We are very satisfied with Medicare original with supplemental plan f. Two heart attacks, and breast cancer for a year of chemo at no cost other than monthly premiums.
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
@@McFaddis well I guess we should make a "plan B" for our nderstanding of it all, haha. Probably intentionally confusing, like say the tax code, to keep the best choices not easy to discover
My elderly daddy fell on our icy back yard last winter and completely tore in two his R rotator cuff. He was too old and not healthy enough for an invasive lengthy surgery but his orthopedic surgeon told us about a less invasive balloon procedure they could have done to at least ease his constant pain, but his Medicare “Advantage” plan denied him.(Humana)😖 12:39 He suffered not even understanding why he was in such pain( daddy had Alzheimer’s 😢, until he died in March.
In my area Ambulance companies do not contract with ANY insurance. I found that out after a 2600 bill and lots of phone calls. I finally negotiated it down, but I think it's crucial for people to find this stuff out beforehand. I wish I had, but I was not expecting to fall and break both ankles...
I have A,B&G. I was hospitalized twice in 2022, once for 16 days plus a 10 day stay at a rehab center for PT. Aside from my Medicare and Part G premiums, I paid $0 including two ambulance rides.
If you can afford a Plan G, IMOO, it is worth peace of mind to have a choice of doctors AND not having insurance companies with the “power” of pre-“dis”approvals. IMOO
All plans have the exact same coverage for the same plan But the premium can be vastly different between carriers. It was well worth checking out who was the most affordable.
I have a supplement plan with my Medicare. United Health care plan F. I had cataract surgery on both eyes and it was fully covered. I now have macular degeneration and need injections into my eye every 4 to 6 weeks (at approximately $3000 a procedure) which is fully covered. My monthly premium to United Health Care is a little over $200 per month. Guess I was lucky to sigh up with them when I signed up for Medicare when I turned 66.
Clear and logical, thank you. However, you did not say what the emergency was. Nationwide, the most likely event is a heart attack that would possibly include diagnostic testing and treatment such as a catheterization and angioplasty which would add more cost dollars on the advantage side. Did this event not have any diagnostic testing, and no treatments that required copays?
Great video. May I add that the amount Medicare doesn't pay the hospital, that amount will used as a tax write-off by the hospital at the end of the year. That's how they play the game.
Pay $850 round trip ticket to Thailand. I have a doctor recommended by John Hopkins there. Nurses are great! Cost is 1/4 the cost than the USA and you get a vacation.
For not a lot more than a regular part G I have a no deductible, no copay plan. No worry about out of network. If regular medicare pays anything, my Blue Cross covers the rest. I was in the hospital twice in 2019. Once for a hip replacement & the other for an accident with a power saw. Total charge to me: ZERO. I don't have to worry about pre approvals. In 5 years of being on medicare, they denied me one blood test. Cost me a whole $20. Sure Advantage covers out of area EMERGENCY care. If you just decide to move, you're out of luck until the next enrollment. No surprise network bills. You might be covered on advantage for a surgery, & get a bill for thousands because the anesthesiologist isn't in your network.
Quick clarification on the moving... if you move out of the coverage, you can switch plans at that time, you don't have to wait until the October enrollment period. Also, the No Surprises Act in 2022 eliminates the anesthesiologist issue. www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills That definitely was a problem, but a lot has changed even over the past 5 years to eliminate a lot of issues. They aren't perfect by any means, but they aren't as bad either. The supplement side is super solid, and for those who can afford them, they take a lot of stress out of the equation. Thank you for watching and sharing!
Going to go with supplement (probably N) for as long as I can afford it. If the day comes when I can't, I'll go Advantage. Not a fan of managed care. I've been fortunate to have very few medical expenses, but ya gotta figure that's more than due to change. On we go.
I guess the bottom line is with an advantage plan, you're betting on staying healthy for the rest of your life and no freak accidents that would necessitate hospitalisations.
No, location is everything. My folks had great MA plans in So. CA but also had major comorbidities... heart attack, heart surgery, heart failure, oral autoimmune diseases, degenerative disc disease, etc., but had terrific doctors, top hospitals, great medical group, no to low copays with no denials, and fab coverage over 15+ years in So. California.
My sister came down with dementia and their advantage plan apparently is very good. My brother in law said they have never had a problem with them and never get a bill from doctors. They live in San Leandro.
It all comes down to your comfort level and budget. Having a Supplement allows you to utilize any provider that excepts Medicare nationwide without referrals. And there are no recurring deductables and coinsurance for a possible second surgery or Hospital stay within the same calender year. An Advantage plan will cost less per year just for the plan but you have referrals and are restricted to networks and need to understand if you have more than one major surgery or hospitalization you could be hit with double maximum out of pockets. Just saying.
My problem, if you want to call it that, is after retirement and after COVID, I was offered contract work by the company I retired from. My income shot up and so did my Medicare and Supplement premiums. That was a bit of a shock!
When you add the copay and deductable to the monthly premium of plan G the cost of plan F premium is not that much more. Plus the peace of mind of not needing your check book is to me worth the additional cost.
If she does not have any chronic pre-exiting conditions and is not always at the doctor's office, checkout Plan N. There are $20 co-pays for office visits, but the premium difference between Plan N and Plan G should compensate for that.
@@GearMaven that’s not Medicare advantage plan. It’s Tennessee Farm bureau , she pays 175. Deductible,Then nothing else, even for hospital, not sure they even sell these plans anymore. Does not cover vision or dental.
I have been on Medicare part a and b now for 17 year Plus my benefit from 20 years in the USN (tri-care-for-life(TFL), Plus I have a veteran disability which get Eye Glasses and Hearing aids. Almost nothing out of pocket. It also includes Mail-order Pharmacy with generic at no cost. I am very lucky in the past 20 years I have had prostate surgery, tumor on my pituitary gland and bladder cancer. Again almost no cost. Nearest thing to socialized medicine.
You might have been in the hospital longer waiting on the advantage plan to approve a scan or other services. Had you needed nursing care afterwards you might not get it with advantage.
I have had 2 experiences with ambulance short rides from one medicdl facilty to the ER within 1 mile. Both times the cost billed was over $1000, I had bought anbulance indurance seperately or it would have been another story
To me, insurance is about making sure i can choose my doctors. Its also about avoiding financial risk. I might not go to the doctor often this year but if i relapse i would have lots of visits. I would not save money on plan N. Hoping for the best but planning for the worst.
Don't forget all the hassles of dealing with in and out of network providers that come hand in hand with medicare advantage plans. I'll pay the money upfront to not have to deal with private insurance companies that work very hard to deny coverage. Nice example though. It exactly matches my most recent experience with an ER visit and post visit hospital treatment. I'm thankful that I can still afford to buy the car I had been saving for this year instead of handing over my savings for a 3 day stay in the hospital. I'm also thankful that the care I received, from the hospital I wanted to receive it from, probably saved my life. There are other values in the comparison that aren't being discussed.
I feel the same way! My time IS worth something and the stress of battling an insurance company is not worth it. I feel like choosing an advantage plan is like signing up to be the victim in the next John Grisham novel (Read the book or watch the movie of The Rainmaker if you don't know the reference).
Another great and well explained video. As I get closer to 65 (July) I continue to lean more towards Original Medicare although the increasing supplement costs as I get older do freak me about a bit.
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
You forgot to mention the Medicare Part B charges for doctors services while in the hospital under original Medicare. Also, it is important to mention Medicare Advantage max out of pocket as well as the fact many Medicare Advantage plans offer Part B premium reimbursement.
This was an excellent analysis of the three major options to retiree medical insurance. Nobody covers the extended costs scenario like you did. Generally they stop their comparison at what the costs are in the month of an incident, which is not important to a person that lives a long and relatively healthy life.
Absolutely...depending on location which is most important in determining if an MA plan will be good. So. California, Florida, Massachusetts...they are great. Out in the boonies of Louisiana, not so great.
Still very confusing but your video helped greatly in cutting through the mysterious finances of health care in the golden years. Thanks for posting the video! Zk
The BILLED AMOUNT is the scary part, it was for me. It took me a long time to realize that I can pay the 20% myself . My plan G pays very little of annual tests and Dr. visits. And remember there’s a 1600. Copay for Medicare A for a hospital visit. If there’s a large bill ,people set up payment schedules.
I found you through google news. I have a new agent who is trying to figure this out. Excellent video. I sent it to him hoping to clarify the difference between the 3 sources of payments. Thank you and i will look at your other videos for sure!
Thanks for the video and best wishes for your loved one. I expected the Advantage plan to be substantially more expensive. I am going with Kaiser North Advantage. We have been with Kaiser HMO for 30 years and don't have a reason to change with Medicare. Our out of pocket max per year is $6K.
I think you're positive experience with an HMO, and a specific one that you could take with you, made this a smooth transition for you. My company tried that. It was like... Surprise we've made this decision for you...enjoy! The HMO experience was so bad and met such resistance. The company used its out clause. So when I retired HMO was a four letter word, spelled with only 3. I went with "G". But if the HMO works for you... I can see the $$ savings would be significant.
Yep, great experiences over 15 years for my parents with MA plans. Mom's max OOP this year is $800, while mine is $699. Can't beat it, as well as the over $4250/year extra freebie benefits!
@@GearMaven You have a nice low out of pocket! I figure if I pay $6K a year for copays and coinsurance I'm not going to be around too long to worry about it.
In Emergencies, that's not true. In fact, In non-emergencies that's not true either. Here's a video on actual denial rates with real data: th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
2:15 I find the American system even more ridiculous of a game when the hospital system is also the medical insurance. As a long term employee of a sister company of the hospital I have the hospital's insurance.
But fear not America. It's Sunshine, Lollipops, and Rainbows and everything that's wonderful... From Becker's Payer Issues: The following were the 10 highest paid CEOS at publicly traded health insurance companies in 2021, according to an Aug. 19 report from S&P Global Ratings. The CEOs' total earnings included cash compensation, stocks granted, options granted and nonequity incentive plan compensation. The 10 highest paid CEOS in 2021 were: 1. Vivek Garipalli, Clover Health: $389.6 million 2. George Mikan, Bright Health: $180.8 million 3. Mario Schlosser, Oscar Health: $60.8 million 4. John Kao, Alignment Healthcare: $46 million 5. Michael Neidorff, Centene: $20.6 million 6. Joseph Zubretsky, Molina Healthcare: $20 million 7. David Cordani, Cigna: $19.9 million 8. Gail Boudreaux, Elevance Health: $19.3 million 9. Andrew Witty, UnitedHealth Group: $18.4 million 10. Bruce Broussard, Humana: $16.5 million
Although at some point I can see being forced into an advantage plan just for the ever rising costs. However I have traditional medicare and a part G plan now which has saved me from some pretty stiff costs. I have been in good health most of my life but as is pointed out you do not get healthier as you get older. Unfortunately 2024 has been a workout for my medicare and my only cost other then the $240 and the part b and g premiums $400 for part b charges over $50,000. I can not imagine what an advantage plans would have cost. On another note in our area we have a lot of volunteer ambulance companies and for a small membership fee of $60 for a family they will take whatever the insurances pay.
I think that's an absolute yes because medicare really doesn't deny and the supplement always pays their 20% amount. The thing to watch for in the future though is how the laws are changing state by state, nationally, and the rulesbeing implemented by medicare itself. Lots of pressure to solve this Prior Authorization problem and the politicians are feeling the heat. Nowhere near solving the issue yet, but keep an eye out for improements down the road. But as mentioned, not in an emergency.
This is one of the reasons my wife and I opted for a supplement plan. An advantage plan has a pre-authorization clause where our supplement does not. If it is covered by Medicare the supplement plan must also cover it.
Yep, mom's Wellcare Giveback paid $125 of her Part B in 2022. We change every year if need be to best plan offered THAT year. Our medical group does fabulous seminars in Sept-Dec discussing top 5-6 MA plans for our area so we switch if better options appear.
Medicare has an overhead of about 3% compared to the typical HMO/PPO etc. of 10%/15% or more. Pool the risk of the entire working population under Medicare. Phase out the middleman corporate Wall Street health insurance. No more holes in senior's Medicare and everybody would be adequately insured. It's the most fiscally conservative way all Americans could be covered for less cost. Physicians for a National Health Program Healthcare Now!
When ever I leave a comment I always do so before reading the others as I have my own thoughts and don't want anyone else's to influence my thought process. With that being said I do love reading what others have to say. I have found that different circumstances dictate what many will do while others are set on what they think they will do. It really varies, so much so that one cannot watch just one video and truly know. I am pretty sure I have watched every video except the one dealing with the HSA because it didn't pertain to me, well no, now that I think about it I watched it anyway because I remember you talking about it being one of the best saving options for investing. So if anyone has an HSA they need to watch it. I think the point I am trying to make to others is watch them all. Every one of them has something new to learn, or just will expand your knowledge immensely. Great Job!
This does assume that the Advantage plan administrator isn't screwing around on coverage and claims. I've heard many do since they are privately managed.
And with no medicare or insurance you're stuck for the whole bill. So many people don't go to the ER when they should and just hope whatever the problem is it clears up on its own. Healthcare is a privilege of the wealthy.
Hospitals are forced by insurance companies to charge extremely high bills because they won’t pay more than 10%. It’s a way to get people to buy insurance.
Well thankfully our income is so low since my complete disability( a nurse b4 this) I get Extra help or we'd be residing in a cardboard box under a bridge😵
Always great content and comparison's. Thank you! I'm still wrestling with what my best option is g, hdg or n. I will most likely be stuck with it for life due to a blood disorder and the need to be on thinners for life. Otherwise healthy and in good shape at 65+ Florida $180 for g, $140 for n and $60 for hdg. Leaning towards n at this time based on your content and projected rising costs of each. Currently employed but need to make a decision in the near future. Wish I had a crystal ball...
What happens when you statrt medicare in May and go for a advantage plan. Does it run from Jan to Jan or May to May before you have the MOOP start over?
This not correct and just play neglecting many benefits of Advantage plan (0 deductible & 0 supplement premium) which includes dentist, vision, eye ware, hearig exam and hearing devices, $350 over-counter, fitness membership in very elite club, and drug coverage. All these benefits for out of pocket maximum $2400/year with Atena or $2900 with UHC. If I pay $1045 including all above in January , in worst case scenario that every month I go through as January, I only pay $2000 rest of the year. With supplement plan at least $175 monthly premium ($1750/year) add to this deductible, copayment with no dentist or vision or hearing coverage, no over counter benefits. By all mean Advantage is the best of all. I am with advantage for 6 y and many of my friends switched from supplement to advantage plan.
If you can afford the premium and part D drug plan G is the way to go. Otherwise you’re playing musical medical chairs every damn year. Plan G and forget it 👍
Now run a scenario using a good Advantage plan like we have in So. California, where we have loads of fabulous plans with the top hospitals, best doctors and generous and huge medical group! We've never had the high numbers you're quoting in our 15+ years of using MA plans for my Dad, Mom and now me here in desert Southwest! Our max Out-of-Pocket this year is $800 for Mom and only $699 for me with Anthem Prime and Aetna respectively! Our hospital inpatient copays are ZERO for days 1-5! Where are you getting your numbers that you are using? Please, please make sure folks know that LOCATION is everything for MA plans with some places fabulous (Valifirnia, Florida, etc.) and some other places absolutely medical deserts. Show BOTH sides of the coin!
I also have an MA plan here in Texas that has a vast selection of doctors, clinics and hospitals. The problem here is that when you are searching and calling for providers in network, many say that they are no longer in network, and others state that they no longer accept my plan. That's concerning to me. So finally, I qualified (medical underwriting), and went with a HDG plan. No more worries!
What he doesn't mention is the advantage plans say they cover prescriptions but that is not all prescriptions. If you are on very expensive meds like me you need to be sure they or a stand alone prescription drug plan covers the meds you take. None of them cover every drug. None.
Yes, this video wasn't about prescription drug plans, but you are correct about drug plans not covering every drug. That includes both drug plans through an Advantage plan and standalone drug plans for those who go the supplement plan route. A video here goes over drug plan differences between Advantage and standalone plans: th-cam.com/video/RoGM1iF82_s/w-d-xo.htmlsi=ZvZV_-BVq_T7wmNo Hope that helps!
The problem with Medicare, medicaid and other government managed insurance programs is the government itself. Insurance plans are as only as good as the contract. How well the members/teams that make up the program office determine how well and how strong a contract is written!!!! All corporate and government health insurances are equally proportionate to the contract itself, the agreement between the insurance company and the government or corporate business. In case of Medicare how poorly the contract is written dictates how poor the coverage will be. As a COR for DHS and seeing how loosely Medicare is I would lose my job if my contracts were this poor. Hold your government accountable!
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
And if you want a real joke, compare this to my $1600/mo Gold plan coverage. The negotiated amount would be double the Medicare rate, apply copay and deductible and I bet my out of pocket would be about $7000. Looks like any of these plans offer excellent value.
Here in Canada it doesn’t matter if you are a billionaire or homeless with no money, we all get treated the same. We can visit a doctor as often as we want. In case of medical emergency we go to the hospital, get any and all tests and treatment needed, if necessary stay in the hospital until we are well enough to go home, get fed 3 meals per day during the hospital stay…… We do not receive a bill for services. There is zero out of pocket cost. There are many reasons I’m glad I’m not American, health care is one of them.
Well, you might have to pay for a cab or for parking. And for prescriptions, although the elderly get part of that covered, also dental care is covered now.
@@mimi1o8 It’s certainly not a perfect system but for the most part it works. Obamacare was the foundation to build a similar system. Republicans would instead prefer health care for profit
And yet in our health group we're hearing new horror stories from Alberta about long delays, no doctors, etc. New worries creeping into Canadian system.
@@GearMaven Yes. Too many Canadian doctors and nurses have been lured to the US for more money unfortunately. Although the shitty system down there might just drive them back. Who knows?
ER charges in particular and hospital charges in general are ridiculous. What they charge people without insurance versus what they accept from the insurance companies including Medicare is a national shame. Then there’s Medicaid people that mostly wasted their lives though poor choices and now the taxpayers have to support their “golden coverage” medical expenses until they’re buried.
Hi. How are you doing. So you are say. As long as you are still working at 65 years old. You do not have to file for Medicare . Cause I work for the city. Medical is no problem for me. I am think about going out at full retirement age at 67 or maybe at 70. So for me at 65. It’s ok for me not to file for Plan A. I would not get fine for filling late
And add $2400 to the taxes for every man woman and child in USA (335 million souls, $800billion) for the public cost of medicare. Altogether, one expensive system.
So you missed the Part B costs of the physicians while in the hospital. Each doctor bills Medicare under Part B separately for each visit with the patient. You call yourself an expert. Your just a sales agent, people who don't understand Medicare may believe everything you tell them, but your missing a large expense.
Hi Jim, I hope you are doing OK. Your comment seems intent on trying to ashame or discredit, which seems to be a reflection of something hurting within you. The unique situation with this being my mother and me being in charge of handling her medical bills is that I have the actual bills, explanation of benefits, and exact dollar amounts of billed charges, Medicare approved, and our responsibility. These aren't made up. If there should have been other Part B charges, that's one thing. We didn't receive them. We pulled from Medicare.gov and these are the exact claims with a little rounding to keep things more simple. Oh, and I never call myself an expert. Again, I hope you are okay.
Your analysis does not take into account that as we age our medical needs increase, sometimes exponentially. With an advantage plan your outfit costs for these treatments rise with them and you will have huge bills to pay. I'd rather pay the premiums and deductibles each year and have much less in outfit expenses further down the road when medical treatments are needed. You also didn't discuss the controversies of advantage plan prep approvals and high rates of non-stop rivals for treatment as they use computer algorithms to make those decisions, overruling your doctors, and that many hospitals are pulling out of advantage plan participation, so you may have to travel great distances to get treatment.
Congress passed a bill a few years ago that requires out-of-network doctors who treat you at a hospital that is in your network, to accept your plan's in-network allowable charges for services. And yes, this includes Medicare Advantage.
Everyone gets sick so eventually all your finances are doomed with the ridiculous medical costs. Come on, 80,000 for a helicopter airlift? what, some gas, a hour of a couple persons time etc.
We do the advantage plan that is operate it from our local hospital It has been wonderful for the two years we’ve been retired Friends at church and other friends that we know they keep paying these extra premiums above and beyond the $170 a month is taken out of Social Security and first of all they can’t afford them second of all they don’t have all the luxuries of dental and eye exams, etc. that we have on the advantage plan They have to pay for their over-the-counter meds where we get $100 a quarter for each of us for such things We had our colonoscopies my wife had a tumor taken out. I recently had stents, and it has cost very little out of pocket. Unfortunately, people get all psyched out when TH-camrs scare them by saying they have to pay co-pays and other such things, but they do it with the same way a politician scares people with their speech For us the max out-of-pocket is just under $3000 each so with that being the case why would we want to pay $2000 above and beyond $170 a month and that $2000 each would pay for everything but it’s something that would be a very rare Expense whereas on Medicare advantage the cap is 3000 bucks each Medicare advantage is wonderful
They can work great for a lot of people! Thank you for sharing! A lot of fear around them. We made this video a while back to try and help: th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
Those in the medical, government, and insurance industries should all be ashamed of themselves. All of this crap has come about because they all use someone’s health struggles as a tool to enrich themselves. While you call the billing practices a game, I call it what is: dishonest fraud. There is no free lunch. We all got better care when we paid the bill in full and we were the patient and customer. Back then, medical offices were filled with doctors and nurses, not insurance paper pushers. Shame on all of you! I’d rather get care from a vet that loves their job.
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We are very satisfied with Medicare original with supplemental plan f. Two heart attacks, and breast cancer for a year of chemo at no cost other than monthly premiums.
F is amazing! Expensive premiums, but the coverage is awesome! Thank you for sharing :)
that plan isn't offered any more but my dad had it and although it was expensive in the long run when he needed it the costs were mostly covered.
We have plan F, would not change it for anything. I call it the Gold plan, expensive, but worth it. 😊😊😊
Why do they make things so confusing for old people when they need this stuff less confusing at that age.
Its not just confusing for old people.
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
@@DanPVerne haha
It's confusing for everyone. I don't even know what plan g is above
@@McFaddis well I guess we should make a "plan B" for our nderstanding of it all, haha. Probably intentionally confusing, like say the tax code, to keep the best choices not easy to discover
Few years ago, I had a emergency three day ER stay at a major Taiwan hospital , without any insurance cost me $350 !
Look up Medicare Advantage suits for denial of care and other issues.
My elderly daddy fell on our icy back yard last winter and completely tore in two his R rotator cuff.
He was too old and not healthy enough for an invasive lengthy surgery but his orthopedic surgeon told us about a less invasive balloon procedure they could have done to at least ease his constant pain, but his Medicare “Advantage” plan denied him.(Humana)😖 12:39
He suffered not even understanding why he was in such pain( daddy had Alzheimer’s 😢, until he died in March.
I learned from my mom’s experience with a major heart attack to stay away from advantage plans. They are cheaper until you need them.
In my area Ambulance companies do not contract with ANY insurance. I found that out after a 2600 bill and lots of phone calls. I finally negotiated it down, but I think it's crucial for people to find this stuff out beforehand. I wish I had, but I was not expecting to fall and break both ankles...
Thank you for sharing this! Sorry about your ankles! Sounds awful!
We have Kaiser Advantage Plan and it is great. Best care I have ever received in my 76 years.
I have A,B&G. I was hospitalized twice in 2022, once for 16 days plus a 10 day stay at a rehab center for PT. Aside from my Medicare and Part G premiums, I paid $0 including two ambulance rides.
So glad you're okay! Thank you for sharing!
If you can afford a Plan G, IMOO, it is worth peace of mind to have a choice of doctors AND not having insurance companies with the “power” of pre-“dis”approvals. IMOO
All plans have the exact same coverage for the same plan But the premium can be vastly different between carriers. It was well worth checking out who was the most affordable.
I have a supplement plan with my Medicare. United Health care plan F. I had cataract surgery on both eyes and it was fully covered. I now have macular degeneration and need injections into my eye every 4 to 6 weeks (at approximately $3000 a procedure) which is fully covered. My monthly premium to United Health Care is a little over $200 per month. Guess I was lucky to sigh up with them when I signed up for Medicare when I turned 66.
Clear and logical, thank you. However, you did not say what the emergency was. Nationwide, the most likely event is a heart attack that would possibly include diagnostic testing and treatment such as a catheterization and angioplasty which would add more cost dollars on the advantage side. Did this event not have any diagnostic testing, and no treatments that required copays?
Great video. May I add that the amount Medicare doesn't pay the hospital, that amount will used as a tax write-off by the hospital at the end of the year. That's how they play the game.
Pay $850 round trip ticket to Thailand.
I have a doctor recommended by John Hopkins there.
Nurses are great! Cost is 1/4 the cost than the USA and you get a vacation.
Tell me more about
it will be so much easier to follow if you leave the chart up longer than going back to your view.
For not a lot more than a regular part G I have a no deductible, no copay plan. No worry about out of network. If regular medicare pays anything, my Blue Cross covers the rest. I was in the hospital twice in 2019. Once for a hip replacement & the other for an accident with a power saw. Total charge to me: ZERO. I don't have to worry about pre approvals. In 5 years of being on medicare, they denied me one blood test. Cost me a whole $20. Sure Advantage covers out of area EMERGENCY care. If you just decide to move, you're out of luck until the next enrollment. No surprise network bills. You might be covered on advantage for a surgery, & get a bill for thousands because the anesthesiologist isn't in your network.
Quick clarification on the moving... if you move out of the coverage, you can switch plans at that time, you don't have to wait until the October enrollment period.
Also, the No Surprises Act in 2022 eliminates the anesthesiologist issue.
www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills
That definitely was a problem, but a lot has changed even over the past 5 years to eliminate a lot of issues. They aren't perfect by any means, but they aren't as bad either.
The supplement side is super solid, and for those who can afford them, they take a lot of stress out of the equation. Thank you for watching and sharing!
Going to go with supplement (probably N) for as long as I can afford it. If the day comes when I can't, I'll go Advantage. Not a fan of managed care. I've been fortunate to have very few medical expenses, but ya gotta figure that's more than due to change. On we go.
Thank you for watching and sharing your thoughts!
Choose HDG before you go that route.
I guess the bottom line is with an advantage plan, you're betting on staying healthy for the rest of your life and no freak accidents that would necessitate hospitalisations.
No, location is everything. My folks had great MA plans in So. CA but also had major comorbidities... heart attack, heart surgery, heart failure, oral autoimmune diseases, degenerative disc disease, etc., but had terrific doctors, top hospitals, great medical group, no to low copays with no denials, and fab coverage over 15+ years in So. California.
My sister came down with dementia and their advantage plan apparently is very good. My brother in law said they have never had a problem with them and never get a bill from doctors. They live in San Leandro.
It all comes down to your comfort level and budget. Having a Supplement allows you to utilize any provider that excepts Medicare nationwide without referrals. And there are no recurring deductables and coinsurance for a possible second surgery or Hospital stay within the same calender year. An Advantage plan will cost less per year just for the plan but you have referrals and are restricted to networks and need to understand if you have more than one major surgery or hospitalization you could be hit with double maximum out of pockets. Just saying.
My problem, if you want to call it that, is after retirement and after COVID, I was offered contract work by the company I retired from. My income shot up and so did my Medicare and Supplement premiums. That was a bit of a shock!
When you add the copay and deductable to the monthly premium of plan G the cost of plan F premium is not that much more. Plus the peace of mind of not needing your check book is to me worth the additional cost.
My mother in law pays 900 every three months for her part G, we are trying to decide which way we want to go. Thanks for addressing this!
Thank you for spending some time with us!
If she does not have any chronic pre-exiting conditions and is not always at the doctor's office, checkout Plan N. There are $20 co-pays for office visits, but the premium difference between Plan N and Plan G should compensate for that.
Wow, we'd find that outrageously expensive for our area with low cost, high benefit Medicare Advantage plans. So. California is great for MA plans.
@@GearMaven that’s not Medicare advantage plan. It’s Tennessee Farm bureau , she pays 175. Deductible,Then nothing else, even for hospital, not sure they even sell these plans anymore. Does not cover vision or dental.
Love my part g, had quite a few problems last year, almost nothing out of pocket
I have been on Medicare part a and b now for 17 year Plus my benefit from 20 years in the USN (tri-care-for-life(TFL), Plus I have a veteran disability which get Eye Glasses and Hearing aids. Almost nothing out of pocket. It also includes Mail-order Pharmacy with generic at no cost. I am very lucky in the past 20 years I have had prostate surgery, tumor on my pituitary gland and bladder cancer. Again almost no cost. Nearest thing to socialized medicine.
NYC ambulance ride was charged $3,000. Insurance paid $1,500. We paid $0.
You might have been in the hospital longer waiting on the advantage plan to approve a scan or other services. Had you needed nursing care afterwards you might not get it with advantage.
I have had 2 experiences with ambulance short rides from one medicdl facilty to the ER within 1 mile. Both times the cost billed was over $1000, I had bought anbulance indurance seperately or it would have been another story
I'm 2.5 years away from the circus that starts at 65. I hope Iowa total care doesn't change. But of course it will.
this summer, sigh
thank you for showing the differences (no surprise)
Excellent presentation. Your family must be very proud. I (and others, I'm sure) am grateful for the information and how you have explained it.
Thank you so much for watching and your support!
To me, insurance is about making sure i can choose my doctors. Its also about avoiding financial risk. I might not go to the doctor often this year but if i relapse i would have lots of visits. I would not save money on plan N. Hoping for the best but planning for the worst.
Check network doctors and how much notification you get if they change
Medicare Advantage costs Medicare more than regular medicare cuz if so called risk adjustments. These may change so benefits would change.
Don't forget all the hassles of dealing with in and out of network providers that come hand in hand with medicare advantage plans. I'll pay the money upfront to not have to deal with private insurance companies that work very hard to deny coverage. Nice example though. It exactly matches my most recent experience with an ER visit and post visit hospital treatment. I'm thankful that I can still afford to buy the car I had been saving for this year instead of handing over my savings for a 3 day stay in the hospital. I'm also thankful that the care I received, from the hospital I wanted to receive it from, probably saved my life. There are other values in the comparison that aren't being discussed.
No HMO for me.
I feel the same way! My time IS worth something and the stress of battling an insurance company is not worth it. I feel like choosing an advantage plan is like signing up to be the victim in the next John Grisham novel (Read the book or watch the movie of The Rainmaker if you don't know the reference).
Another great and well explained video. As I get closer to 65 (July) I continue to lean more towards Original Medicare although the increasing supplement costs as I get older do freak me about a bit.
Thank you Greg! Appreciate you watching!
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
You forgot to mention the Medicare Part B charges for doctors services while in the hospital under original Medicare. Also, it is important to mention Medicare Advantage max out of pocket as well as the fact many Medicare Advantage plans offer Part B premium reimbursement.
This was an excellent analysis of the three major options to retiree medical insurance. Nobody covers the extended costs scenario like you did. Generally they stop their comparison at what the costs are in the month of an incident, which is not important to a person that lives a long and relatively healthy life.
Thank you, 😮for the information, wow, I'm sorry about your family
Advantage all the way for me. It's a no brainer.😊
Absolutely...depending on location which is most important in determining if an MA plan will be good. So. California, Florida, Massachusetts...they are great. Out in the boonies of Louisiana, not so great.
Still very confusing but your video helped greatly in cutting through the mysterious finances of health care in the golden years. Thanks for posting the video! Zk
Thank you so much for watching!
The BILLED AMOUNT is the scary part, it was for me. It took me a long time to realize that I can pay the 20% myself . My plan G pays very little of annual tests and Dr. visits.
And remember there’s a 1600. Copay for Medicare A for a hospital visit.
If there’s a large bill ,people set up payment schedules.
I'll have to work this out for HD-G.
I found you through google news. I have a new agent who is trying to figure this out. Excellent video. I sent it to him hoping to clarify the difference between the 3 sources of payments. Thank you and i will look at your other videos for sure!
Glad you found us!
Thanks for the video and best wishes for your loved one. I expected the Advantage plan to be substantially more expensive. I am going with Kaiser North Advantage. We have been with Kaiser HMO for 30 years and don't have a reason to change with Medicare. Our out of pocket max per year is $6K.
Thank you so much! Appreciate you sharing!
I think you're positive experience with an HMO, and a specific one that you could take with you, made this a smooth transition for you. My company tried that. It was like... Surprise we've made this decision for you...enjoy! The HMO experience was so bad and met such resistance. The company used its out clause. So when I retired HMO was a four letter word, spelled with only 3. I went with "G". But if the HMO works for you... I can see the $$ savings would be significant.
Yep, great experiences over 15 years for my parents with MA plans. Mom's max OOP this year is $800, while mine is $699. Can't beat it, as well as the over $4250/year extra freebie benefits!
@@GearMaven thank you for sharing this
@@GearMaven You have a nice low out of pocket! I figure if I pay $6K a year for copays and coinsurance I'm not going to be around too long to worry about it.
What you are not saying is with advantage plans they often refuse the services more then approve them
In Emergencies, that's not true.
In fact, In non-emergencies that's not true either. Here's a video on actual denial rates with real data:
th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
2:15 I find the American system even more ridiculous of a game when the hospital system is also the medical insurance. As a long term employee of a sister company of the hospital I have the hospital's insurance.
But fear not America.
It's Sunshine, Lollipops, and Rainbows and everything that's wonderful...
From Becker's Payer Issues:
The following were the 10 highest paid CEOS at publicly traded health insurance companies in 2021, according to an Aug. 19 report from S&P Global Ratings.
The CEOs' total earnings included cash compensation, stocks granted, options granted and nonequity incentive plan compensation.
The 10 highest paid CEOS in 2021 were:
1. Vivek Garipalli, Clover Health: $389.6 million
2. George Mikan, Bright Health: $180.8 million
3. Mario Schlosser, Oscar Health: $60.8 million
4. John Kao, Alignment Healthcare: $46 million
5. Michael Neidorff, Centene: $20.6 million
6. Joseph Zubretsky, Molina Healthcare: $20 million
7. David Cordani, Cigna: $19.9 million
8. Gail Boudreaux, Elevance Health: $19.3 million
9. Andrew Witty, UnitedHealth Group: $18.4 million
10. Bruce Broussard, Humana: $16.5 million
Although at some point I can see being forced into an advantage plan just for the ever rising costs. However I have traditional medicare and a part G plan now which has saved me from some pretty stiff costs. I have been in good health most of my life but as is pointed out you do not get healthier as you get older. Unfortunately 2024 has been a workout for my medicare and my only cost other then the $240 and the part b and g premiums $400 for part b charges over $50,000. I can not imagine what an advantage plans would have cost. On another note in our area we have a lot of volunteer ambulance companies and for a small membership fee of $60 for a family they will take whatever the insurances pay.
Thank you for sharing your experience!
Are Advantage plans more likely to deny procedures during a hospital stay versus traditional Medicare?
During an emergency stay like this? Probably not.
In general, yes.
We have a video on denial rates here:
th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
I think that's an absolute yes because medicare really doesn't deny and the supplement always pays their 20% amount. The thing to watch for in the future though is how the laws are changing state by state, nationally, and the rulesbeing implemented by medicare itself. Lots of pressure to solve this Prior Authorization problem and the politicians are feeling the heat. Nowhere near solving the issue yet, but keep an eye out for improements down the road.
But as mentioned, not in an emergency.
Probably. They usually deny first and let your provider explain why you needed the procedure. Then they do a redetermination.
This is one of the reasons my wife and I opted for a supplement plan. An advantage plan has a pre-authorization clause where our supplement does not. If it is covered by Medicare the supplement plan must also cover it.
They definitely deny more. They also approve stays for shorter periods of time. You have to stay on top of advantage plans a lot more.
There are advantage plans that give back about $165 of part B.
Yes! They are rare and not available everywhere, so we don't promote this.
Sounds like you are in an area that has that option. Most don't.
Yep, mom's Wellcare Giveback paid $125 of her Part B in 2022. We change every year if need be to best plan offered THAT year. Our medical group does fabulous seminars in Sept-Dec discussing top 5-6 MA plans for our area so we switch if better options appear.
I have such a plan, $125 give back. But, the copays are higher and so is the MOOP.
Medicare has an overhead of about 3% compared to the typical HMO/PPO etc. of 10%/15% or more. Pool the risk of the entire working population under Medicare. Phase out the middleman corporate Wall Street health insurance. No more holes in senior's Medicare and everybody would be adequately insured. It's the most fiscally conservative way all Americans could be covered for less cost.
Physicians for a National Health Program
Healthcare Now!
When ever I leave a comment I always do so before reading the others as I have my own thoughts and don't want anyone else's to influence my thought process. With that being said I do love reading what others have to say. I have found that different circumstances dictate what many will do while others are set on what they think they will do. It really varies, so much so that one cannot watch just one video and truly know. I am pretty sure I have watched every video except the one dealing with the HSA because it didn't pertain to me, well no, now that I think about it I watched it anyway because I remember you talking about it being one of the best saving options for investing. So if anyone has an HSA they need to watch it. I think the point I am trying to make to others is watch them all. Every one of them has something new to learn, or just will expand your knowledge immensely. Great Job!
Thank you so much my friend!
Yes. Very helpful. Just wish you presented another scenario with a great MA plan like those in So. California!
little confused, what was my out of pocket cost at the end for each plan ?
This does assume that the Advantage plan administrator isn't screwing around on coverage and claims. I've heard many do since they are privately managed.
We've heard the same. And denials happen, but not as much as we hear. This looks at the actual data:
th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
Advantage with Giveback no monthly Medicare payment. So even on the yearly or 20 years average one must remove $175/month…
My mom had Aetna advantage and they screwed her over at every turn. She witched to blue cross. Way way better
And with no medicare or insurance you're stuck for the whole bill. So many people don't go to the ER when they should and just hope whatever the problem is it clears up on its own. Healthcare is a privilege of the wealthy.
No, you can negotiate the bill after the treatment, if you're low income may pay hardly anything
Hospitals are forced by insurance companies to charge extremely high bills because they won’t pay more than 10%. It’s a way to get people to buy insurance.
Should point out impact of out of pocket max
Absolutely, as mine on MA plan this year is only $699, while Mom's is $800. And $0 inpatient hospitalization copays!
You know, it's be nice to see an 2 addtl comparisons. That would be Vets with VA coverage & Medicare and Retired with Tri-care for life & Medicare
What about all of the dr and lab fees, etc incurred while your relative was there? Not covered by Part A.
Well thankfully our income is so low since my complete disability( a nurse b4 this) I get Extra help or we'd be residing in a cardboard box under a bridge😵
Always great content and comparison's.
Thank you!
I'm still wrestling with what my best option is g, hdg or n. I will most likely be stuck with it for life due to a blood disorder and the need to be on thinners for life. Otherwise healthy and in good shape at 65+
Florida $180 for g, $140 for n and $60 for hdg. Leaning towards n at this time based on your content and projected rising costs of each. Currently employed but need to make a decision in the near future. Wish I had a crystal ball...
I wish we had a crystal ball too!
G in FL is quite expensive
When talking income based rates, are they talking gross or MAGI?
MAGI for Medicare premium purposes
Nice work and great analysis. Thank you.
Thank you!
I pay for a second insurance to be fully covered in retirement, it ain’t cheap.
What happens when you statrt medicare in May and go for a advantage plan. Does it run from Jan to Jan or May to May before you have the MOOP start over?
January to January. MOOPs reset January 1st of each year. Great question.
This not correct and just play neglecting many benefits of Advantage plan (0 deductible & 0 supplement premium) which includes dentist, vision, eye ware, hearig exam and hearing devices, $350 over-counter, fitness membership in very elite club, and drug coverage. All these benefits for out of pocket maximum $2400/year with Atena or $2900 with UHC. If I pay $1045 including all above in January , in worst case scenario that every month I go through as January, I only pay $2000 rest of the year. With supplement plan at least $175 monthly premium ($1750/year) add to this deductible, copayment with no dentist or vision or hearing coverage, no over counter benefits. By all mean Advantage is the best of all. I am with advantage for 6 y and many of my friends switched from supplement to advantage plan.
Not really sure what you're disagreeing with from the video.
Still will never get an adv plan
So, you're saying, for this scenario, it's better to have a pla G than not.
In this scenario, having Original Medicare only is the most costly.
And for THAT scenario, a very high cost Medicare Advantage plan was chosen as an example. Ours are nowhere near those numbers here in So. California!
If you can afford the premium and part D drug plan G is the way to go. Otherwise you’re playing musical medical chairs every damn year. Plan G and forget it 👍
File for bankruptcy after you saw the bill seems less confusing...
Now run a scenario using a good Advantage plan like we have in So. California, where we have loads of fabulous plans with the top hospitals, best doctors and generous and huge medical group! We've never had the high numbers you're quoting in our 15+ years of using MA plans for my Dad, Mom and now me here in desert Southwest! Our max Out-of-Pocket this year is $800 for Mom and only $699 for me with Anthem Prime and Aetna respectively! Our hospital inpatient copays are ZERO for days 1-5! Where are you getting your numbers that you are using? Please, please make sure folks know that LOCATION is everything for MA plans with some places fabulous (Valifirnia, Florida, etc.) and some other places absolutely medical deserts. Show BOTH sides of the coin!
Oops, "California" not that misspelling! LOL
I also have an MA plan here in Texas that has a vast selection of doctors, clinics and hospitals. The problem here is that when you are searching and calling for providers in network, many say that they are no longer in network, and others state that they no longer accept my plan. That's concerning to me. So finally, I qualified (medical underwriting), and went with a HDG plan. No more worries!
Except most people in the whole country don’t live there. There is a reason all the Medicare late night commercials are advantage plans lol.
What he doesn't mention is the advantage plans say they cover prescriptions but that is not all prescriptions. If you are on very expensive meds like me you need to be sure they or a stand alone prescription drug plan covers the meds you take. None of them cover every drug. None.
Yes, this video wasn't about prescription drug plans, but you are correct about drug plans not covering every drug. That includes both drug plans through an Advantage plan and standalone drug plans for those who go the supplement plan route.
A video here goes over drug plan differences between Advantage and standalone plans:
th-cam.com/video/RoGM1iF82_s/w-d-xo.htmlsi=ZvZV_-BVq_T7wmNo
Hope that helps!
Love your videos and style! Buzz
Thank you so much!!
The problem with Medicare, medicaid and other government managed insurance programs is the government itself. Insurance plans are as only as good as the contract. How well the members/teams that make up the program office determine how well and how strong a contract is written!!!! All corporate and government health insurances are equally proportionate to the contract itself, the agreement between the insurance company and the government or corporate business. In case of Medicare how poorly the contract is written dictates how poor the coverage will be. As a COR for DHS and seeing how loosely Medicare is I would lose my job if my contracts were this poor. Hold your government accountable!
It’s too complicated and expensive for an uneducated man like me… I’m just gonna have a DNR and hope it’s quick
Why it is so important to take advantage of any FREE senior resources in your area for help in making these decisions...HICAP (Health Insurance Counseling and Advocacy Program), State Health Insurance Assistance Program (SHIP), your county Office on Aging, etc. Great book also to prep for Medicare is "10 Costly Medicare Mistakes You Can't Afford to Make" by Danielle Kunkle Roberts. Hope this helps!
And if you want a real joke, compare this to my $1600/mo Gold plan coverage. The negotiated amount would be double the Medicare rate, apply copay and deductible and I bet my out of pocket would be about $7000. Looks like any of these plans offer excellent value.
Medicare is a strong option for many compared to their company plan.
Here in Canada it doesn’t matter if you are a billionaire or homeless with no money, we all get treated the same. We can visit a doctor as often as we want. In case of medical emergency we go to the hospital, get any and all tests and treatment needed, if necessary stay in the hospital until we are well enough to go home, get fed 3 meals per day during the hospital stay……
We do not receive a bill for services. There is zero out of pocket cost.
There are many reasons I’m glad I’m not American, health care is one of them.
Well, you might have to pay for a cab or for parking. And for prescriptions, although the elderly get part of that covered, also dental care is covered now.
You have a great system, no doubt about it. It’s the opposite in the “land of the free”
@@mimi1o8 It’s certainly not a perfect system but for the most part it works. Obamacare was the foundation to build a similar system. Republicans would instead prefer health care for profit
And yet in our health group we're hearing new horror stories from Alberta about long delays, no doctors, etc. New worries creeping into Canadian system.
@@GearMaven Yes. Too many Canadian doctors and nurses have been lured to the US for more money unfortunately. Although the shitty system down there might just drive them back. Who knows?
I love your chart!
Thank you!!
7:38 wow !!!!
Oh yeah, my son's 41 mile ambulance ride in Texas was $1925. Ridiculous. Police and Fire services are taxpayer funded. Ambulances should be as well.
Great video. Thanks again!
Thank you!!
An advantage plan is only an advantage while you're healthy and may God have mercy on you when you get sick
Than you! Very good information
Thank you so much! Appreciate you spending time with us
ER charges in particular and hospital charges in general are ridiculous. What they charge people without insurance versus what they accept from the insurance companies including Medicare is a national shame. Then there’s Medicaid people that mostly wasted their lives though poor choices and now the taxpayers have to support their “golden coverage” medical expenses until they’re buried.
Our MA ER charges are waived if admitted within 24 hours and our inpatient hospitalization copay is ZERO for days 1-5! So. CA has great plans.
@@GearMaven someone is paying for it (hint: taxpayers)
As always, great video. Thank you so much.
Thank you!!
I thought the ambulance was covered under medicare if admitted
It is :)
That part is in the video around the 0:20 mark.
Hi. How are you doing. So you are say. As long as you are still working at 65 years old. You do not have to file for Medicare . Cause I work for the city. Medical is no problem for me. I am think about going out at full retirement age at 67 or maybe at 70. So for me at 65. It’s ok for me not to file for Plan A. I would not get fine for filling late
Correct, as long as your city has 20 or more employees :)
I work for Mayor Erica Adams. One of the branches of the city. So I know they is a lot of people.
@syeedali1364 yeah, over 20 employees and you will be okay from a Part B perspective
Great video. Thank you.
Thank you so much!
And add $2400 to the taxes for every man woman and child in USA (335 million souls, $800billion) for the public cost of medicare. Altogether, one expensive system.
Is it possible to have both a supplement plan and advantage plan at the same time, using the advantage plan exclusively for the freebies? 🤔
Unfortunately, no. You can't have both at the same time.
Go see an independent broker who is well versed in Medicare, Medicare Supplements & Medicare Advantage Plans..
We agree
What state are you in?
Once again, great information!!!
Thank you so much!
Always a great and easy to follow presentation!
Thank you!
"yea we were just kidding" How much does "just kidding" cost in labor?
Great question
@@Theretirementnerds Perhaps this is the superpower of single-payer government insurance? Less friction in the system.
So in this example, there was no benefit for plan G.
Depends on the time window you're looking at and if anything else ever comes up outside this one event.
So you missed the Part B costs of the physicians while in the hospital. Each doctor bills Medicare under Part B separately for each visit with the patient. You call yourself an expert. Your just a sales agent, people who don't understand Medicare may believe everything you tell them, but your missing a large expense.
Hi Jim, I hope you are doing OK. Your comment seems intent on trying to ashame or discredit, which seems to be a reflection of something hurting within you.
The unique situation with this being my mother and me being in charge of handling her medical bills is that I have the actual bills, explanation of benefits, and exact dollar amounts of billed charges, Medicare approved, and our responsibility. These aren't made up.
If there should have been other Part B charges, that's one thing. We didn't receive them. We pulled from Medicare.gov and these are the exact claims with a little rounding to keep things more simple.
Oh, and I never call myself an expert.
Again, I hope you are okay.
Your analysis does not take into account that as we age our medical needs increase, sometimes exponentially. With an advantage plan your outfit costs for these treatments rise with them and you will have huge bills to pay. I'd rather pay the premiums and deductibles each year and have much less in outfit expenses further down the road when medical treatments are needed. You also didn't discuss the controversies of advantage plan prep approvals and high rates of non-stop rivals for treatment as they use computer algorithms to make those decisions, overruling your doctors, and that many hospitals are pulling out of advantage plan participation, so you may have to travel great distances to get treatment.
I don’t understand how this can be so bad. Obamacare was passed 10 years ago 😂
without 'g'...all your numbers are WRONG!!!!!!! AND once you go into hospital some doctors are NOT in your 'plan'!!! therefore HIGHER FEES!!!!
Can you elaborate? Not following what you're saying.
Congress passed a bill a few years ago that requires out-of-network doctors who treat you at a hospital that is in your network, to accept your plan's in-network allowable charges for services. And yes, this includes Medicare Advantage.
@@g0989 sure, but at a higher rate than in network!
Everyone gets sick so eventually all your finances are doomed with the ridiculous medical costs. Come on, 80,000 for a helicopter airlift? what, some gas, a hour of a couple persons time etc.
We do the advantage plan that is operate it from our local hospital
It has been wonderful for the two years we’ve been retired
Friends at church and other friends that we know they keep paying these extra premiums above and beyond the $170 a month is taken out of Social Security and first of all they can’t afford them second of all they don’t have all the luxuries of dental and eye exams, etc. that we have on the advantage plan
They have to pay for their over-the-counter meds where we get $100 a quarter for each of us for such things
We had our colonoscopies my wife had a tumor taken out. I recently had stents, and it has cost very little out of pocket.
Unfortunately, people get all psyched out when TH-camrs scare them by saying they have to pay co-pays and other such things, but they do it with the same way a politician scares people with their speech
For us the max out-of-pocket is just under $3000 each so with that being the case why would we want to pay $2000 above and beyond $170 a month and that $2000 each would pay for everything but it’s something that would be a very rare Expense whereas on Medicare advantage the cap is 3000 bucks each
Medicare advantage is wonderful
They can work great for a lot of people! Thank you for sharing! A lot of fear around them. We made this video a while back to try and help:
th-cam.com/video/sA9EzoiHjEM/w-d-xo.html
So true. Location is EVERYTHING for MA plans! Great near us in So. CA.
Those in the medical, government, and insurance industries should all be ashamed of themselves. All of this crap has come about because they all use someone’s health struggles as a tool to enrich themselves. While you call the billing practices a game, I call it what is: dishonest fraud. There is no free lunch. We all got better care when we paid the bill in full and we were the patient and customer. Back then, medical offices were filled with doctors and nurses, not insurance paper pushers. Shame on all of you! I’d rather get care from a vet that loves their job.
But Mafp...this would not be the case had Medicare never passed. Prices have exploded since 1965, so govt is responsible for this aberration.
He skipped the part that Advantage plans may or may not pay where the other two are required to....
Advantage plans are also required to in emergency situations, which is what this example was. Hope that helps!