Medicare Costs Comparison | Advantage vs Supplement
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- เผยแพร่เมื่อ 24 ก.ค. 2024
- Which will cost you more in 2023? A Medicare Supplement Plan or a Medicare Advantage Plan?
We look at what your fixed and variable costs will be with an average Medicare Supplement Plan G vs a zero dollar Medicare Advantage plan.
The numbers we use are typical costs we see in our area of the country (Mountain West). We do not address all of the positives and negatives of each plan (Supplement and Advantage). There are things outside of strictly dollars to consider with these plans. Always work with an agent on this decision.
Need help? Email me!
Erik@TheRetirementNerds.com
For even more on retirement, visit our website: www.TheRetirementNerds.com
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
Chapters:
0:00 Introduction
1:18 Part A Premium
1:36 Part B Premium
2:30 Plan Premiums
3:12 Part D Premiums
3:38 Dental Premiums
3:59 Vision Premiums
4:15 Total Premiums
5:04 Deductibles
5:19 Copays
5:35 Excess Charges
5:58 Out of Pocket Max
6:32 Total Cost Sharing
6:58 Total Cost Comparison
9:01 Part D Cost Sharing
9:37 Dental and Vision Costs
9:49 Wrapping Up
![THE TOYS x NONT TANONT - ดอกไม้ที่รอฝน (spring) [Official MV]](http://i.ytimg.com/vi/pPa1d5cC8M4/mqdefault.jpg)
This video was made to discuss strictly the bottom-line dollars someone can expect to pay in a good year vs a bad year with a Supplement Plan compared to an Advantage Plan. There is a lot more that goes into the decision besides just the cost including ease of use, access to providers, and other benefits. We go into more detail on the other factors involved in the decision in this video here: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Thank you for watching and we appreciate all comments!
A couple of things about your analysis. ( I am a medicare sales agent): 1. Your analysis is only a snap shot in the beginning. Medicare Supplement plans go up every year. 2. On the MOOP for the MA plans. The MOOP is only reached in about 5% of MA clients. A hospital visit has a daily copay of average amount of 200 dollars a day for 1-7. so 1400 dollars. All other costs are minimal compared to the costs of Med Sup G. Hospital stay is the most cost you will have in a Med Advantage policy. The only health conditions that make a Med Advantage client reach the MOOP are cancers and kidney dialysis.
You did not mention the government yearly payment to the insurance companies that sell advantage plans ! Try around $ 10000 ? This is OUR life investment paying Medicare taxes ! Nice present to them !!
@@johnpantazopoulos4228 did you watch the link in the comment you are commenting on?
Hi David, for some reason we weren't notified when this came through and just now seeing this. Thank you for your perspective. Yes, it is only a snapshot, that's the best we can do in a video that is posted. We have a video we released about 5 days ago on the hospital and cancer as well as a video coming out tomorrow that will have an actual claim breakdown. A lot of people are concerned with networks and freedom to choose, which we cover more in this video: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Thank you again for watching.
Hi John, we have a video coming out tomorrow that will go through how a high-cost claim is handled that will address your comment.
It is important to understand how the dollars work in all of this. Yes, the government does send payments to the insurance company that offers Advantage plans - for this example, let's use your number of $10,000.
With the alternative - Original Medicare + Supplement - Medicare is now responsible for 80% of everything a person is billed. In the video we release tomorrow, it was a $27,000+ claim. With Original Medicare and a Sup, your life investment paying Medicare taxes must pay for $22,000 for that procedure compared to - if the patient were on an Advantage plan - it would be your $10,000 number. This means the advantage plan saves the government $12,000.
So, for those who use healthcare more often, Advantage plans are LESS expensive to the government - but often more expensive for the individual.
For those who don't ever use healthcare, Advantage plans are MORE expensive to the government - but less expensive for the individual.
I love that you showed the comparison visually instead of just rambling numbers like other TH-cam posters. Great job…
Thank you!
To me the biggest factor is original medicare allows me to go to any doctor, specialist or hospital in my area or anywhere in the country and the advantage plans lock me into a medical group and their doctors. That alone is worth a few extra bucks in the best years for me
To a certain degree, yes. 100%.
Not all doctors and facilities participate with Medicare so it's not any doctor, but yes, it is still a much MUCH higher number of doctors.
We break this down in much more detail in other videos on our channel for sure. This one was strictly a financial comparison between the two options.
Ease of use... that's a different story.
This is the best, most objective comparison of supplemental vs advantage plans I've seen. It is, however, all about costs, which the narrator acknowledges. The key point in this video for me is the statement, "you are confined to a network of doctors and hospitals", referring to advantage plans. Bingo! This is the main reason I chose a supplemental plan over an advantage plan. I don't want my insurance company telling me what doctors and hospitals I MUST use, or there is a higher cost. And I don't want to have to wait 3+ months for appointments. With my supplemental plan, I can go to any doctor or hospital in the country that accepts Medicare. I chose; I have control over my providers; not the greedy insurance companies. Plus, if you live in an area like mine, where good doctors and hospitals are rare and health care is poor, having a supplemental plan allows me to go to where I can get good health care from good providers. This is a big decision that should not be all about up-front costs.
Thank you so much Kathi. You are right on with your insights.
You may appreciate this video that goes into more detail around usability rather than just costs. Thank you for watching!
th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
I believe this is one of the best videos anyone approaching 65 can watch. There is so much information. I like the 2 sisters touch. that gets people thinking. For me it is peace of mind with the "G" plan and the fact that you can go to any doctor in the country that excepts medicare is a plus. Then out of pocket $233.00. I know the premiums are more but I would rather it paid up front than on the back end. I did learn something today as far as Part "D" We have to pay $505.00 towards our prescriptions before anything is paid. I see advertisements on plans that will have like 1,200 drugs (tier one or tier 2 I think) that are $0 cost. Is that after the $505.00 deductible or is this an Advantage plan? Also within these plans "G, Dental, Vision, Part D" are there different ones or options. example 3 part "G" plans to choose from with different deductibles. Just curious as I thought I saw something like that. Now on another note I now have copies of my son's cookbook "The Cajun Ninja" I would be happy to send you a copy. Just need an address you know you will receive it. Any address you feel safe it getting to. If you or your wife love to cook I think you will love this cookbook. It is just a thank you for the awesome information you are putting out there for older people facing all these questions dealing with medicare. Great Job!
Love seeing your comments!
Send me an email to erik@90daysfromretirement.com and I can pass along my address that way. Don't really want it all over TH-cam :)
Your questions:
1. $0 cost drugs?
Yes, there are plans that cover Tier 1 medications to where you don't have to pay for them. This would be before your deductible, so if you only have these drugs, you wouldn't need to pay anything and you would not need to meet your deductible to enjoy this benefit. There are a lot of plans that do not have $0 Tier 1 coverage, but they still have very inexpensive Tier 1 coverage. We're talking $1 - $7. That is before and after the deductible.
2. Are there different plans and options?
With Dental, Vision, and Part D plans, there are LOTS of options, especially when you're looking at buying them separately because you have a supplement plan.
With Plan G, or any of the supplement plan letters, the plans are standardized, meaning a Plan G with one insurance company covers the exact same things as a Plan G with a different insurance company. A Plan N with one covers the exact same things as a Plan N with another. The only difference would be the monthly premium between the two companies and customer service.
The supplement Plan letters are all slightly different from each other. Plan G covers a bit more than Plan N. Plan A is different than both. You may have heard of a High Deductible Plan G that acts like a regular Plan G, just with a higher deductible than the $226 (in 2023).
Hope that helps!
You explained in 5 mins what I have been trying to get answered in about 5hrs of phone conversations in the last week. And still never getting any helpful ideas on Medigap and Medicare Advantage. Thank you !
Glad we could help!
Feel free to email me if you have any other questions! Erik@90daysfromretirement.com
A LOT wasn't covered because (dis)Advantage plans are so complex and arguably full of loopholes for companies.
Highly recommend you watch this one: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Thanks for your time creating more great content!💯
Appreciate you watching and taking the time to leave encouraging comments! Really helps us stay motivated to keep making more.
@@Theretirementnerds Absolutely!
Thank you for helping to clarify the differences ~ I appreciate it!!😊❤
Thank you so much for watching! Means a lot and glad it was helpful
I am three years away from Medicare. I am still looking at videos like yours to learn what I will do. I am on company provided insurance until then. Thanks so much. Also, you are a good looking man.
So glad they are helpful! Best time to start the formal process once the time comes is 90 days before you need Medicare. Good job starting to learn early!
I found this presentation very helpful and informative. It is a well balanced presentation of original Medicare versus Medicare Advantage. There were two major points it did not address that were very important to me:
1. You only have guaranteed acceptance into one of the supplement plans for several months of your 65 birthday or retirement date. After those few months, you are required to complete a questionnaire that many cannot pass (e.g., if you are diabetic you are not acceptable) and must take a Medicare Advantage plan which are guaranteed acceptance. At least this is most generally true.
2. Medicare Advantage plans are more local and if you travel out of state, you will likely be out of network and pay higher fees.
Hi Harry, appreciate you watching and your insights!
This video was strictly dollars and cents.
You may appreciate this video for more details around how the plans work:
th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
And this one on how to switch from Advantage to Supplement:
th-cam.com/video/djuGeI829M4/w-d-xo.html
Appreciate you!
You failed to mention that under the advantage plans it is private insurance companies covering the plan. They can cancel or change the cost structure at any time . If they decide to cancel you , getting back into medicare can be troublesome. They are not required to accept you back
Thank you for watching and for your comment. A couple things to note:
This video is strictly around the bottom-line costs someone can expect from the two options during a good year and a bad year. There are a lot of other factors that should go into this decision, including what you mentioned. We have several videos on our channel that go over the other things to look out for when making this decision, including another video that will come out in the next day or two.
A point of clarification, they - meaning Advantage plans - cannot cancel or change the cost structure at any time. This is not accurate. They can change benefits and premium costs. To do so, they need to file those changes with CMS and get them approved. If you are on a plan that has changes you do not like, you may switch to another Advantage plan during a time we are currently in called the Annual Enrollment Period (October 15 - December 7 each year).
The Advantage plan cannot cancel you unless you stop paying premiums (if you have any at all).
If the Advantage plan pulls out of a county or no longer offers that plan in your area or is shut down because of fraud, you can change to a different Advantage plan or you can go on a Supplement plan with guaranteed issue.
Important distinctions. But an Advantage plan cannot, in the middle of the year just say, "we cancel you" and you are left hanging.
And my experience a year ago, new to the Advantage plan, was that some of my medications I have been on for over 10 years were not initially covered (advantage plan is Aetna, with whom we have had private health insurance for 30 years). Because the entity I was fighting with was not Aetna, but Medicare plan D. So Aetna slurped up my plan D into the advantage. I had never needed plan D before. It was He*l. All the hoops I had to jump through. I had to become the coordinator between myself, my Doctor, Aetna and CVS pharmacy, who, by the way is owned by, you guessed it, Aetna. I’m getting divorced so now have to struggle with coming up with $$$ to pay for a nice, safe coverage. No way can most of us afford $400.00 a month in addition to just living expenses. So I think the scare tactic is built in. I would be one of the people who would have to choose between affording medications or eating. Even after giving up any cable or high speed internet, got to have a phone. Not to mention car insurance. And Advantage in Kansas does not cover in any way dental or vision. So I am in the investigative mode and I found this video helpful but scary😬. So, good luck to us all😢
Awesome info as always,
Very easy to understand .
Thank you so much!!!!👍
Thank you so much!
perhaps the best and most concise explanation that i have ever heard. thank you.
Thank you so much Gary!
The best explanation I could ask for was provided in a concise form and touched all the major questions I had. My PCP was recently acquired by a healthcare group and BCBS does not cover the new group - out of program, so big changes. Thanks for the outstanding contribution!
Thank you so much Robert! We are glad this was helpful. This just covers the financial conversation between the two plans. A lot more goes into this decision for most people. We have a longer video that goes into that in more detail if you're interested: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Appreciate you watching and taking the time to comment!
If you are half of an elderly couple, consider how the remaining spouse will deal with leftover medical bills when one dies after a lengthy illness. It can be a blessing to have a Plan G where there are NO bills to deal with.
Very good point. You may appreciate this video: th-cam.com/video/_L0A556wA1s/w-d-xo.html
thanks for clarification in very simple way without too much technical jargon.
Thank you so much for watching and commenting!
Informative, concise, excellent. Thank you!
Thank you so much!
My daughter works is a social worker in a hospital and told us never to do an advantage plan. She says it can be very hard if you have to go to rehab and/or the nursing home to get placed on advantage plans, she said they are the worst at fighting what the doctor orders.
They can be. All depends on the company offering it and where you live. If people can afford supplement plans, they are amazing. You may appreciate this video a bit more as it goes into the ease-of-use topic of both of them:
th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Thank you for watching and adding your insights!
I am a physical therapist who works in rehab. What your daughter says is true. What is also true is that MA plans contract for therapy hours which are always less than Medicare pays for. So a MA plan may cover 30-45 minutes of therapy per day where a Medicare pt. will receive twice that.
IEarlier in the year, I fractured a hip and, after three nights in hospital, I was 20 days in a skilled nursing facility. It was pretty seamless. Ten sessions of PT and OT per week. No quibbles about charges. My share was zero. Maybe I was lucky with my Advantage plan (after being unlucky in my original fall). I have no complaints regarding how my Medicare Advantage plan handled this.
Medigap + a Part D PDP, which I agree is the best option, has become a mid to upper income product -- usually purchased by folks with multiple retirement income streams or very high PIA. If available, I suggest High Deductible Plan G. Few brokers will mention it because of the low commission.
Hi Brock, you have a good point on the higher costs of regular G. I think brokers in areas that have HD G bring it up a lot. We have a video we released this week on it. I think it isn't mentioned as much as regular G is because it isn't as desired. The now $2700 deductible dissuades a lot of people and they go for N instead. The main reason (not the only by any means) but the main reason people who meet with us want a supplement plan is they don't want to worry or think about healthcare costs. They want to go and know it's covered and they won't get a lot of bills. Or, they have high healthcare costs already and know they will hit any high deductible. HD Plan G is great for the right person, just fewer people want that.
I think it's a little unfair to attribute it to the agent doesn't make as much. In this business, we are solely focused on service because for each person we help well, they send 3, 4, 10 friends to us and that is more sustainable for us than forcing people into plans they don't like for a couple extra bucks. A couple extra bucks at the detriment of our clients is a horrible business model.
Appreciate you watching and adding your insights
This helped me Greatly Thanks!
So happy it helped! Thank you for watching and commenting!
Very informative, thank you!
Thank you for watching!
My wife and I use the supplement plans because we have very good doctors and none of them except the Advantage plans which seem like an HMO to me ! We could use the savings but not at the expense of quality of health care!
There are tradeoffs. Both plans have strengths and weaknesses outside just costs (this video). We have some other videos that go into those pros and cons. Thank you for watching!
Thank you , you have really bin a big help
So glad to hear! We have several other videos we are making as well. If there is ever a topic you'd like us to cover, don't hesitate to throw it here in the comments!
Outstanding video sir, thanks for the valuable information. I am about 3 years away from 65 and just starting to look at my options.
Thank you Ritch! Appreciate you watching and commenting. You are wise to start planning early. A lot could change in 3 years, but we'll keep making videos to keep you up to date :)
Extremely informative and helpful. I really like how everything is explained in a simple and easy to understand manner. A truly invaluable service is being provided. Great job. 👍🏽
Really appreciate you saying that!
Excellent explanation hubby and I have had advantage plan for 16 years and are relatively healthy. And are very happy with our choice. Have a friend that pays $300 a month and seems to go to doctors a lot with many health problems and she is happy with her coverage.
This is such an important comment. People love to hate on Advantage plans based on what they heard somewhere. There are a lot of people who enjoy their advantage plan. Thank you for watching and sharing your insights!
I didn’t realize Advantage plans had been around for 16 years.
@@craftsmanctfl3493 signed into law in 1997 🙂
You helped me alot thanks
So happy this was helpful! Thank you for watching!
Thanks for your helpful video.
Of course! Thank you for watching and taking the time to leave a comment!
One thing to consider that is totally separate from the costs but MUCH more important is this: In a Medicare Advantage Plan, the Plan determines what medical procedures are "necessary". In a Supplement Plan, you and your doctor decide what medical procedures are "necessary". So I'll keep the decisions on my medical well being to myself and my doctor and always go with the Supplement Plan.
Valid point and solid logic. This video was strictly a bottom-line dollar amount comparison. We just released a video yesterday that digs deeper into the practicality and ease of use differences that I think you would appreciate.
Thank you for watching and adding your insights!
Very good point. One thing I would really like explained is why so many health insurers are spending so much money to lure people onto medicare advantage plans? My suspicion is that the federal government is paying them a whopping large bonus for every person they can lure onto plans that severely limit the potential exposure of medicare to pay for cancer treatments and other catastrophic illnesses.
@@wbwarren57 great question. We made a video about this that sort of addresses the topic. We'll release it early next week. Maybe it warrants it's own full video though.
There is priceless value$$ in having control over who your doctors are and decisions you make with the doctor in a supplement and not in an Advantage plan. Some pay extra to their Advantage plan for having choice, and this was not included in the discussion. Friends with Advantage plans pay towards their dental and vision plans too.
@@karenk3339 I self insure on dental and vision. There are so many "$59 for 2 pair of glasses and an exam" out there right now. And you can get the same deals from most dentists that they give the ins co., so no good deal there.
Great info. Thank you for confirming my thoughts on the difference on plans.
I have plan G & D. Had open heart surgery this year. The surgery alone was over 90k not including 5 days in ICU. My total out of pocket was only the $226 deductible.
No co pays on MRI, or cardiologist. I’ll be keeping my plan as is.
Glad it was helpful! Yes, Plan G is unbelievable coverage, especially with high medical costs or chronic costs. Hope you are recovering well!
@Boca Riley agree 100%
The main point of this video is strictly costs. Ease of use and actually living with the plans are covered in other videos. Trying to keep videos to less than an hour haha but may need to do a full deep dive 🙂
Hope you are well, too! Thank you for watching and commenting!
I also had open heart surgery this year, you paid $226 plus $4678( your monthly premium) for total $4904, I have an Advantage plan I I paid deductible of $1100 for the surgery( co pays,and items not covered) my max out of pocket is$2500 /year, which I never come close to hitting. plus monthly premium of $161.90 or$1978.00 /year total $ 3078, for the open heart surgery IN ADDITION,I had two dental cleanings, NO CHARGE, and one dental crown, No charge, IN ADDITION I have two Silver Sneaker memberships, cost per month if I did not have the Advantage plan $219/mo.I plan on having cataract surgery in December my projected out of pocket cost is $40. Keep your plan if you like to pay more, and I might add you pay a lot more! Now I will conceded Advantage plans cost more or less depending where you live ,fortunately for me my plan is very cost efficient. As far the Advantage plans turning you down for procedures, this refusal of procedure has never happened to me
@@nicholasb1784 great perspective. You are correct on the geography. You are fortunate to have one with such a low out of pocket max. Very happy you are happy with your plan!
@@nicholasb1784 have to admit I never thought of adding premium. If I could find advantage plan like that I’d take it. My wife started Medicare a year before I did. She was diagnosed with breast cancer not long after starting an advantage plan. After surgery and radiation she’s now cancer free. Can’t put a price on that. We paid $7500 out of pocket that year so that’s what I tend to go by when looking at plans.
Thanks for your reply. Gives me a different angle to consider.
This is the most helpful video ever!!!
Aww thank you!
Awesome Video! Thanks!!!!
Thank you for watching!
I am a volunteer Medicare counselor in my state (a SHIP program) and this commentary is ignoring one of the most painful aspects of advantage plans which is denial and delay of benefits. Denial of benefits that plans promise to cover (every advantage plan contracts to cover all of the Medicare A and B benefits, and Medicare pays them accordingly) is a painful and real problem with advantage plans. Needed care that is covered by Medicare can be delayed for months while the beneficiary works through the four levels of appeal allowed to advantage plans. People with medigap plans are NEVER confronted with these kinds of denials and delays. I have been a Medicare counselor for 15 years and this year has seen more denials and delays of benefits with advantage plans than I have ever handled before. I've had clients who have incurred over $12,000 in copays by the end of July, and while the maximum out of pocket expense for their plan was
$7,350, that is still a huge bill for a widow living on Social Security in a rented trailer. She will never be able to pay that amount of money without compassionate care help.
Thank you for your help in the Medicare space. This video is solely comparing costs based on a good year vs a bad year and financial risk with both plans. We have several videos on our channel that go into the details you mention around pros and cons outside the financial conversation.
Appreciate you watching and commenting!
I'm 3 years away from Medicare but trying to learn what I can now. This is the most helpful video I've seen yet. I mean it, great job thank you! 🙂👍👍
We appreciate you saying this. Means a lot! We are releasing a video that goes into details outside of just costs between the two plans soon (tomorrow) so keep an eye out for that!
@@Theretirementnerds I can’t stand the fact that we have to pay so much for the premiums of Medicare and a supplemental! How are elderly people supposed to afford this. I’m still working and at a hospital where I pay very little for my benefits. I have to have things done in a network but everything is paid for except $15 co pays for office visits. It’s gonna be a shock to my system as a single woman on my own to have to pay for all that. I guess I have to work until I’m 100
@@dawn2508 It is frustrating. This is why Advantage plans (for better or worse) are becoming so popular. Most are $0 premiums and you'll experience similar coverage to your work plan with copays and a network. However, many people want the coverage and freedom of a supplement plan - they are just costly.
Thank you very much it will help my discussion with my agent tomorrow.
So glad we could help!
Clear presentation, you covered so much information. Thank you.
Thank you!
Since switching 15 years ago, I have saved an estimated $50,000 in the cost of supplemental plans and co-pays by going to an Advantage plan. So much for the recent onslaught of attacks on the best thing to happen to Medicare coverage for most seniors.
Thank you for sharing your perspective!
Who do you think pays the premiums on your Advantage plan? The Insurance companies don't cover you for free. That would be the Federal Government. Around $800-$1200 a month.
@@bobbycoln5626 If the federal government is willing to do so, why should I care? I paid taxes all of my life -- why should I object to getting some of it back?
@@machintelligence you get what you pay for
@@youngtimer964 So I prepaid for it.
The biggest reason I won’t choose advantage plans are the terrible network that the ins company provides. Which limits your access to care and limits the doctors that are accepting new patients. More over if you move the number of doctors (especially small towns) are very bad. Bottom line nothing is free, and insurance company’s use their network to limit access to care (imo)
Networks with Advantage plans are definitely more limited than what you have with supplement plans. This video was strictly to show costs between the two but I think you may appreciate some of the other videos on the channel that go over what you are saying. Although, you seem well versed in Medicare so you likely already know what the other vids will say 🙂
Thank you for watching and sharing your thoughts!
Thanks, this is great information!
Thank you Gwen!
Hi 🙂 I’m a new subscriber. Just found your channel. Very informative. Thank you.
Welcome! And thank you!
Finally, a straightforward explanation, using a simple table, to explain the advantages and disadvantages of Advantage plans vs Original Medicare with a Supplement Plan. Thank you for providing this excellent explanation.
Thank you so much for watching!
AHH research Please !!!!
I totally agree; he did an excellent job explaining. A very invaluable resource for sure.
@@user-qc8vj3vp9v thank you so much!
excellent concise explanation of the two plans. you only left out a few things. such as the difficulty to get back into a supplemental plan once you get out which will require underwriting which means you could be refused. also the supplemental plans are consistent and an advantage plan can change here by year. people also need to read the fine print in the advantage plans because some of their advantages require very low income or Medicaid level income then the amount changes from 0 to whatever
Hi Kathy, thank you for watching and your insights. You may appreciate this video a bit more as it focuses less on the dollars and more on what you mentioned:
th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Where have you experienced not being able to get back to supplemental? Has this happened to you? Because it is against the law and a lie.
@@DJElectraFry You may not be allowed back on traditional Medicare, and certainly not without medical underwriting. Why would Medicare accept you back if you have high medical costs? And if the Medicare advantage plans are so good, why would you want back on traditional Medicare?
@@seniordockman2946 You have no idea what you're talking about.
@@CVE42287 Yes, I do. However, I have no idea what you are talking about and since your reply explains nothing, it will remain that way. Have you read that some Medicare advantage companies continue to overcharge Medicare, essentially stealing taxpayer funds?
Thank you this was very helpful because I thought I made a mistake but It was not, thanks again.
Thank you for watching!
Best explanation I’ve heard in my life.
Thank you Michael!
For me it is less about the cost than the in-network aspects and the pre-approval aspects.
Great point Michael. Thank you for prefacing that with "for me."
Everyone is different. For some, it is only about costs. For others, it is about the freedom to make their own healthcare decisions. This video was just about the costs, but you may enjoy this one that goes into more of the other aspects you mentioned: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
I appreciate the updated information. Having recently retired after spending several decades as a financial advisor, I well-understand it is impossible to cover all the options and minutia in a 10 minute video. Ignore the quibbling and keep up the good work. Giving people an awareness that there are many things to consider/research and seek competent advice is a service in and of itself. Despite having more securities and insurance industry licenses and credentials than I care to count, I always referred my clients to an agent I trusted who’s focus was in this specific area.
We appreciate that. Thank you for watching and taking the time to leave such an insightful comment. It is impossible to cover everything, even in an hour video, so we do our best to cover as much as we can and try to consistently put out a lot of videos to help. Your clients are lucky to have had you serve them.
Thank you for telling the truth about Medicare Advantage. I just watched a video from a guy who is a sham and only interested in lining his pockets! Medicare Advantage plans... $0 premiums, deductibles and copays. Dental, vision, hearing and an over the counter card that can be used for food or utility bills comes out to be about $6000 a year. For someone on a fixed income, making less than $10,000 a year the Medicare Advantage plans are a big help.
Thank you for watching!
The best video explaning Advantage vs. Supplement Medicare plans. By far The Best!!!!
Wow, thank you Jeff! That is very kind of you to say! Thank you for watching!
This is all about what is your risk level. Advantage plan cost less yearly especially if you aren't sick. If you develop an illness, you may get stuck on your Advantage plan because shifting to Plan G or Plan N requires underwriting. The insurance company can elect to not take you. Whatever money you saved in the "good years" will be nothing compared to what the potential costs are.
Mostly agree! Depends on the area and Advantage plan for sure. Lots of variables here, but in general, yes. If you have several high cost years, supplement will save lots of money.
Another excellent demonstration and discussion to compare the two.
Thank you!
Thank you so much for watching!
You got a new sub. Thanks for the info.
Thank you so much Stephen!
Good video. Important to me is the fact that Advantage plan can dictate who you get to see even though if you got some form of Cancer and wanted to see a particular Oncologist you could be denied or pay out of network cost which would increase the payout for Advantage plan.
Valid point for sure. We address things like that mich more in the video we released yesterday. If that freedom and flexibility around which providers you can visit is weighed heavily in your decision, then yes, Supplement plans are amazing!
@@Theretirementnerds In MA, we have two huge medical conglomerates, each with about a dozen hospitals, and about 10,000 MD's, and numerous specialty centers for cancer etc. Both of these huge conglomerates (and many smaller hospitals) are in-network for my Advantage plan. It would be a very unusual case to require an out-of-network referral (I don't travel anymore since retirement), but having asked for one once, it was granted immediately.
@@douglasjensen8986 great perspective. Thank you Douglas!
Definitely helpful. Glad I have VA benefits. I don't have to worry about this BS.
VA benefits are a different story for sure!
Still get A and B. May have $0 Advantage plans in your area if you wanted something just in case you used a civilian hospital or provider but don't need to if you don't want to
thank you. i have already forwarded to a friend turning 65 in six months
Thank you so much John!
Excellent video and graph.
Thank you!
Excellent presentation; Unfortunately Medicare is very expensive for middle income seniors.
Indeed it is. It's an important decision and a plan is important
@@Theretirementnerds how should low income seniors do it? My father is trying to get a transplant. They will cover 80 percent but say that the other 20 is to be covered by him. We're trying to get him in Mayo Clinic. He is disabled and on disability and has medicare. But he pays so much in copays, supplements... could you help? I have some savings.. not a lot but I'd pay you however I can.
@@jghobbiesandtoys5914 happy to look into some options. Agents cannot accept money for helping with Medicare, so whether you work with us or any other licensed agent, you won't have to pay money for assistance.
Mayo won't take Advantage plans and often charge the excess charge for supplement plans. If your father has a Plan G, he will have coverage at Mayo if it is a Medicare-approved procedure.
Other options for lower income if they qualify would be Medicare + Medicaid. All depends on the state you live in and income thresholds.
erik@90daysfromretirement is a good email to reach me. In that email, let me know what state/zip code you're in.
We are physicians in Florida, and just went through this process. We took a Plan G high deductible $46 per month with an $8 plan D. We know that for average healthy people health care comes in occasional spurts until they get to older ages. We also wanted more travel coverage.
When running the numbers the supplemental route is usually cheaper, especially the more healthcare one uses. We are obviously counting on being average and thus using minimal services most years. All of our parents were on Advantage plans, and they are tedious and more expensive than people think, and way complicated when getting into multiple care needs.
The dental and vision plans of Advantage look way too basic to cover much.
If a high deductible Plan G is available, it makes the financial numbers much closer. Unfortunately, high deductible Plan G options are not available in all states. Great option though.
Dental and vision benefits are highly dependent on the plan and where you live. There are Advantage plans in areas of the country that have unbelievable dental and vision coverage. Other areas and companies that leave a lot to be desired.
You nailed it though, the more you have to use the healthcare system, the more financial savings you will see with a supplement plan.
Thank you for watching and adding your thoughts!
I chose the same and my premiums are very similar. (In fact, my supplement plan premium went down for next year.) I am very satisfied so far!
@@ga6589 that is fantastic! We love hearing about people who are happy with their Medicare choices!
NY guaranteed issue. 290 for plan G. 68 for hi deductible G. If i don't use it i save. If i do, my deductible will be a wash if i had the reg G premium. So there is no down side. Medicare pays 80% anyway. Need a lot of care to reach the deductible.
@@batbat7043 yes high deductible plan G is a great option. Also as you said it’s not really a true deductible unless hospitalized, since Medicare pays first, it is really a copay for most everything outpatient. The only downside over time might be that the deductible is adjusted up with inflation. But, as a doctor I know that most persons who are not chronically ill, use care minimally most years, and only have an occasional major health event. So most will easily save $1000 or more a year on premiums, with a major event only once in a while, and then it’s still a reasonable deductible for the year. I was also told that it was possible with my wife’s plan to upgrade to regular G after 2 years with no underwriting(same insurance company)
Very good presentation, well organized and comprehensive.
Thank you so much for watching and commenting! Very much appreciated!
Thank you very much.
It's still clear as mud
It can be tough. I promise that talking with an agent will help. It'll be fewer general numbers and more specific to your situation, which will make it much more clear.
@@Theretirementnerds thank you
you left out a MAJOR point between the two types of plans ! On the Advantage Plans … THEY … not you … get to have the final decision on what doctors you get to use, what medications/prescriptions they with cover or not cover and lastly what tests you can have or not have. Advantage plans are just like HMO’s ( Health Maintenance Organization ) plans your employer may use !
You are correct. This video is meant to discuss dollar figures only. We don't take the time to go into the other differences between the two plans. However, we do have a few videos that outline what you mention.
This is one of them: th-cam.com/video/gabm20lxdJo/w-d-xo.html
Thank you for watching and commenting!
Right! I am an RN. Advantage plans will screw you!
Medicare is also a form of a managed care PPO plan. Doctors choose to "participate" or not. The ones who don't are the ones who can charge the 15% excess charges because they are effectively out of network. Also, the drug plan on the advantage plan is usually the same as the stand alone PDP "saver plan" of the same carrier. They're still deciding what drugs will be on their formulary and at what tier, you just pay a significantly higher deductible on the stand alone PDP.
But, you are correct that a responsible agent needs to look at all the angles of a client's health, and that includes financial. A monthly supplement and PDP premium coupled with the Medicare B deduction could cut a SSA check in half. I don't know where you live, but the average part G for a 65 y.o. nonsmoking female in my area is $190/m. With the ancillaries you mention, that is $430/m. I know several seniors who only get $800-$1000/m in SSI benefits.
@@SuRFerretti exactly right! We see a few agents put there that only push sups or only push Advantage. Medicare is not a one-size fits all approach. Thank you for watching and your insights!
You should mention that stand alone Part D drug plans have a formulary too, so they decide what drugs they cover and ones they don't. All the drug plans are like that.
I have been with three different advantage plans in Florida since I retired. I have never paid any money for medical services, drugs, vision, etc. The maximum out of pocket for my 2023 plan is $1,000. The plans I had before had$1,500 and $2,000 max. Still never paid a cent. Advantage plans are the best if you have limited financial resources. And people should stop the campaign against them. This will only throw thousands of retirees into non affordable care.
Thank you for your perspective. There are some great plans out there
I have also been with three different Advantage Plans. UHC refused to pay for intestinal meds to keep me from getting esophageal cancer. Kaiser expected me to walk Grey distances though both my knees were damaged when my car was hit by a bus. Inova’s not bad - at least I understand what’s expected of me.
But I have to have at least two surgeries next year, so I’m considering Supplemental Medicare this year.
@@cherylmcnutt9905 Everybody’s experience is different, partly because of health problems, plans availability in different states, and so on. I have two good friends who required surgery and special care, from open heart surgery to cancer treatment. They both were affiliated with Florida Blue and their wives told me they didn’t have to pay for these. They have had this plan for years. I don’t know in which state you are but you mY check with them. This is from their website: Florida Blue and its affiliated companies serve 27 million people in 35 states. Headquartered in Jacksonville, Fla., it is an independent licensee of the Blue Cross and Blue Shield Association. Good luck with your surgery and a speedy recovery.
@@deadpoet50 Blue Cross Blue Shield isn’t available in my part of the state.
Very helpful!
Thank you so much James!
Thank you. I took a screenshot for future decisions.
Sounds great! Happy to help if you have any future questions :)
Both my wife and I have a Medicare Advantage PPO plan by Wellcare with a part B give-back which is $60 a month or $720/yr in 2023. That's an additional $1,440 in premium savings for us both each year. When you are living on SS, that's huge.
We are full-time RVers who travel the country and the PPO allows us to see plan doctors regardless of where we are, from coast to coast. We have never had to go out of network, which saves us even more. It's much easier to use than an HMO. Our total out of pocket last year for both of us put together was less than $200 - including drug coverage as many prescription drugs have zero copay. There are also advantages that regular Medicare doesn't have, such as a $59 a quarter ($236/yr) allowance for over-the-counter medications.
Considering that we only pay $1,258.60/yr per person - $236/yr non-prescription drug allowance = $1,022.64 cost vs $4,904.80 Medicare cost in the above example. This means we save $3,882 per person each year. That's $7,764/year for both of us - over 20% of our total income! Let that sink in. That's a lot of money to put in the bank every good year. We could have 2 bad years for each good year and still be thousands of dollars ahead! It's a no-brainer for us, but your unique situation might be different. Run the numbers yourself before you decide.
Your situation is what we try to help those who hate on Advantage plans see. Advantage plans can work very well for people. They are not great for everyone, but they are great for some. Happy to see you are happy with your plan!
@@Theretirementnerds Yes Medicare Advantage PPO plans are great. Not all states offer them. CA is primarily a HMO state. It would be nice if the plans were standardized through all 50 states.
@@katecart8790 agree with you 100%!
@@katecart8790California does have PPO
As a surgeon, I don't accept advantage plans because its a bunch of garbage that private insurance does to make more money and not pay. Esp with inflation, everything is like 1.5x the cost of what it used to be yet insurance reimbursement is dropping. Ppl don't understand that eventually they will drive out private doctors and make corporate hospital rich with insurance.
Excellent point. We cover this in other videos on the channel with another coming out in the next day or two. Thank you for watching and adding your perspective!
You will never drive out a private doctor how ridiculous. This is how they make their ridiculous money it is the hospitals and the doctors they have these ridiculous charges. Seriously what oath did they really take to drain all of the blood out of you. Here is my question so Sally goes in to have a procedure done at the hospital. 30 days later we get the mail and it is $60,000 and you didn't even spend the night I took him 15 months tops so the reason he won't take advantage is because he has to agree to what the insurance company will pay for this surgery he did. Fully agreed with the insurance and must just say they said we will pay $5,000 so the insurance company pays the doctor with a $5, 000 everybody is Happy except for the person who has no insurance at all and is wondering why he will never get out of debt on the big question why didn't I get offered $5,000.
What the hell would these doctors in hospitals do if people were not sick or if scientists did not make them sick people really need to pay attention to that 3%
@@deborahlyle7121 Are you trying to justify having a middleman (insurance company) as a cost saver? That’s absurd. The American healthcare system is a racket and doctors are caught up in the middle of it.
LMAO. As a surgeon... Riiight...
I Agree and part of the problem is Medicare pricing Part B based on what your income was 2 years prior . That is pushing a lot of people to Advantage plans unfortunately.
You can always call to get approval from your advantage/HMO to go out of network and not get dinged
Ty for the video.
Thank you Paula!
Well done! Your presentation was a clear and concise comparison of Part G and Advantage. Thank You
Thank you for watching Scott! And thank you for taking the time to leave a comment. We appreciate it!
Nice overview of both plans....similar to how I present to my clients. There was one glaring omission however, and that is what happens to MedSupp premiums as people age. I had some people come to my office during last fall's AEP who were in their 80s and spending over $6,000/year in premiums for their Plan F, Part D, and $505 D deductible. This is higher than the $5,000 MOOP for local MAPD plans with NO Part D deductible. As the guaranteed annual costs of having a supplement plan approaches the potential MAPD MOOP, it's a no-brainer to move them to MAPD. This has happened countless times in my agency and no ONE person has regretted that choice. Most later lamented that they should have switched to MAPD sooner.
We see similar patterns. Supplement plans can price themselves out of contention because it takes substantial resources to pay for them. Thank you for watching and sharing your insights.
By far the best explanation of the Medicare Mind Melt!
Thank you so much for watching!
Very good at explaining the differents
Thank you so much for watching Pam!
I wish more agents/brokers would discuss the high-deductible G supplements. This can be a good choice for people who don’t use a lot of healthcare services. I’ve been on original Medicare with an HD supplement and a low-cost Part D plan for eight years now. At age 74, I’m paying $45/mo for my G-HD premium. Max out of pocket, if/when I ever reach it, is reasonable: More than with an ordinary G supplement but less than with an Advantage plan.
These are great plans. There are 2 reasons we don't cover them more:
1. Regular Plan G is chosen much more often and applies to a greater number of people.
2. Related to #1, HD Plan G isn't available everywhere nor do as many carriers offer it. So, where we are as an example, there is only 1 carrier that has one and the general population here does not choose it.
We will likely end up doing a video on it at some point though.
Agents in areas that have HD Plan G talk about it often because they are a good middle ground between regular Plan G and an Advantage plan
That's great for you...but at some point that will change in time. If you health is ...sounds 🥰
@@Theretirementnerds : Odd there was no mention of Plan N as an alternative to G, even though annual premium increases tend to be less by percentage than G.
Hi Ric, similar to other your other comments on this video, we do have a video on this: th-cam.com/video/LmpaQdZxyl4/w-d-xo.html
That video will hopefully give the comparison you are looking for.
Excellent video! It’s very beneficial to have the known costs broken down side by side.
Thank you so much! Appreciate you watching!
Very good explanation. Thanks
Thank you so much!
Thank you.
Of course!
AT 2:06 you listed the IRMAA numbers for the Part B Premium, but it would also have been good to show the IRMAA numbers for the Part D Premium. Other than that, I appreciate the way you broke down and listed the costs for comparisons of Supplement vs. Advantage plans, as well as the mention of the two sister-in-laws at the end to illustrate different viewpoints on the resulting numbers.
Appreciate you watching and your comments!
We break down Part D in a lot more detail in this video, which may help a little.
th-cam.com/video/17F6LUcujDE/w-d-xo.html
I have a question. Can you use Humana insurance to give a birth? Please reply
@@ndayembidi6781 Ask your Humana representative.
Great presentation. I use the same format on my presentations and it really works. Clients see the difference in both.
Thank you Jeffrey!
Well done. Excellent explanation. Thanks.
Thank you so much John!
It’s a great video for what it is. Two points: I think you deemphasize just how limited most of these advantage networks are. Most major cancer hospitals - like Sloan Kettering- are not in them. 2. If you want to take in more risk - dramatically lower premiums - stay within original Medicare, you left out high deductible plan G. Same great network. Lower out of pocket than Advantage plans and very low premiums.
100% agree with you on your points. We were trying to keep this video shorter than a half hour haha. We have some other videos that go into more of the advantages and disadvantages and in more detail:
th-cam.com/video/gabm20lxdJo/w-d-xo.html
There are so many variables that go into this. Also, High Deductible Plan G options are not available in all states, so we were trying to cover something that was more widely available. Love your insights and comments! Thank you for watching!
Finally. Someone who makes it clear. (Many/most of these presentations are basically commentary). I'm 76, good health (walk 4 miles a day, lots of veggies and such) and haven't been sick much in my life. I have Sutter Advantage and know that, in a way, kind of throwing the dice as for as out of pocket is concerned.
Another concern is that, it seems to me, so many doctors choose HMOs it's more difficult to find 'single' doctors who will bother with Part G and let the HMO take care of it. Maybe I'm wrong here and there are plenty of doctors who are private. I live in the Sacramento area and that's true for my area (Part G doctors)?? Anyway, Sacto. or elsewhere. Anyone had trouble finding a doctor who accepts Part G?
Appreciate your kind words and thank you for watching. Also great to hear how healthy you are! I need to be more like you!
I may be misunderstanding, but there is a Plan G that is a supplement plan and any doctor that participates with Medicare will be covered under that plan. In California, there are some nuances related to different physician networks that do not participate with Medicare so it gets a little bit complicated.
Any doctor who accepts Medicare will accept a Supplement plan, including Plan G. I have had no problem at all
@@ga6589 100%
California is tricky and has large hospital systems that do not participate with Medicare so I think that is where he is having a problem finding doctors that accept Plan G.
As a cancer patient who will be getting chemotherapy every 2-3 weeks for the rest of my life, I was told by a patient navigator at my hospital that if I chose anything other than traditional Medicare with a Plan-G supplement I will be paying much more than I need to.
So sorry to hear about your cancer. We are uploading a comparison video tomorrow that walks through a cost comparison for cancer specifically that I think you'll find helpful. Hoping to have that live tomorrow.
Just watching for the first time! Need to get a few more views and then get involved in these various programs!! THANKS.
Thank you for watching!
We have had the Advantage plan for years now. We have both been healthy (a BP pill and some motrin) but that is changing. I had to have emergency heart surgery. She had hospitalization and surgery for a blocked intestine. Our total out of pocket cost for both of us for that year were roughly $500 (small enough we didn't bother to write them down) Not changing plans or the carrier (BC/BS)
This is an important perspective that we appreciate you sharing
Impossible
While I generally see a lot of doctors and pay a lot of co-pays, I'm also low income and can't afford the monthly premium of a Supplement Plan! This is an excellent video and makes me want a Supplement Plan, I simply can't afford it. Thoughts?
Yeah, finances will determine options. Plan N is less expensive per month in most cases and still great coverage. A high Deductible Plan G is another option that is a lower premium but has a $2700 deductible.
If you want to send me an email: erik@90daysfromretirement.com
We can figure out Plan options in your area.
Sounds like you would qualify for your states Medicaid
@@westsparks6844 You'd be surprised at how many people are low income but still don't qualify for Medicaid. The income limits are set that low. People in the most trouble with medical care in this country are not those on Medicaid, but those who just barely don't qualify for it.
@@sassy0010
Yes, but if you never paid taxes and illegal immigrants, you'll be qualified for Medicaid!
two additional points:
1 Advantage adds a profit cost into the plan.
2 Sales seminars re Advantage are designed to get you to sign up for Advantage.
1. Not to the beneficiary. Supplement plans do as well to a lesser degree, but directly from the beneficiary.
2. Wouldn't recommend sales seminars. Educational presentations are beneficial, sales seminars are not. There is a clear difference between the two according to CMS.
My MAPD has 1 $150 give back on Part B with a max out of pocket of 3400. My cost per year is $3580 at most. Last year I was out of pocket only the Part B premium with $125 give back. So my out of pocket for the whole year was $552.
Certain Advantage plans in certain areas are hard to ignore. Glad you are happy with your plan!
I agree it was a very helpful summary for someone coming up on Medicare time frames. However I also worked as a nurse in a rehab facility and I found that there were a lot of denials both original and on appeal for rehab stays that were covered without any problem for the same diagnosis etc. with traditional Medicare. Another thing is that for some if they needed more rehab care such as the skilled nursing facility many of the places either denied it or had such poor coverage that you had only options where to go home before you need to care or to go to a skilled nursing facility that may not be up to the standards that you have. I found it strange that you really could present an excellent case for why someone who Medicare that was traditional would pay without any problem such as strokes especially dense strokes, yeah Medicare advantage plans almost universally denied many cases even ones that were clear-cut without any appreciable reason to deny. I know I will seem biased on this but it was really hard to explain to people that either they couldn’t get in or they couldn’t stay as long as they needed to get their care So they could go home and be independent again or at least as independent as if they could be versus going to a skilled nursing facility where they might not ever leave
Appreciate your perspective and thank you for watching. This video attempts to go into a bit more detail around the things outside just dollars.
th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
I have a question. Can you use Humana insurance to give a birth? Please reply
Going through this scenario with my mom. United Healthcare is the worst. They are actively trying to kill her by denying nursing care. I hope the executives at United rot .
I have a chronic medical condition that generates high medical bills every year and will continue to do so for the rest of my life. With an advantage plan I would hit the out of pocket maximum every year. Consequently, the only way for me to go is the supplement route. Also if I had an advantage plan I would be constantly fighting with my plan to get authorizations for the MANY expensive procedures and tests I get every year. With a supplement if my doctor says I need something Medicare pays its part and my supplement pays the rest - no questions asked. Also, since I travel out of state frequently, I would have to buy a more expensive PPO advantage plan to get coverage other than emergency room when traveling. In contrast traditional Medicare and my supplement plan are nation wide - if a provider accepts Medicare I am covered. Basically, there is more than money involved in the decision about which way to go. In my opinion, the only reason to go the advantage route is if you simply can't afford to buy a supplement. Even in that case you should have a couple of year's maximum out of pocket amount in savings just in case.
All great and valid points! You are correct, it is MUCH more than strictly a dollars and cents conversation as ease of use and access are a big part. We have several videos that go over what you outline on our channel. This one was strictly as a dollar cost comparison for sure.
Thank you for watching and adding to the discussion!
@@felixpeterman9303 Not really, all the information is available on medicare.gov.
My Advantage plan pays in full with no copay if I need emergency treatment out of state. Already happened once a couple of years ago.
False. Most PPOs are $0 premium and with large carriers like UHC, you have access to their 1 million providers nationwide when traveling as in-network.
@@todddunn945 NOT Fair and you know it, not everyone understands at the same level. And that is a very disadvantage to some senior who in their time growing up and working and paying their dues. Believe it or not once upon a time 40 or 50 years ago when you worked for a company they provided insurance and you're premiums or based on
Good info. Thanks!
Thank you!
Very great breakdown
Thank you Mark!
As a retired physician, I would not recommend an advantage plan to anyone. There is tremendous value in the fact that traditional Medicare with a supplement does not lock you in to a particular healthcare network. You are free to choose any physician that accepts Medicare and no referral is required to see a specialist. When I was working and had health insurance provided by my employer, I was locked in a network. More than once I paid the additional expense to go out of network to use the physician that I thought was best.
Thank you for watching. We agree that supplements are amazing. What would you recommend to those who cannot afford them?
During the last open enrollment i bought a stand alone part d and that got me kicked back onto original medicare! well the first week in january i fell and they had to do a reverse shoulder repacement! i was denied NOTHING and the doctors had complete control of my healthcare! not only that but the doctors, hospitals, home healthcare WERE ALL PAID 2 to 3 weeks later! not when the private insurance feels like if EVER paying the bills! a friend of mine fell at the same time i did and she said YOU HAVE HOME HEALTH CARE? her plan G refused to pay for it! not only that but they said she didnt get preauthorization? the doctor is out of network? BIDEN wants to end medicare advantage and i hope he does because its nothing but a big scam!
@@Theretirementnerds can you recommend a decent supplement to me, who is 65 with Medicare A&B. I live in Brooklyn NY 11229. Your videos are amazing, thank you so much.
@Dora Pekar thankbyou for watching!
I'm not personally licensed in NY, so I can't recommend, but I have a partner who is. Would you mind sending me an email to erik@90daysfromretirement.com and I will connect the two of you?
@@Theretirementnerds super thanks.
Some things not mentioned in this video are the following. If you are on a Medicare Advantage plan you are not on original Medicare, you are on a private plan that is subject to change each year. Also on Medicare Advantage plans you do have to seek prior authorization for many services and that authorization can be denied by that plan. This puts the plan in between you and your doctors decisions.
This video is strictly a cost comparison between the two plan types using real dollar amounts from plans in our area. We have several videos on our channel that go into the pros and cons of both including what you mentioned 🙂
Thank you for watching and adding to the discussion.
thanks
Thank you for watching!
Thank you for the excellent video, I have been sitting on this for months and down to two months. I understand a lot more now. Where do I actually go to start filing for it and recommendations on supplement plans? Thanks.
Hi Rob, thank you for your kind words.
To go about signing up for Original Medicare, the easiest way is:
1. You'll need to create a My Social Security Account
th-cam.com/video/A-YQC4nLIHg/w-d-xo.html
2. You'll sign up for Medicare Part A & Part B if that is what you need and are planning to take.
th-cam.com/video/fRoIdFfgdrw/w-d-xo.html
If you want to email me, we can go through where you live and show you some plans/costs.
Erik@90daysfromretirement.com
Very good! Choosing the best option is about choosing the best option for YOU, specifically and you alone. It’s about your health status, your financial position and your anticipated healthcare needs for the next year. It is my understanding that if a client chooses Advantage plan and no longer wants it they CANNOT go back to original Medicare with a supplement plan. If the client’s health status changes for the worse that great original Medicare coverage at an affordable price would not be available to switch back to.
Thank you Andre!
Mostly correct. If you get an Advantage plan at 65, you have a year to try it and can switch back to Original Medicare with a Supplement with Guaranteed issue. Also, if you start with a supplement, switch to Advantage, you have a year to try it out and can switch back. This is just after your first time trying the Advantage from Sup though. Can't keep going back and forth.
@@Theretirementnerds Different states have different laws about that.
@@douglasjensen8986 100% correct
I see many comments about that on a plan G, you can go to any doctor that accepts Medicare. The problem with that, is that a lot of doctors don't take new patients, so it might not be so easy to find one in smaller markets.
There are some large hospital systems around the country as well that have their own Advantage plans and don't participate with Medicare. It's all makes it quite tough on beneficiaries
Great presentation!
Thank you!
*Excellent* video.. sharing this info. as it's the most clear and concise breakdown of 2023 facts and figures. *Thank* *You* for all your work providing this info.👍💯🌝
Thank you so much for watching!
@@Theretirementnerds would have helped for a reminder that Advantage plans limit you to in network doctors and clinics, and pre approval for many tests and surgeries. In addition, costs incurred while traveling, especially foreign travel are much better covered through a supplement plan that is an optional add on.
@@jdstolz3474 thank you for watching and your comment. This video was strictly a cost comparison rather than an ease of use comparison. You may appreciate this video more as it goes deeper into what you mentioned: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
Other IMPORTANT things to consider is that with the Advantage Plans, the out of pocket starts from Jan to Jan. So, should you only need expensive medical care in the later months, your out of pocket will start again in Jan. Your out of pocket can be double in 12 months. Also, if you do not like having to stay in network for your choice of doctors or hospitals, to get back into a Supplement plan you will have to go through underwriting. You may not ever be able to qualify for a Supplement plan again because they can deny coverage due to medical conditions. Also, Advantage plans can change from year to year. You do not know what the plans will cover from year to year. Supplement plans stay the same and do not change coverage.
Thank you for watching and commenting. You may appreciate this video as well if you haven't seen it already: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
@@DJElectraFry You need to check your information. People are trying to decide what plan works best for them. It does not help to give completely false information.
@@DJElectraFry You can go back to Medicare which cover 80% from an advantage plan but you will have to qualify to get a supplemental policy. You can go to another Advantage plan yearly or switch from a Supplement plan to an advantage plan but you are wrong about switching back to a Supplement plan without underwriting your health.
_Lions and tigers and bears, oh my!_
On my Blue Shield of California Medicare Advantage (HMO) plan, which I've had for 8 years, if you're admitted to a network hospital on, say, Dec. 31, 2022, for an authorized surgery but not released until, say, Jan. 31, 2023, the entire cost of your hospital stay (including the surgery) goes on your 2022 tab. It is NOT split between 2022 and 2023. The year of the date you are admitted determines the year to which the expenses of your hospital stay are allocated.
Under California law, I have the right to purchase a Medigap plan A, B , D, G, K-N if my Medicare Advantage plan terminates coverage in my area or if I move out of my Medicare Advantage plan's area of coverage.
In 2023, a person my age in my area would pay $2600 more on Medigap than he would on my Blue Shield of California Medicare Advantage (HMO) plan, which has a no premium, no deductibles, and a $999 out-of-pocket maximum and includes a large network of quality providers, Part D prescription drug coverage, basic dental at low prices, corrective lens prescription coverage, gym membership, and other benefits.
BTW, Blue Shield also offers Medigap plans without a medical review.
One of the problems with Medigap plans is that the premium, which is based on your attained age, tends to increase at each annual renewal. You may find yourself priced out of your Medigap plan as you get older.
Of course, California is a progressive state, which, under Democrat control, has become the 4th largest economy in the world. (Republican's hate that.) So if you live in a Republican state, you may not have the options we have in California.
@@herrickinman9303 When I lived in Montana and Arizona they offered PPO Medicare Advantage plans which allows you to choose your own Dr. and see specialists without a referral from a gate keeper Dr.like in a HMO. Arizona also allowed you to pay a little extra to add additional counties of coverage. California really only offfers HMO Medicare Advantage plans which limit you to one medical group in order to stay in network. Doesn't sound all that progressive to me.
This is an excellent video. But, I would frame the trade off a bit differently. The trade off between Supplemental and Advantage is not so much between a good year and a bad year. It is about access. Even in a bad year, with an Advantage plan your cost will not rise that much and be far lower than with a Supplemental plan. But, that is as long as you remain in network. As long as you do that, you are actually better off with Advantage. But, if the access limitation hinders your quality of care in your area... then you are better paying up to get better access with a Supplemental plan.
Great points! This video may cover what you're thinking more accurately: th-cam.com/video/yxXuGQYJ-ug/w-d-xo.html
That one goes into more of the differences around actually using your plans rather than just the dollars and cents.
Thank you for watching and adding your thoughts!
Also all care is affected if you choose an advantage plan. They deny and postpone and your physician will choose the tests and treatments you receive with this in mind.