. After spending more time researching medigap vs advantage I decided to go through medical underwriting to switch to a supplemental plan G. Thank you for providing easy to understand information.
I am definitely going with a Supplement. I have been on disability for 15 years and have seen the up and downs of Advantage plans. I am turning 65 in May. I have been working with a broker and she has been talking to me about this. I was nervous about the amount I would pay. Since I am being paid disability only. I come out better with the G plan. Thank you!
Thank you for a concise overview of the Medicare plans and their history. You have convinced me that my decision to go with a Supplemental plan instead of the Advantage Plan is correct. I will advise others to watch this video before succumbing to the "eye-candy" Advantage Plans with their perks. Again, thank you!"
You omitted a number of key elements: 1) A Medicare Advantage plan is no different than any current ACA (Obamacare plan). Unless you have a "Cadillac" plan, most if not all ACA insurance plans have a restricted networks of providers and require previous authorization for most expensive procedures and prescriptions. 2) Medicare A and B + a Supplement do not provide insurance for prescriptions, dental or vision. Advantage Plans offer all three. In Metro Houston, Plan G premiums go from $200 to $400 per month, and prescription, dental and vision will cost another $100 to $300 per month. This makes total monthly insurance premiums for A+B+G+D+ dental + vision over $500 per month, comparable to a MOOP of most advantage plans. In scenario A you will pay $6,000 in premiums, and in the advantage you will only reach the MOOP if you have actual medical expenses. 3) Most Retirees usually stay put in the location they selected. Supplement plans will sell you the idea that you can choose any doctor, anywhere. If your current PCP and specialists are in and Advantage PPO, that suits most people well.
Re: 2) Medicare A and B + a Supplement do not provide insurance for prescriptions, dental or vision. Advantage Plans offer all three. - Some Medicare Advantage Plans offer some coverage for DVH, but you do not own the policy. Your benefits can be reduced or taken away when plans reset in January. That is happening to a lot of plans in 2025. RE: "Plan G premiums go from $200 to $400 per month," That depends entirely on where you live. In most areas of the country Plan G is below $125 / month , some places under $100. RE: "A you will pay $6,000 in premiums, and in the advantage you will only reach the MOOP " Very few places in the US will premiums be even close to that. Where they are, we recommend a High Deductible supplement with a MOOP under $3,000. - By the way, Medicare Advantage plan MOOPS increase each year and some plans are already over $13,800. RE: "Most Retirees usually stay put in the location they selected. Supplement plans will sell you the idea that you can choose any doctor, anywhere. If your current PCP and specialists are in and Advantage PPO, that suits most people well." Not true at all, and when seriously ill most people search out the best doctor available, not one that just happens to live near them. Most seniors travel, which is a big weakness for local Advantage plan coverage. Keep in mind, your Advantage plan doctor can drop your plan at any time.
Great video. My husband turned 65 this year and I turn 65 in February 2024. I worked for many of the Advantage Plans as a Network Development Contractor. I did the actual negotiations with Providers for the Plan. I watched many Specialty Groups and Hospitals term their contracts mid year. So many do not know that the Providers can term with a 90 day notice. This is one of the Big Dis-Advantages on the Plans. Also, the Insurance Plan has a huge Department that reviews the Prior Authorizations and will deny, deny & deny many services. The Free benefits out way the stressful issues that come along with the prior authorizations and Denial that happen with a so called Advantage Plan. My hubby and I will be staying with a supplement. Thank you for this video!!!!
After a year of researching my Medicare options, I chose original Medicare with Plan N. Living in SW Florida, it was a close call between Plans N & High Deductible G, but because of underwriting requirements here, I had to pick the plan that would be best for the long-term. Initially, my HD-G's total costs would be cheaper (if I remain healthy). But after about 10 years, it's likely that my N's total costs would be cheaper as I need more medical services and HD-G's max out-of-pocket would keep getting higher. In the end my decision came down to my concern about HD-G's deductible increasing each year at an unpredictable rate of inflation versus the much more predictable & budgetable N monthly premiums.
@@MedigapSeminarschoose Plan N to avoid high rate increases of plan G, avoid HDG for inflation and EOB issues, avoid advantage plans and pay dental and vision with an HSA to avoid networks and denials.
I chose G-HD. I have a well funded HSA which I never touched (except to contribute!) prior to Medicare. I live in a state that allows me to switch from one Medigap to another at any time (no birthday rule) and community only rating. So I can switch in later years with guaranteed issue and no age related issues.
@@robannmateja5000 HDG deductible has gone up 27 percent over 5 years. Having said that most people will not reach that deductible. Remember your paying only 20 percent of Medicare approved charges. Unless you have cancer you simply will not hit that deductible. NY you can switch back and forth so you can play that game. Of course that's why the regular G rates are so high.
Yes, I am aware of that, thank you. And thank you for your videos. My state allows me to switch to any other plan except Plan A (no longer sold?) and Plan F (don't qualify for that one due to my age) , so I can switch to a Plan N later, if that makes more sense. Right now, this is the path that works best for me. I have done extensive research and also discussed and got assistance from my SHIP representative. I had to get some Medigap plan within the bounds of my SEP (because, although my state - not NY btw- has better guaranteed issue rights than many others, I am still bound by the SEP timing or I lose guaranteed issue. HD-G premiums in my state are lower than Plan N, I am healthy right now (thank God!) and have few doctor's visits, so this seemed like a good choice for me. Am I taking advantage of the system, well, just doing what is right for me. I wish everyone the best. This is much more convoluted than it should be, and as I mentioned, your videos are very helpful in finding the way through the maze.
You told us in this video very much what our agent told us when we enrolled in A+B+Supplement, we pay a monthly fee for the supplement but beyond that the only thing we have paid is the once yearly $230 Medicare deductible and last year I had 3 overnight hospital stays for a total out of pocket cost of $0.00. I am trying to spread the word, that if you have the choice and the funds, stick with a supplement. Medicare Advantage or should we say Medicare Dis-Advantage is great as long as you never get sick.
Thank you for taking the time to explain these things. I am a nurse practitioner and specialize in geriatric care and your videos are invaluable because they have helped me explain these plans better so they don’t get fooled by plans that just generates income to those who pretend to actually have the patients in mind 🙏
Matthew, thank you for explaining these differences. I have been on original Medicare with a supplement policy for about 5 years. I was often concerned about paying the premiums for my supplement policy and not ever needing it. However, this past year changed my thinking. I was diagnosed with prostate cancer and decided on a radiation therapy treatment. The provider charges for tests and treatments was over $120K. Medicare approved about 50% of costs of those charges and paid about $26K. My supplement plan ($2K in premiums) paid another $4K and my out-of-pocket was less than $500.00. My prognosis is excellent and I am glad I chose to have supplement plan.
This is a good point but dental and vision on Advantage plans are partial coverage. Depending on your prescription list Plan D can be very cheap or even free. If you are very healthy and rarely see a doctor an Advantage plan can save you money. One BIG issue is you can’t go back to original Medicare if you don’t like your Advantage plan anymore. That is you can’t get a supplement plan without listing all your preexisting conditions and the plans can deny coverage.
This was definitely an eye opener for me and my husband! He was “sold” on a Medicare Advantage plan but I was not. I have been watching your videos for a few years now and I really, really trust you. I can’t say that enough. I really trust you! We have now decided NOT to get the advantage plan. Every year at open enrollment I become a nervous wreck and feel sick because I just don’t understand so much about Medicare , especially part D. My hubby is now sold on MedigapSeminars!!! If we could afford a supplement, we would get one, but it’s not an option for us. Thank you so much. I’m sending you a big hug!
I been choosing a Medicare Advantage Plan but after listening to your video, I think I will be getting a Medicare Supplement Plan once I am 65 which is three years to go. Thank you for explaining the difference.
Excellent explanation. I have done all my due diligence over the past year and made my choices already, as I'm turning 65 next month. I'm going with traditional Medicare parts A and B, taking part D drug supplement and selecting part G high-deductable as my supplement. I live in Washington State, so I can change this to regular G anytime if I have serious medical issues coming up. Right now, I'm on Obamacare paying $75 a month. When I transition to Medicare on February 1st, I'll be paying $275 (including part B). My social security increased by $100 this month, so I'm really only losing a grand total of $100 a month. Luckily, I worked in corporate America for 30 years and sold my old home, so I'll simply ask Fidelity to transfer that $100 to my bank account each month. All that hard work and saving money since the creation of the 401k in 1986 has finally blessed me. I hope everyone else is as fortunate.
@@EXPLOREWITHME. - The Medicare Supplement (Medigap) plans are a no-brainer for those who are chronically ill (e.g. diabetic, HIV, Cancer etc.), but what these presentations don't tell you is that the Medigap insurance providers raise their premiums by 3-5% EVERY YEAR. So in 10 years or so, your premiums are 2x what they are today. And there are lifetime maximum coverage limits on nearly all of the medigap plans (some as low as $1 million). So us 'patients' need to read the detailed Evidence of Coverage contracts very carefully. That goes for the separate Part D drug insurance you must buy ($25 / month or more). The reason that Medicare Part C (Advantage) programs were put in place is because over half of the Medicare qualified population can't afford Medigap insurance, which for a retire couple, can amoung to $1000 / month plus whatever you spend on dental and vision care.
14:30 matches what I heard from a Statistician who had then just completed an INSANELY lucrative contract with a large health insurance provider. He told me to expect an onslaught of ads trying to lure me in to "privatized Medicare" as he called it. Now 64, my friends and I are all receiving these. They are very professionally done - not on glossy paper with all red caps, but in an official communication from my current (private) insurer implying that I have little choice but to go through their Medicare. They didn't use the word "Advantage" anywhere but it clearly is MA.
Thanks for sharing. The simple truth is there is too much money in Advantage plans, all fueled by our tax dollars. Everyone involved benefits except the consumer. Wherever there is too much government money, there is greed and corruption.
Very good explanation of the differences between Medicare A+B, Advantage Plans and Supplemental Plans. Thank you.. My wife and I are very pleased to have chosen to go with supplemental plans from Mutual of Onaha.
Thank you, Matthew, for your excellent explanation. I have watched this presentation twice: once when signing up for Part A while still having employer coverage and again after retiring and signing up for Part B. I will see if you have a presentation about supplemental plans and watch that as well.
I have a brand new video on Medicare supplement plans that will be out late this week. It is in editing now. This will be followed by two short videos, one on Plan n and one on Plan G
I have had Humana Advantage plan for five years now and I love it. I have never been turned down for any surgery or procedure. My copays are a fraction of the cost of the premiums. Maximum annual out-of-pocket is $20,000. I can easily afford that. All of my doctors and hospitals take my insurance. I see no reason for the much more expensive plan.
A very heartfelt thankyou for this video. You gave me the information I needed. In a way I could understand it. More importantly, I very much sensed that you are for us, the people who need the care of good information.
You are very welcome. Please reach out to us for specific guidance on which plans and insurance company for your area medigapseminars.org/contact-us/ Our services are at no cost to you, the consumer.
Thank you, Matthew. Your information was very helpful. I'm in my initial enrollment period and was talked into an HMO advantage plan. Your information has convinced me to switch to a Part G Supplement. I appreciate your communication skills and excellent information. What an excellent and critical service you provide.
Thank you so much. Very informative discussions you bring to the table. It's no wonder that during open enrollment period Insurance companies are all over the airwaves with their commercials trying to enroll the unsuspecting.
I will be making choices after my spouse's plan covering me as part C&D secondary runs out. Like most things in life, if you can afford the premiums of the supplemental plans you are better covered and minimizing the risk. Thanks!
Selected original Medicare, part d and supplemental g. When I did a cost analysis, the cost was an additional $100 per month. I rather pay a little each month and not have to worry about maximum out of pocket when I get sick. This was based on the comparison of Medicare advantage PPO and original Medicare. The PPO cost was $125 a month more. Although the HMO had $0 premium, it had a smaller network than the PPO. Both had limited within network, pre authorization, and referral requirements. Could I have chosen supplemental N and save some money? Yep, I could have but I am very happy with my choice. For me it has been peace of mind. Thank you for providing great videos. If I did not see your videos and get educated on the differences in both programs, I would still be with Medicare advantage. Thank you Matt!
Factually Brilliant!!! I have shared my limited research with friends and family on this. You have identified key points I shared but better yet, many i didn't. A bragging point - bonuses on employee retirement insurance. Thank you again.
You haven't confused me at all. This is the most clear-cut explanation I have heard. Thank you. (However... Pls see my previous comment about your wording). You talk at a speed I can follow. There is another guy on youtube who is good, but talks incredibly fast, and I cannot follow. (I know; there's a playback speed button). I met with an insurance rep, and he pretty much talked me and my partner into an Advantage Plan, but my GUT said NO to this, and when I expressed my concern, they both seemed to take offense. The salesman wants his chunk of change from the ins. co., and my partner (the one paying my bills) wants this to be as close to FREE as possible.
@@wordswords2094 Canada pays for it with significantly higher taxes & costs. NOTHING IS FREE. My friend's grandma needed gall bladder surgery & was going to have to wait for months. She & other relatives chipped in & they paid to have her surgery done here in the USA within days.
Thank you for spelling all this out in a way thats easy to understand. I play pickleball and love it. Im turning 65 in a week and started medicare this month. I chose to keep A and B and add N since im very healthy and can afford N. I like the idea of chosing what ever Dr. I want where ever I am. I like to travel. I also at this point in my life only see a Dr for my annual physical or an emergancy once in a while. I take no meds and stay active. Everyone I have talked to has an advantage plan. I think its the zero cost that sold them and they all like the silver sneakers free gym thing. Im very happy I chose what I did and will recommend anyone watch your vidoes, thank you.
Thanks for the video. I am fortunate enough to be able to get a Medicare Supplement plan. Lots and Lots of horror stories with Medicare advantage and I will not miss my opportunity for a Med Sup.
Thanks again for your informative videos! I still have a few years to go before I’m eligible for Medicare, but I feel confident that I will understand my choices.
Thank you for providing this clear and concise explanation of Medicare vs Advantage plans. I have viewed several videos on the subject and yours is by far the best.
I am 77 years old and currently in a Medicare advantage nightmare. At first I had original Medicare with a supplement. I was looking for a way to cut my costs but still have decent health insurance. So a friend of mine said there was a lady who worked at Walmart that you could walk in and talk to and she was a good broker. Taking my friends advice, I did that, got into a Medicare advantage plan, which I’ve had for two years. I am really feeling stupid for not doing more research but Medicare and capitalism have made this process so complicated, that one must do extensive due diligence before deciding on a plan. I was diagnosed with rheumatoid arthritis about five or six years ago. As my symptoms are advancing, my RA doctor recommended some better but higher price drugs. I started looking into it and found that Medicare advantage will not pay for these drugs. Out-of-pocket cost run at least around $5000 per year. Also, since I have RA, it is almost impossible for me to get back to original Medicare. I am devastated and not sure what I’m going to do. I have been talking to your Medicare seminar agents and am seeing if there are any possibilities left. It does not look promising.
All Part D plans, including those bundled with an Advantage Plan, must cover at least two prescriptions from every category of prescription. In addition, there are six categories of drugs that the insurance company must cover substantially all drugs available. Autimmune disease is one of those categories. If you can't get a drug it is for a reason other than "not available".
Outstanding video. I have been in independent life sales since 2020 but this year I have decided get into Medicare. It is something I have always wanted to do. Luckily I was hired in a a full time roll that is providing all of the training and a small base to get me ready for AEP. I will continue to watch your content! I understand that many simply will not be able to afford a supplement, but I will make sure to do my due diligence with every client and educate them on all their options.
Thank you so much for these very informative videos. I am a SHIP counselor in NY but you have clarified so much and I thank you. Quick story, in 2023 my wife had an Advantage Plan. She had a critical event that totaled over $500,000 in medical care but, gratefully, our out of pocket was less than $2000 - I was shocked! Perhaps because it was emergent? Anyway, in 2024 we switched her to Plan N and haven't used it. These supplement plans in NY are quite costly so we are considering a high deductible plan for 2025, do you have a video about that option?
Thank you for your comment. The High Deductible plan is the right plan for NY because you have Community Rated Plans and a perpetual open enrollment. This is my latest video on G-HD - th-cam.com/video/uvbjxxAb2tg/w-d-xo.html I also have a video specific to NY. Consider subsribing to make them easier to find: www.youtube.com/@Medigapseminars?sub_confirmation=1 and feel free to contact us if we can help 800-847-9680
It's not one size fits all. I've been on Medicare Advantage for many years and am very satisfied. The max out of pocket is not much above what I had with employer health care. I hit that a couple of times over the last 10 years. I live in a large metro area. I've never had a problem with doctors or hospitals being out of network. Prior approvals have been effectively immediate. I have one single plan that covers everything and my healthcare providers have one number to call for insurance. I've never had to show my Medicare card. My monthly cost in years where I've not had major health issues has been well below the monthly cost for a supplement. I'd recommend a supplement plan if you have or expect to have a chronic condition that requires regular medical treatment that is expensive. I'd also recommend it if you live in a small and remote community where staying in-network might be more of a challenge.
Mathew, thanks for this helpful video! Great info. Just wanted to add a little depth on advantage plans: I work in transitional care physical therapy and people covered with Medicare therapy and nursing have significant say in length of stay as needed; however like you said, advantage plans have reviewers who limit length of stay --- many times before the person is fully functional for returning home. (Drives us crazy)
Thank you for this valuable information. It was very clear the difference between Medicare and the Advantage Plan but still no clear the difference between Medicare and the Supplemental Plan, or the Supplemental plan and MA. I'm a federal retiree and have original Medicare and BCBS.
I currently have original Medicare Parts A and B as well as BCBS employer retirement supplement insurance coverage and a separate dental and vision plan, with of which I continued into retirement. I have diabetes and see an endocrinologist to manage my diabetes with several lab tests yearly and 3 different insulin. I opted out of conversion to a Medicare advantage in place of my original Medicare and BCBS supplement and separate dental and vision plan to retain the right to see any doctors and specialists without prior approval. I will add Medicare Part D, because recent changes to BCBS will not cover some of my insulin at previous lowest rates effective October 1st and my out of pocket prescription cost went from $40 for one drug to $2,500.
You can state whatever you want to say, about original medicare with a supplement is best. It's just not best for everybody. I for one, chose an Advantage plan. It's a plan with one of the big insurance companies, and the best part is that I don't have to worry about having to purchase a separate drug plan, then have to add a dental and vision plan, and pay an astronomical $250 to $300 a month. I also get the part B monthly give back of $125. I have a great primary care physician and a Cardiologist. I just cannot afford those kind of premiums.
It's very important u stay healthy with the Advantage plans. Most people are very happy with them until they experience a serious health issue. That's when the reality of these plans kick in.
I agree. In fact I made a video on it. If I were allowed to offer TFL, I would do it all day.....but too few qualify. th-cam.com/video/AWVDpE4CqNI/w-d-xo.htmlsi=3nLF_PFAkEiRA97I
Thank you so much!! That was so helpful!! I'm definitely going with Medicare part A & B plus a supplemental plan. Now how do I pick the supplemental plan???? Haha!! Hoping you have another video on that!! 😀
I’m a Medicare provider and advantage plans pay providers less than original Medicare. This is why providers reject clients who are with Advantage plans!
I have had a Medicare PPO Advantage Plan for 8 years. I pay $77 month for the plan because I do not want to go through the headache of waiting on a referral to see a doctor. It has been wonderful. I chose my doctors very carefully and have NEVER been turned down for care. I recently had rotator cuff surgery, which cost me $350. My surgeon ordered an MRI….which I had 3 hours later because there was no referral needed. There are Medicare Advantage plans that are HMO’s…no thank you. There isn’t a monthly fee for these, but you pay for it in aggravation and time. My Medicare Advantage plan has a Medicare contract…which means I have the same care as you would get through Medicare, plus dental, gym membership, reimbursement for medical expenses out of the country, and vision services.
I’ve had an MA plan for several years. I have had no difficulty finding participating doctors. If they take my plan, I don’t care how much they get reimbursed.
Not sure how it works here in Mn but my advantage plan with Health Partners PPO seems to cover all the things that are needed as they have there own Dr’s and Clinics and Hospitals
Joe, no disrespect intended but your already behind the 8 ball if your in an Advantage plan. Run, don't walk to get out. It will in the end cost you a lot more money unless you remain healthy and die in your sleep. The bigger issue is the overall quality of care when you do develop a serious illness. These private insurers make their money by denying and delaying services to seniors when they need it most. My sister in law died prematurely waiting for denials to be resolved for tests and acute care which her doctor ordered. She died at home when she should have been in rehab.
You have the best explanations! I wish I had found your videos sooner, especially before I met with a broker whose explanations and knowledge was less than desirable or willfully incomplete. But I still have time and I think I will choose a HDG, will have to make some sacrifices but the freedom is too important. I have worked in skilled nursing facilities for years and I have seen the consequences of denied therapy and it was heartbreaking.
Wow, no one ever explained anything that thoroughly before! While I have limited income, I still would consider a supplement because i wouldn't have enough to pay the max out-of-pocket under an advantag plan. I watched my mom go through that, not even being able to get out of the prescription donut hole before paying out 7 or 8,000. I would like to see how much supplement premiums are.
I am still not sure what to choose. I pay a LOT for Mededicare B and Plan G and drug plan as i am already in my 67th, so i pay 10-20% more more as i am older than 65. 2ndly, i have a low soc. Benefit but still a very high income. So my monthly payments are much much much higher. Also I have European health insurance which pays worldwide. So all that points to an Advantage plan, right?
It depends on a lot of other factors as well...But mostly, Medicare Advantage plans are NOT cheaper than a supplement. They simply divert your costs from the premium to the cost of care when you need it. feel free to call us for specific 800-847-9680
I'll be signing up for Medicare later this year. I helped my older brother sign up last year. Encouraged him to buy a supplement and not take an Advantage plan. He bought a supplement. Worked out great when he had a few medical issues arise soon after. I plan on taking a supplement even though I have no health issues. Haven't decided which one yet. I just can't deal with the Advantage plan horror stories I've heard about. Plus, as mentioned in below comments, I've heard medical providers are pulling out of Advantage plans.
I have Medicare A&B and Supp G. Since I went on Medicare I’ve had many hospitalizations, two major surgeries, and various visits to specialists. The only out of pocket besides my premium is the Part B deductible. This year I had to go to the ER, the bill was $14,000; my portion was $0.
I do have an advantage plan and plan to migrate to supplement plan when we move out of our current Advantage coverage zone to a rural area. In the last 1.5 years I've had the Advantage plan, four services were denied. In my case, the insurance company was correct. Two doctors specified wrong MRI tests three times. Specifically, each specified wrong parts of the body. I changed doctors twice because of these mistakes. The fourth mistake was a coding error that the insurance company caught for care provided. Each of these offices said they prefer dealing with Advantage plans because Medicare delays payments.
Just came across your video. Excellent explanation--you have a new subscriber. If one has chosen a medicare advantage plan (age 69) is it possible to switch to original medicare plus a supplement, and is medical underwriting (Arizona) required? Thanks for the video.
You can switch back to Original Medicare from October 15 - December 07, then from Jan 01 through March 31. You can apply for Part and a supplement. You will need to pass Medicare underwriting for the supplement. see th-cam.com/video/c29jkM5-6bw/w-d-xo.html
very educational video, for clients and agents. If an agent gives you insider knowledge good sign the agent cares more about the client then the company.
You can switch to Original Medicare and apply for a supplement. But your acceptance into the supplement may be subject to medical underwriting. Best to call us and we advise based on your personal situation. 800-847-9680
I have to make a decision like "today". I am on disability and barely have money to pay my regular bills. I guess advantage plans are not for me. I am 52 and pretty healthy. I haven't been sick in over 22 years. I tried to do the research and found these videos. They helped to realize that i am to poor to afford ANY coverage that will actually help me. No advantage plans and supliment plans are almost as bad for OKLAHOMA. I dont know what TF to do..
no. You can ask a doctor if they will accept your insurance as an out of network doctor. But thay can and usually do say no. They are under no obligation to accept your PPO.
I'll be 65 in 2 months. I have been studying this issue and I was leaning toward original medicare and a supplement. Your explanations confirmed my choice but with a different twist. The advantage plans do in fact take away all those choices that we paid into during our working career. As long as I can afford the choice why should I give it up? Thanks
I am glad to have helped. For more personalized recommendations, feel free to call my team 800-847-9680 By the way, my Medicare starts November 01 and I already know what plan and insurance company I will use.
I had original Medicare when received two heart stents in 2009, Medicare paid the entire $76,000. In 2019 I needed another two stents and at that time I had an advantage plan (United healthcare) of the 46,000 total cost UNC paid the hospital $17,000. However, in addition to the $100 co-pay, I received an additional bill from the surgeon for $346 that was not covered by the plan. I should have stayed with original Medicare.
Thank you for your comments. If you liked this video, click here to subscribe: th-cam.com/users/medigapseminarsorg?_confirmation=1
I had already picked a supplement plan. This just reinforced my decision.
Thank You. This was the easiest breakdown I have found on TH-cam. I am lost on all this. I have always had insurance through my employer. I had a stroke due to an injury. I have not been able to get released to go back to work. I am currently on a private Blue/Cross My blue HMO. plan which has cheap monthly rates and low deductible etc. I will be forced in a few months since I am on SSDI to take the switch? So if I am hearing correctly I will only be allowed either Part A&B or The Advantage plan?
@@justink87371 If you are new to Medicare you will have a 180-day period from the start of Medicare Part B to get any supplement plan available to you. However, under 65 is not easy in all states. there is no Federal mandate to offer supplements to people under 65 on SSDI. We can help look for you. that said, in your Medicare welcome packet you should have an "Opt Out" card to opt out of Part B and keep your private coverage, but you may face penalties if you do that. medigapseminars.org/contact-us/
@@MedigapSeminars Ok thank you for the Info. I think it's still a few months away before that package will be sent to me. I just don't like that there is no Out of Pocket Max On Medicare.
I had Medicare and Medicaid with D for years. Here is the deal. I saw a flex card ad on fb. Thinking it was a government program I went to that page. I was called by the company. I’m still thinking this government program. They started a spill and said yes I was eligible. They did not tell me I was leaving regular Medicare at all. So now I am on Medicare Advantage Gold which I totally don’t want. I will go back to original Medicare plan in October. You need warn people like me about the tactic of using flex cards to draw Seniors into their plan. I am 72 and they are crooks and deceivers. They think I am stupid but you have convinced me I am making the right decision. You have shown a video I can understand. Please warn other uninformed Seniors about what they are doing. Top of the day to you
I have a niece who worked for one of the largest MA provider in the US. She worked in several finance sections prior to working in the dept that reviews and approves/denies surgery, procedures, tests, prescription drugs etc. She resigned shortly after discovering the tactics that the company employed through their denials and how they treated their customer's by denying the necessary treatments that doctors had ordered. She said it was the most depressing experience in her life to follow company protocols that she knew were killing people prematurely. She couldnt handle it and is now an outspoken critic of the industry.
Wow. I am not surprised. Thank you for sharing.
Thank you for this message. I received it loud and clear. But I don’t know what to do to help myself. I’m not old enough for a supplement plan.
@@peacefreedom4930 Are you on Medicare yet?
@@peacefreedom4930 if you are old enough for Medicare, you are old enough for a supplement. If you are on Medicare and under 65 you can get a supplement depending on your state laws. If you would like clarification, feel free to call us at 800-8 47-9680.
@@MedigapSeminars Thank you. I’ll give you a call.
Matthew is probably the most informed and objective source for Medicare insurance information. The relentless advertising and promotion of advantage plans to the uninformed General Public is unfortunate. Keep up the great work Matthew!!
Thank you TJ
Excellent! Finally a straight shooter who tells it like it is. I am a physician and I can tell you we hate the administrative red tape The Advantage Plans put us through. That is why we are dropping our participation in these plans. They are not worth the trouble or added administratve payroll that is required of us to provide care. Good luck with your new doctor you had to switch over too be cause you chose advantage plan.
I was a Medicare sales agent with an FMO and I almost was brainwashed against Medicare Supplements. Thanks to your videos and others that tell the truth about medicare advantage plans, the damage done by that company was reversed. Before I left that company, we were told that they would no longer be offering supplements. That disturbed me but I was still under the spell of the lies, I eventually left the company due to health reasons and now I am glad that I did. The more that I learn the less I am willing to go back to companies that enforce advantage plans and leave out information about supplements. If I could find a company that tells the whole truth about Medicare plans, I would go back into the sales field. I live in Florida and so far I have not found such a creature. So, I have to rely on you for the "truth" because I will be going on Medicare in July. I will be getting a supplement!! Thank you for your honesty. I have learned so much.
If i give you my email. Could u tell me more info
In the year leading up to turning 65, I researched this topic and discovered Matthew's videos, and I'm SO glad I did. I chose traditional Medicare with a Plan N supplement. The more I learn about the topic, and there's a lot to learn, the more I confident that I made the right choice for me. Thank you, Matthew!
You are very welcome. Thank you for sharing.
How much you pay it’s the key
It’s crazy now that I am a senior my hard earn money is going to feed the insurance companies no matter which one I choose wether is advantage or original I have to pay the only way is been poor and getting both Medicare and Medicaid now This is am devastated
Good luck with the plan n. You can pay multiple copays in one visit
@@tioswift3676 No, you can't pay multiple copays in ONE visit. But you can pay multiple copays in one day, if you have more than one visit that day.
I've had a Medicare plan and a Medicare supplement plan for about 8 years. And the supplement plan pays whatever Medicare doesn't. Minus whatever deductible you choose. Monthly premium has gone up over the years. In some years I may have paid more for the plan than I got in services, but there have been years when it's literally saved me thousands of dollars. So over the time frame I've had it. It's definitely paid for itself not only financially but in not having to worry about having a procedure done. And not needing a pre-authorization. If my doctor says go I go I can go to any doctor. I want anywhere in the nation. Medicare advantage plans are basically private insurance. High deductibles, high rejection of coverage. Pre-qualifications. Looks cheaper on the front end but you're going to lose on the back end. So listen to this man
Very helpful ❤
Absolutely agree with you and my Husband and I did the same thing and not sorry, we went with Supplement G plan. I had to have an emergency major surgery three years ago, spent seven days in hospital and I only had to cover about $200.00 dollars!!!
NEVER take advice from someone that makes money from the choices they recommend, like this guy. I have a degree in Economics specializing in social insurance, and an MBA. I've had Supplemental and Advantage insurance plans. I prefer Advantage plans in my area. Zero premium, zero cost family doctor, every medical profession in my city are in network, I've never had any surgery or treatment turned down, my medications are all free except for one high cost brand and that costs me $45 per month, free dental care, free eye exams and glasses, free hearing and discounted hearing aids. They have a national network of doctors.
@@samuelbutterworth4303I have Medicare Advantage ppo 2 and it seems like it covers a lot but I’ve still gotten bills for tests and doctor bills for procedures or hospital care.
Don't forget the bigger concern with chronic conditions and surgical needs. Quality of care. This is overlooked by almost everyone that signs up for Advantage Plans. They love the cost vs a supp plan until they need care. Seniors are dying prematurely every day because of these Advantage Plans.
Pretty much have decided on original Medicare (A&B) plus N and Part D, whenever I decide to retire. The cost and "perks" of an Advantage plan sound appealing, but not worth the risk of possible out of pocket expenses compared to original Medicare with a supplement plan. Health conditions can change quickly and with us in the over 65 crowd, that's a huge consideration at least in my opinion. And i want my medical decisions to be made between me and my doctor, not an insurance company.
One point I cut out of this video to keep it from being too long is that a recent study by Medicare showed that about 90% of Advantage plan companies advertise their plans by drawing attention to the extra benefits (I call shiny objects). They do so to take the focus off the healthcare benefits so people assume they are as good as Original Medicare.
Agree
Fortunately for me the Medicare Advantage Plan I was on was discontinued by my provider and I was able to go back to original Medicare with a supplement. You have explained excellently just how this system works and I am personally so very fortunate that I was able to ditch a Medicare Advantage Plan (which is an advantage for insurers). Your video is so educational regarding the pitfalls of Medicare Advantage and should be viewed by all those just going onto Medicare. Thank you for your excellent knowledge of Medicare.
This was the best 24 minutes I have spent on this topic. I am 11 months away from 65 and this info was outstanding.
Thank you !!!
You are very welcome. Please reach out to us when you want see our recommendations. medigapseminars.org/contact-us/
Thank you for explaining this. When I get mailings soliciting my participation in a medical insurance plan, it’s ALWAYS for an advantage plan. Until I watched your video, I didn’t know why there are so many advantage plans looking to hook me up. They talk about free gymn membership, vision and hearing test coverage…all kinds of tempting offerings. But I suspected, and your video confirmed this, there is big money to be made by companies offering advantage plans. Money for them, not medical coverage for me. I just toss these mailings. I have a Medicare Supplement plan, and I’m keeping it!
Do we get prescription and dental with original Medicare?
@@EXPLOREWITHME.NO…..Medicare does not pay for prescriptions or provide dental.
@@EXPLOREWITHME.
No, part D needs to be added on for your drug coverage
Thank you. I have Medicare and a supplement. Never really understood the difference and was curious about the Advantage plan. You did a great job explaining that and I appreciate you.
You are welcome
Thank you. I just met with a Medicare broker yesterday. He tried to tell me original Medicare with a supplement required pre authorizations just like advantage plans and he didn’t know of any of his clients who had delayed or denied procedures. I said I had to review the plans before making a decision. But what I did is make an appointment with a different Medicare agent
Of course, you could call us. That is what we do for a living. I can assure you, I have more experience and knowledge that any local broker you can find. medigapseminars.org/contact-us/ 800-847-9680 Even more, my team is trained to help you after the sale when you may have issues with billing or whatever can come up between your doctor and Medicare.
I agree!! After 65,Dental & vision should be free!!!
Thank you Matt for your clear, concise, medicare explanation, that has been grotesquely obscured by the insurance companies. I am totally amazed at all the young insurance representatives of advantage plans pitching them to Costco and Sam's Club seniors. The few I have discussed medicare with truly have no idea what the basics are and what is at stake for the senior. They promise a free gym membership while not explaining the alternatives of opting out/and opting into an advantage plan, apparently concentrating on the amount of money they will receive when they sign someone up for their advantage plan. I'm a lucky and happy medicare participant with a healthy supplement plan I can afford. I do not have to worry about the cost of that supplemental plan, or worry about not having the right coverage to make "my" own medical decisions based on "my" doctor's recommendations.
As a recent retiree and new to the Medicare and Medicare Advantage systems, your video was just what I needed to inform me of my actual options. I was actually uninformed and I knowledgeable of this whole process. However, your video was well informative so that I now understand and know which option is right for me. Thank you ever so much for this video!
Matthew enjoy listening to your videos as they have helped me navigate the Medicare world, which I entered into early 2023. I am so glad I selected a Medicare Supplement N plan as I have had some unique and life threating illness come up over the past six month. Had no issue in finding a doctor and getting the necessary treatments which have placed me on the road to recovery.
Excellent video. I chose an Advantage Plan when I turned 65 and had no issues with it. After spending more time researching medigap vs advantage I decided to go through medical underwriting to switch to a supplemental plan G. Thank you for providing easy to understand information.
You are very welcome!
I am definitely going with a Supplement. I have been on disability for 15 years and have seen the up and downs of Advantage plans. I am turning 65 in May. I have been working with a broker and she has been talking to me about this. I was nervous about the amount I would pay. Since I am being paid disability only. I come out better with the G plan. Thank you!
Thank you for a concise overview of the Medicare plans and their history. You have convinced me that my decision to go with a Supplemental plan instead of the Advantage Plan is correct. I will advise others to watch this video before succumbing to the "eye-candy" Advantage Plans with their perks. Again, thank you!"
You agree w/my assessment that a suppliment plan is right for me. Its the most flexible arrangement for my future. Thanks!
Feel free to reach out to me for specific prices and recommendations: medigapseminars.org/request-a-quote/
You omitted a number of key elements: 1) A Medicare Advantage plan is no different than any current ACA (Obamacare plan). Unless you have a "Cadillac" plan, most if not all ACA insurance plans have a restricted networks of providers and require previous authorization for most expensive procedures and prescriptions. 2) Medicare A and B + a Supplement do not provide insurance for prescriptions, dental or vision. Advantage Plans offer all three. In Metro Houston, Plan G premiums go from $200 to $400 per month, and prescription, dental and vision will cost another $100 to $300 per month. This makes total monthly insurance premiums for A+B+G+D+ dental + vision over $500 per month, comparable to a MOOP of most advantage plans. In scenario A you will pay $6,000 in premiums, and in the advantage you will only reach the MOOP if you have actual medical expenses. 3) Most Retirees usually stay put in the location they selected. Supplement plans will sell you the idea that you can choose any doctor, anywhere. If your current PCP and specialists are in and Advantage PPO, that suits most people well.
Re: 2) Medicare A and B + a Supplement do not provide insurance for prescriptions, dental or vision. Advantage Plans offer all three. - Some Medicare Advantage Plans offer some coverage for DVH, but you do not own the policy. Your benefits can be reduced or taken away when plans reset in January. That is happening to a lot of plans in 2025. RE: "Plan G premiums go from $200 to $400 per month," That depends entirely on where you live. In most areas of the country Plan G is below $125 / month , some places under $100. RE: "A you will pay $6,000 in premiums, and in the advantage you will only reach the MOOP " Very few places in the US will premiums be even close to that. Where they are, we recommend a High Deductible supplement with a MOOP under $3,000. - By the way, Medicare Advantage plan MOOPS increase each year and some plans are already over $13,800. RE: "Most Retirees usually stay put in the location they selected. Supplement plans will sell you the idea that you can choose any doctor, anywhere. If your current PCP and specialists are in and Advantage PPO, that suits most people well." Not true at all, and when seriously ill most people search out the best doctor available, not one that just happens to live near them. Most seniors travel, which is a big weakness for local Advantage plan coverage. Keep in mind, your Advantage plan doctor can drop your plan at any time.
Great video. My husband turned 65 this year and I turn 65 in February 2024. I worked for many of the Advantage Plans as a Network Development Contractor. I did the actual negotiations with Providers for the Plan. I watched many Specialty Groups and Hospitals term their contracts mid year. So many do not know that the Providers can term with a 90 day notice. This is one of the Big Dis-Advantages on the Plans. Also, the Insurance Plan has a huge Department that reviews the Prior Authorizations and will deny, deny & deny many services. The Free benefits out way the stressful issues that come along with the prior authorizations and Denial that happen with a so called Advantage Plan. My hubby and I will be staying with a supplement. Thank you for this video!!!!
You are welcome and thank you for sharing your story.
I am glad I worked in the medical field and already knew about the differences. Medicare red, white and blue with supplement. This was a good video.
Glad it was helpful!
This was an EXCELLENT video! The FACTS! Thank you for removing the confusion for me.
After a year of researching my Medicare options, I chose original Medicare with Plan N. Living in SW Florida, it was a close call between Plans N & High Deductible G, but because of underwriting requirements here, I had to pick the plan that would be best for the long-term.
Initially, my HD-G's total costs would be cheaper (if I remain healthy). But after about 10 years, it's likely that my N's total costs would be cheaper as I need more medical services and HD-G's max out-of-pocket would keep getting higher.
In the end my decision came down to my concern about HD-G's deductible increasing each year at an unpredictable rate of inflation versus the much more predictable & budgetable N monthly premiums.
You made a good choice. Pre- 2020 I would have chosen a G-HD myself. But now that inflation is back, it's not a risk I want to take.
@@MedigapSeminarschoose Plan N to avoid high rate increases of plan G, avoid HDG for inflation and EOB issues, avoid advantage plans and pay dental and vision with an HSA to avoid networks and denials.
I chose G-HD. I have a well funded HSA which I never touched (except to contribute!) prior to Medicare. I live in a state that allows me to switch from one Medigap to another at any time (no birthday rule) and community only rating. So I can switch in later years with guaranteed issue and no age related issues.
@@robannmateja5000 HDG deductible has gone up 27 percent over 5 years. Having said that most people will not reach that deductible. Remember your paying only 20 percent of Medicare approved charges. Unless you have cancer you simply will not hit that deductible. NY you can switch back and forth so you can play that game. Of course that's why the regular G rates are so high.
Yes, I am aware of that, thank you. And thank you for your videos. My state allows me to switch to any other plan except Plan A (no longer sold?) and Plan F (don't qualify for that one due to my age) , so I can switch to a Plan N later, if that makes more sense. Right now, this is the path that works best for me. I have done extensive research and also discussed and got assistance from my SHIP representative. I had to get some Medigap plan within the bounds of my SEP (because, although my state - not NY btw- has better guaranteed issue rights than many others, I am still bound by the SEP timing or I lose guaranteed issue. HD-G premiums in my state are lower than Plan N, I am healthy right now (thank God!) and have few doctor's visits, so this seemed like a good choice for me. Am I taking advantage of the system, well, just doing what is right for me. I wish everyone the best. This is much more convoluted than it should be, and as I mentioned, your videos are very helpful in finding the way through the maze.
Thank you, I’m just getting into the insurance industry and I think this is important to know. I got into this to help people not harm people.
You told us in this video very much what our agent told us when we enrolled in A+B+Supplement, we pay a monthly fee for the supplement but beyond that the only thing we have paid is the once yearly $230 Medicare deductible and last year I had 3 overnight hospital stays for a total out of pocket cost of $0.00. I am trying to spread the word, that if you have the choice and the funds, stick with a supplement. Medicare Advantage or should we say Medicare Dis-Advantage is great as long as you never get sick.
Thank you for taking the time to explain these things. I am a nurse practitioner and specialize in geriatric care and your videos are invaluable because they have helped me explain these plans better so they don’t get fooled by plans that just generates income to those who pretend to actually have the patients in mind 🙏
That was the best explanation to Medicare with Advantage plan or Medicare with a supplement plan.
Thank you
As someone new to Medicare, I truly appreciate this informative, detailed, unbiased information. Thanks so much!
you are welcome
Matthew, thank you for explaining these differences. I have been on original Medicare with a supplement policy for about 5 years. I was often concerned about paying the premiums for my supplement policy and not ever needing it. However, this past year changed my thinking. I was diagnosed with prostate cancer and decided on a radiation therapy treatment. The provider charges for tests and treatments was over $120K. Medicare approved about 50% of costs of those charges and paid about $26K. My supplement plan ($2K in premiums) paid another $4K and my out-of-pocket was less than $500.00. My prognosis is excellent and I am glad I chose to have supplement plan.
It's not just the supplement premium, It's also part D (prescriptions) dental, vision. It's a lot for some people.
This is a good point but dental and vision on Advantage plans are partial coverage. Depending on your prescription list Plan D can be very cheap or even free. If you are very healthy and rarely see a doctor an Advantage plan can save you money. One BIG issue is you can’t go back to original Medicare if you don’t like your Advantage plan anymore. That is you can’t get a supplement plan without listing all your preexisting conditions and the plans can deny coverage.
I really like the history lesson. It gives me a better understanding of original Medicare and the origins of Medical Advantage. Thank you very much
You are welcome. I appreciate your letting me know.
This was definitely an eye opener for me and my husband! He was “sold” on a Medicare Advantage plan but I was not. I have been watching your videos for a few years now and I really, really trust you. I can’t say that enough. I really trust you! We have now decided NOT to get the advantage plan. Every year at open enrollment I become a nervous wreck and feel sick because I just don’t understand so much about Medicare , especially part D. My hubby is now sold on MedigapSeminars!!! If we could afford a supplement, we would get one, but it’s not an option for us. Thank you so much. I’m sending you a big hug!
I been choosing a Medicare Advantage Plan but after listening to your video, I think I will be getting a Medicare Supplement Plan once I am 65 which is three years to go. Thank you for explaining the difference.
you're welcome!
Excellent explanation. I have done all my due diligence over the past year and made my choices already, as I'm turning 65 next month. I'm going with traditional Medicare parts A and B, taking part D drug supplement and selecting part G high-deductable as my supplement. I live in Washington State, so I can change this to regular G anytime if I have serious medical issues coming up. Right now, I'm on Obamacare paying $75 a month. When I transition to Medicare on February 1st, I'll be paying $275 (including part B). My social security increased by $100 this month, so I'm really only losing a grand total of $100 a month. Luckily, I worked in corporate America for 30 years and sold my old home, so I'll simply ask Fidelity to transfer that $100 to my bank account each month. All that hard work and saving money since the creation of the 401k in 1986 has finally blessed me. I hope everyone else is as fortunate.
May i ask why increase? Was it caz where u live?
@@EXPLOREWITHME. yearly USA cost of living increase
@@EXPLOREWITHME. - The Medicare Supplement (Medigap) plans are a no-brainer for those who are chronically ill (e.g. diabetic, HIV, Cancer etc.), but what these presentations don't tell you is that the Medigap insurance providers raise their premiums by 3-5% EVERY YEAR. So in 10 years or so, your premiums are 2x what they are today. And there are lifetime maximum coverage limits on nearly all of the medigap plans (some as low as $1 million). So us 'patients' need to read the detailed Evidence of Coverage contracts very carefully. That goes for the separate Part D drug insurance you must buy ($25 / month or more).
The reason that Medicare Part C (Advantage) programs were put in place is because over half of the Medicare qualified population can't afford Medigap insurance, which for a retire couple, can amoung to $1000 / month plus whatever you spend on dental and vision care.
14:30 matches what I heard from a Statistician who had then just completed an INSANELY lucrative contract with a large health insurance provider. He told me to expect an onslaught of ads trying to lure me in to "privatized Medicare" as he called it. Now 64, my friends and I are all receiving these. They are very professionally done - not on glossy paper with all red caps, but in an official communication from my current (private) insurer implying that I have little choice but to go through their Medicare. They didn't use the word "Advantage" anywhere but it clearly is MA.
Thanks for sharing. The simple truth is there is too much money in Advantage plans, all fueled by our tax dollars. Everyone involved benefits except the consumer. Wherever there is too much government money, there is greed and corruption.
I’m retired with a pension, RV travel a lot supplemental was my choice and very easy 👍
Very good explanation of the differences between Medicare A+B, Advantage Plans and Supplemental Plans. Thank you.. My wife and I are very pleased to have chosen to go with supplemental plans from Mutual of Onaha.
Thank you, Matthew, for your excellent explanation. I have watched this presentation twice: once when signing up for Part A while still having employer coverage and again after retiring and signing up for Part B. I will see if you have a presentation about supplemental plans and watch that as well.
I have a brand new video on Medicare supplement plans that will be out late this week. It is in editing now. This will be followed by two short videos, one on Plan n and one on Plan G
I have had Humana Advantage plan for five years now and I love it. I have never been turned down for any surgery or procedure. My copays are a fraction of the cost of the premiums. Maximum annual out-of-pocket is $20,000. I can easily afford that. All of my doctors and hospitals take my insurance. I see no reason for the much more expensive plan.
Great!
No comparison. Supplement all the way 👍
A very heartfelt thankyou for this video. You gave me the information I needed. In a way I could understand it. More importantly, I very much sensed that you are for us, the people who need the care of good information.
You are very welcome. Please reach out to us for specific guidance on which plans and insurance company for your area medigapseminars.org/contact-us/ Our services are at no cost to you, the consumer.
Matthew is why I went with traditional Medicare and supplement. It was a great decision.
The best in the country is original Medicare plus Tricare For Life. So glad I qualify for Tricare For Life. Healthcare wise I live a stress free life.
Me too !!!!
Thank you, Matthew. Your information was very helpful. I'm in my initial enrollment period and was talked into an HMO advantage plan. Your information has convinced me to switch to a Part G Supplement. I appreciate your communication skills and excellent information. What an excellent and critical service you provide.
Thank you so much. Very informative discussions you bring to the table.
It's no wonder that during open enrollment period Insurance companies are all
over the airwaves with their commercials trying to enroll the unsuspecting.
They really need to change the name of Medicare Part C / Advantage Plans. They are not Medicare and they confuse people.
I will be making choices after my spouse's plan covering me as part C&D secondary runs out. Like most things in life, if you can afford the premiums of the supplemental plans you are better covered and minimizing the risk. Thanks!
Selected original Medicare, part d and supplemental g. When I did a cost analysis, the cost was an additional $100 per month. I rather pay a little each month and not have to worry about maximum out of pocket when I get sick.
This was based on the comparison of Medicare advantage PPO and original Medicare. The PPO cost was $125 a month more. Although the HMO had $0 premium, it had a smaller network than the PPO. Both had limited within network, pre authorization, and referral requirements. Could I have chosen supplemental N and save some money? Yep, I could have but I am very happy with my choice. For me it has been peace of mind. Thank you for providing great videos. If I did not see your videos and get educated on the differences in both programs, I would still be with Medicare advantage. Thank you Matt!
Factually Brilliant!!! I have shared my limited research with friends and family on this. You have identified key points I shared but better yet, many i didn't. A bragging point - bonuses on employee retirement insurance. Thank you again.
you are welcome
You haven't confused me at all. This is the most clear-cut explanation I have heard. Thank you. (However... Pls see my previous comment about your wording). You talk at a speed I can follow. There is another guy on youtube who is good, but talks incredibly fast, and I cannot follow. (I know; there's a playback speed button). I met with an insurance rep, and he pretty much talked me and my partner into an Advantage Plan, but my GUT said NO to this, and when I expressed my concern, they both seemed to take offense. The salesman wants his chunk of change from the ins. co., and my partner (the one paying my bills) wants this to be as close to FREE as possible.
How in the world do seniors afford dental & vision?!? Why isn’t this made free for Seniors over 65?!?
@@wordswords2094 Canada pays for it with significantly higher taxes & costs. NOTHING IS FREE. My friend's grandma needed gall bladder surgery & was going to have to wait for months. She & other relatives chipped in & they paid to have her surgery done here in the USA within days.
Thank you for spelling all this out in a way thats easy to understand. I play pickleball and love it. Im turning 65 in a week and started medicare this month. I chose to keep A and B and add N since im very healthy and can afford N. I like the idea of chosing what ever Dr. I want where ever I am. I like to travel. I also at this point in my life only see a Dr for my annual physical or an emergancy once in a while. I take no meds and stay active. Everyone I have talked to has an advantage plan. I think its the zero cost that sold them and they all like the silver sneakers free gym thing. Im very happy I chose what I did and will recommend anyone watch your vidoes, thank you.
Thanks for the video. I am fortunate enough to be able to get a Medicare Supplement plan. Lots and Lots of horror stories with Medicare advantage and I will not miss my opportunity for a Med Sup.
Thanks again for your informative videos! I still have a few years to go before I’m eligible for Medicare, but I feel confident that I will understand my choices.
You are welcome.
Thank you for being honest about this
Matthew, very interesting about the 37% of Advantage plan people are on SN Medicaid plans or Employer Retirement Advantage plans.
Ya, it's always what they don't tell you that matters most.
Thank you for providing this clear and concise explanation of Medicare vs Advantage plans. I have viewed several videos on the subject and yours is by far the best.
Glad it was helpful!
So informative, thank you so much for explaining everything. Medicare supplement is the way to go.
I am 77 years old and currently in a Medicare advantage nightmare. At first I had original Medicare with a supplement. I was looking for a way to cut my costs but still have decent health insurance. So a friend of mine said there was a lady who worked at Walmart that you could walk in and talk to and she was a good broker. Taking my friends advice, I did that, got into a Medicare advantage plan, which I’ve had for two years. I am really feeling stupid for not doing more research but Medicare and capitalism have made this process so complicated, that one must do extensive due diligence before deciding on a plan. I was diagnosed with rheumatoid arthritis about five or six years ago. As my symptoms are advancing, my RA doctor recommended some better but higher price drugs. I started looking into it and found that Medicare advantage will not pay for these drugs. Out-of-pocket cost run at least around $5000 per year. Also, since I have RA, it is almost impossible for me to get back to original Medicare. I am devastated and not sure what I’m going to do. I have been talking to your Medicare seminar agents and am seeing if there are any possibilities left. It does not look promising.
All Part D plans, including those bundled with an Advantage Plan, must cover at least two prescriptions from every category of prescription. In addition, there are six categories of drugs that the insurance company must cover substantially all drugs available. Autimmune disease is one of those categories. If you can't get a drug it is for a reason other than "not available".
Your videos are so well made and easy to listen to. Thank you for sharing your experience and knowledge with all of us.😊
Excellent video. Important information framed in a new way. One of your very best.
Thank you! 🤗
Outstanding video. I have been in independent life sales since 2020 but this year I have decided get into Medicare. It is something I have always wanted to do. Luckily I was hired in a a full time roll that is providing all of the training and a small base to get me ready for AEP. I will continue to watch your content! I understand that many simply will not be able to afford a supplement, but I will make sure to do my due diligence with every client and educate them on all their options.
Thank you so much for these very informative videos. I am a SHIP counselor in NY but you have clarified so much and I thank you. Quick story, in 2023 my wife had an Advantage Plan. She had a critical event that totaled over $500,000 in medical care but, gratefully, our out of pocket was less than $2000 - I was shocked! Perhaps because it was emergent? Anyway, in 2024 we switched her to Plan N and haven't used it. These supplement plans in NY are quite costly so we are considering a high deductible plan for 2025, do you have a video about that option?
Thank you for your comment. The High Deductible plan is the right plan for NY because you have Community Rated Plans and a perpetual open enrollment. This is my latest video on G-HD - th-cam.com/video/uvbjxxAb2tg/w-d-xo.html I also have a video specific to NY. Consider subsribing to make them easier to find: www.youtube.com/@Medigapseminars?sub_confirmation=1 and feel free to contact us if we can help 800-847-9680
It's not one size fits all. I've been on Medicare Advantage for many years and am very satisfied. The max out of pocket is not much above what I had with employer health care. I hit that a couple of times over the last 10 years. I live in a large metro area. I've never had a problem with doctors or hospitals being out of network. Prior approvals have been effectively immediate. I have one single plan that covers everything and my healthcare providers have one number to call for insurance. I've never had to show my Medicare card. My monthly cost in years where I've not had major health issues has been well below the monthly cost for a supplement.
I'd recommend a supplement plan if you have or expect to have a chronic condition that requires regular medical treatment that is expensive. I'd also recommend it if you live in a small and remote community where staying in-network might be more of a challenge.
Mathew, thanks for this helpful video! Great info. Just wanted to add a little depth on advantage plans: I work in transitional care physical therapy and people covered with Medicare therapy and nursing have significant say in length of stay as needed; however like you said, advantage plans have reviewers who limit length of stay --- many times before the person is fully functional for returning home. (Drives us crazy)
Thank yo for sharing this. Insurance companies should not have a say in our healthcare.
Thank you for this valuable information. It was very clear the difference between Medicare and the Advantage Plan but still no clear the difference between Medicare and the Supplemental Plan, or the Supplemental plan and MA. I'm a federal retiree and have original Medicare and BCBS.
You need to see this video: th-cam.com/video/gdOR0c1opyg/w-d-xo.html
I currently have original Medicare Parts A and B as well as BCBS employer retirement supplement insurance coverage and a separate dental and vision plan, with of which I continued into retirement. I have diabetes and see an endocrinologist to manage my diabetes with several lab tests yearly and 3 different insulin. I opted out of conversion to a Medicare advantage in place of my original Medicare and BCBS supplement and separate dental and vision plan to retain the right to see any doctors and specialists without prior approval. I will add Medicare Part D, because recent changes to BCBS will not cover some of my insulin at previous lowest rates effective October 1st and my out of pocket prescription cost went from $40 for one drug to $2,500.
You can state whatever you want to say, about original medicare with a supplement is best. It's just not best for everybody. I for one, chose an Advantage plan. It's a plan with one of the big insurance companies, and the best part is that I don't have to worry about having to purchase a separate drug plan, then have to add a dental and vision plan, and pay an astronomical $250 to $300 a month. I also get the part B monthly give back of $125. I have a great primary care physician and a Cardiologist. I just cannot afford those kind of premiums.
It's very important u stay healthy with the Advantage plans. Most people are very happy with them until they experience a serious health issue. That's when the reality of these plans kick in.
Me either I'm a widow and they just tax you to death...
Economically, it all boils down to the Dirty Harry dialog: Well punk, do ya feel lucky, do ya??
The best insurance for people over 65 in the country is Medicare A & B and Tricare For Life. My opinion.
I agree. In fact I made a video on it. If I were allowed to offer TFL, I would do it all day.....but too few qualify. th-cam.com/video/AWVDpE4CqNI/w-d-xo.htmlsi=3nLF_PFAkEiRA97I
Thank you so much!! That was so helpful!! I'm definitely going with Medicare part A & B plus a supplemental plan. Now how do I pick the supplemental plan???? Haha!! Hoping you have another video on that!! 😀
Hi Carol - I have over 300 videos. This is the next one to see...then subscribe th-cam.com/video/EaO_P7ttfqg/w-d-xo.html
I’m a Medicare provider and advantage plans pay providers less than original Medicare. This is why providers reject clients who are with Advantage plans!
Not always true. Depends on your contacts. Some MA plans will pay much higher than original Medicare
I have had a Medicare PPO Advantage Plan for 8 years. I pay $77 month for the plan because I do not want to go through the headache of waiting on a referral to see a doctor. It has been wonderful. I chose my doctors very carefully and have NEVER been turned down for care. I recently had rotator cuff surgery, which cost me $350. My surgeon ordered an MRI….which I had 3 hours later because there was no referral needed. There are Medicare Advantage plans that are HMO’s…no thank you. There isn’t a monthly fee for these, but you pay for it in aggravation and time. My Medicare Advantage plan has a Medicare contract…which means I have the same care as you would get through Medicare, plus dental, gym membership, reimbursement for medical expenses out of the country, and vision services.
I’ve had an MA plan for several years. I have had no difficulty finding participating doctors. If they take my plan, I don’t care how much they get reimbursed.
Not sure how it works here in Mn but my advantage plan with Health Partners PPO seems to cover all the things that are needed as they have there own Dr’s and Clinics and Hospitals
Joe, no disrespect intended but your already behind the 8 ball if your in an Advantage plan. Run, don't walk to get out. It will in the end cost you a lot more money unless you remain healthy and die in your sleep. The bigger issue is the overall quality of care when you do develop a serious illness. These private insurers make their money by denying and delaying services to seniors when they need it most. My sister in law died prematurely waiting for denials to be resolved for tests and acute care which her doctor ordered. She died at home when she should have been in rehab.
Thanks a million,aha!!!And WOW!!! Appreciations galore!!!!
Very informative and concise.
You have the best explanations! I wish I had found your videos sooner, especially before I met with a broker whose explanations and knowledge was less than desirable or willfully incomplete.
But I still have time and I think I will choose a HDG, will have to make some sacrifices but the freedom is too important. I have worked in skilled nursing facilities for years and I have seen the consequences of denied therapy and it was heartbreaking.
Feel free to contact us . We can help. medigapseminars.org/contact-us/
Wow, no one ever explained anything that thoroughly before! While I have limited income, I still would consider a supplement because i wouldn't have enough to pay the max out-of-pocket under an advantag plan. I watched my mom go through that, not even being able to get out of the prescription donut hole before paying out 7 or 8,000. I would like to see how much supplement premiums are.
Hi - use this form to provide us with the information we need, and we will email you prices: medigapseminars.org/request-a-quote/
Thanks for this explanation. I've heard of the stories involving the advantage plans, so this video has made my mind up to keep my supplement plan.
I am still not sure what to choose. I pay a LOT for Mededicare B and Plan G and drug plan as i am already in my 67th, so i pay 10-20% more more as i am older than 65. 2ndly, i have a low soc. Benefit but still a very high income. So my monthly payments are much much much higher. Also I have European health insurance which pays worldwide. So all that points to an Advantage plan, right?
It depends on a lot of other factors as well...But mostly, Medicare Advantage plans are NOT cheaper than a supplement. They simply divert your costs from the premium to the cost of care when you need it. feel free to call us for specific 800-847-9680
I'll be signing up for Medicare later this year. I helped my older brother sign up last year. Encouraged him to buy a supplement and not take an Advantage plan. He bought a supplement. Worked out great when he had a few medical issues arise soon after. I plan on taking a supplement even though I have no health issues. Haven't decided which one yet. I just can't deal with the Advantage plan horror stories I've heard about. Plus, as mentioned in below comments, I've heard medical providers are pulling out of Advantage plans.
I have Medicare A&B and Supp G. Since I went on Medicare I’ve had many hospitalizations, two major surgeries, and various visits to specialists. The only out of pocket besides my premium is the Part B deductible. This year I had to go to the ER, the bill was $14,000; my portion was $0.
I do have an advantage plan and plan to migrate to supplement plan when we move out of our current Advantage coverage zone to a rural area.
In the last 1.5 years I've had the Advantage plan, four services were denied. In my case, the insurance company was correct. Two doctors specified wrong MRI tests three times. Specifically, each specified wrong parts of the body. I changed doctors twice because of these mistakes. The fourth mistake was a coding error that the insurance company caught for care provided.
Each of these offices said they prefer dealing with Advantage plans because Medicare delays payments.
Thank you!! You are a good man doing great work.
You are welcome
Choosing Medigap
Just came across your video. Excellent explanation--you have a new subscriber. If one has chosen a medicare advantage plan (age 69) is it possible to switch to original medicare plus a supplement, and is medical underwriting (Arizona) required? Thanks for the video.
You can switch back to Original Medicare from October 15 - December 07, then from Jan 01 through March 31. You can apply for Part and a supplement. You will need to pass Medicare underwriting for the supplement. see th-cam.com/video/c29jkM5-6bw/w-d-xo.html
very educational video, for clients and agents. If an agent gives you insider knowledge good sign the agent cares more about the client then the company.
If you’re on Medicare advantage plan can you switch to Medicare with supplement plan during sign up period?
You can switch to Original Medicare and apply for a supplement. But your acceptance into the supplement may be subject to medical underwriting. Best to call us and we advise based on your personal situation. 800-847-9680
I have to make a decision like "today". I am on disability and barely have money to pay my regular bills. I guess advantage plans are not for me. I am 52 and pretty healthy. I haven't been sick in over 22 years. I tried to do the research and found these videos. They helped to realize that i am to poor to afford ANY coverage that will actually help me. No advantage plans and supliment plans are almost as bad for OKLAHOMA. I dont know what TF to do..
Please give him a call him and his team will guide you through benefits you may qualify for. You got through part 1 now stay strong 💪🏾
Very good and got clarity after listening to this session.
Thank you!
With advantage PPO, can I choose any doctor who accepts Medicare? Thanks.
no. You can ask a doctor if they will accept your insurance as an out of network doctor. But thay can and usually do say no. They are under no obligation to accept your PPO.
N o.
I'll be 65 in 2 months. I have been studying this issue and I was leaning toward original medicare and a supplement. Your explanations confirmed my choice but with a different twist. The advantage plans do in fact take away all those choices that we paid into during our working career. As long as I can afford the choice why should I give it up? Thanks
I am glad to have helped. For more personalized recommendations, feel free to call my team 800-847-9680 By the way, my Medicare starts November 01 and I already know what plan and insurance company I will use.
Thank you Mathew, very good explanation.
You are welcome
Hi there Matthew! Thanks for the very informative video! We will be choosing a supplement plan, Plan N to be exact, :)
MA plan was basically created to increase profits for the insurance companies and Mathew thanks for confirming it.
Thank you a lot for this video. This is very interesting and informative. Keep posting like those amazing videos, this is awesome.
It’s hard too switch from an advantage plan to a supplement plan. You have to go through medical underwriting
I had original Medicare when received two heart stents in 2009, Medicare paid the entire $76,000. In 2019 I needed another two stents and at that time I had an advantage plan (United healthcare) of the 46,000 total cost UNC paid the hospital $17,000. However, in addition to the $100 co-pay, I received an additional bill from the surgeon for $346 that was not covered by the plan. I should have stayed with original Medicare.
yep
Matthew Thanks for the eye opening 👀 I wasn’t sure a the advance plan , now all I have do is decide on G Or N plan thanks again .
Thank you for the great insight . It really helped me decide what direction to take.
God Bless.
Would be nice to see All plans for retired seniors with Low Income(20K a year), Any way to avoid the 20% out of pocket?
You can. There are agents who specialize in the low income market. But you have to be careful. A lot of new agents work this market as well.
I see, so Medicare will not, and medicaid pays for Medicare premium only, seems cut off is like $1340 a month, over that we pay@@MedigapSeminars