The Medicare "Gotcha" that will surprise you
ฝัง
- เผยแพร่เมื่อ 2 มิ.ย. 2024
- www.abtinsuranceagency.com | (888) 465-9728 . Changing your Medicare Plan may not be as easy as you think, and when it comes to choosing your Medicare plan when you turn 65, this "gotcha" shocks many of our clients. It's important to know the pros and cons of choosing your Medicare plan, because depending on your health, you may be 'stuck' in that plan.
This video also reviews the Medicare Advantage "Trial Right" rules than can help you when to comes to moving between Medicare Advantage and Medicare Supplement/Medigap Plans.
Free Medicare Quotes and Plan Comparison : www.abtinsuranceagency.com
Medicare Supplement vs Medicare Advantage: • Medicare Advantage vs ...
What other Medicare "tricks" have you experienced? Let me know below!
As you point out at th-cam.com/video/qtSeHOsvoFM/w-d-xo.html, does this mean that NY residents can switch from Advantage to Traditional and buy any supplemental plan without underwriting during EVERY year's enrollment period? Are there any other restrictions? Thanks for the great video!
Having TRICARE the advantage plan works fine.
@@laurapalmer6850 Just keep in mind that the Medigap premiums in some states (such as NY and FL) are higher than elsewhere. In these states, one of the High Deductible F or G plans might make more sense.
When you push your Medicare Supplement plans, you are as bad as those whom you diss for pushing their Medicare Advantage plans. Kind of a double standard there, isn't it? Supplements = good, Advantage plans = bad. Who made YOU the decider of an individual's health care choices.
@@purplenights1 I don’t “push” either option. I educate, and am licensed to sell both.
Our government sends billions overseas every year but can't assure retirees free medical care without this complicated mess. A disgrace!
It does amaze me how billions are sent out all the time, yet the gov’t claims there’s not enough money for our healthcare we already paid for while we were working. We should all be in the streets with pitchforks demanding we get what we paid for.
What's ironic is that seniors have paid their dues and shouldn't have to contend with the complications. In the meantime, younger people who mostly haven't paid their dues get free care through Medicaid.
Make sure you vote out all Repugnants and we can get to the point where we can get this all free because we’re already paying for it.
This comment should be thousands! I doubt that the 95 billion Biden is sending to Ukraine could be used by Americans.
The US government spends more money on healthcare for seniors than it does on foreign aid. There's a great quote:
"The US government is an insurance company with an army."
Peter Fisher
Undersecretary of the Treasury
2002
Before Medicare was created by the Democrats under LBJ in the 1960's, only about 1/3 of retirees had any form of medical insurance. No for-profit company wants to have anything to do with insuring the sickest population. The only reason why traditional Medicare supplement programs exist is that Medicare picks up the first 80% of bills. The private companies only have to pay for the 80% of the last 20%.
Medicare Advantage only exists because the government pays the insurance companies to cover their policy holders.
Health care in the USA is a sad sad joke.
Unless you're undocumented.
@@rhondennis979 Provide evidence, not guesses.
@rabokarabekian409
Must be one of which I was referring to. Anyone who pays premiums (that's insurance) witnesses evidence as you asked for. You're cost is zero because we the actual ones who work pay for yours. Too bad we aren't given that courtesy in whatever country you're from.
Shame on our govt for making senior citizens having to deal complexities at a point in their lives, myself included. The system is complex at a time when people need ease of issues, not insurance companies bombarding with advertising. The insurance lobby owns Congress
Holy shit, Batman. I may have an attention deficit in my old age. Medicare and insurance in general have become more complex than a 2 1/2-hour crime drama on Netflix that I have to watch twice and take a lot of notes and still don't follow completely.
This is a republican option added to get their votes in congress. Your representatives have sold their soles for corporate money. You get screwed. They get rich. Why are old people voting republican? Stupid. I know there is more than this one issue but is there anything really more important that your health?
This all just makes my head spin. I need to figure this out. There's all this info spewing from every angle and from no one I would trust to put my interests first.
@@GeorgeMinton-jb8ky So, Publicans drove Obamacare?
"Who run Bartertown?"
I just turned 62 suddenly bombarded with medi b.s. phone calls ive zero clue about this stuff spent whole day i have to study learn strategize all these b.s. plans...im sooo upset..im recovering from concussion and im supposed to have ZERO stress
One plan for EVERYONE! Stop all the corruption between hospitals and insurance companies. 💥🤛
and the GOP
We are in our 70s using Medicare Original supplement plan F. Combined we pay $350 a month for F. Wide has chemo every three weeks. On our most recent Medicare F statement, we observed $51,000 for a single injection of one drug only. So far we estimate her breast cancer charges over $600,000. We want readers to know. By the way, those Medicare brokers put you into advantage plans that is best for them. Not you!
Thank you for sharing this!
We have the same coverage! We pay more for it in California, but are SO glad it’s what we went with. Choice of doctors (including UCSF, Stanford and Mayo Clinic, if needed). Almost never get anything billed to us, it covers us completely. I noticed that Plan F is no longer offered - we are grandfathered in and hope we can keep it forever!
Damn! I'm turning 65 this year. I already have good medical coverage for my wife and I that I've paid a lot for over an eternity. I'm getting blind calls and offers in the mail. Until I understand medicare, I'm blowing off everything. This was the first video on the subject I've viewed. Holy shit could it be made anymore confusing? I've got a lot to learn I see.
We are in the same boat with hubby turning 65 this year. I am watching tons of videos and plan on attending a free seminar in our area. Might be something to look into for your area, as well.
The main thing about Medicare Advantage, it is a privatized for profit program and if your local Medicare Advantage doesn't include various in-network specialists, you will have to pay out of pocket for care.
Medicare Advantage is for profit heatlh care and not patient oriented care, it is for profit care.
Leave it to politicians to make laws horribly complicated.
What a convoluted and screwed up system we have.
Another reason we need universal HC. It is INSANE that people must navigate this next to impossible maze just when they are nearing one of the most vulnerable seasons of life.
Medicare Advantage is not that much of an advantage. You get into an HMO and they deny so many things due to cost. They literally said to us, “Well, your granddad has lived a good, long life. So for seniors past a certain age, you’ll need to appeal for cancer treatment. We’d like to put him on Hospice.”
Also, they don’t work with private retirement organizations that track and dispense medications for your loved one or provide other types of care (like physical therapy) on-site. Mobility is a lot for some elderly folks. So having a pharmacy (and dispensary) service on-site is a godsend. Ditto with PT. Fortunately, we were able to switch Grandma because Granddad also had Tricare.
If you get Medicare Advantage plan you are in a Private plan.
Traditional Medicare is always the best.
Let no one. Kid you. Med Advantage put money in
Politicians.
*To be clear...*
You MUST enroll on a TUESDAY, UNLESS it's on a LEAP YEAR, then it must be on the second Wednesday of the month if you own a primary color car -- all owners of non-primary colored colors MUST enroll on the third Sunday of the month ESPECIALLY if you have a ginger cat. If said ginger cat is sick on that day, then you are eligible for Medicare part 24.b where you will be given FREE dental service -- EVERYTHING is FREE, except most things to do with teeth. If you still have teeth and desire Medicare part 24.b, make sure that you are NOT enrolled in Massachusetts (or if it is a holiday, any state beginning with the letter M), because most people do not realize that realizing things can cost you more than enough money to get all that is almost coming to you. And the mostest biggest "gotcha" is today which is the day that you are reading this unless you still have that ginger cat, in which case it is far too late unless you are reading this last week. This "gotcha" INCLUDES all you can eat FREE buffets from 3:32am to 3:34am in most dine-in restaurants, UNLESS you have money or must pay with a credit card. It is important to remember that wet paint can be substituted for not-so-wet paint, if you know what kind of hat to wear to the parking lot if it is storming outside and no one is watching. Failure to notice this will mean immediate forfeiture of all the things that you found handy about the house or two days notice of which is friendly again for the sake of all seniors in the need of special Tuesdays "progressive certification" for a while, or not, which ever comes first.
Sad but true!
@@vivianramsay2527 Indeed, otherwise it might get complicated.
😂 funny but not funny😢
Hysterical TRUTH!!!
But my ginger died from melanoma. Of course the vet wouldn't accept insurance for him because he had cancer too😮. Can I sub a black long hair instead?
Another important aspect of traditional Medicare plans vs Medicare Advantage plans is, if Medicare denies a lab charge due to improper coding for the reasons (symptoms or diagnosis) for testing, traditional Medicare CAN'T bill the patient for denied charges on lab tests, Medicare Advantage, can and will, bill the patient. Most doctors don't understand theses rules and limitations of Medicare and often order testing that Medicare won't pay for at all, or will only cover a test a limited number of times in a year. I used to work with lab denials in a couple of facilities I had worked at, and it was common for very angry Medicare Advantage patients to come in with their bills and demand that I "fix" it. They don't understand why their doctor would order tests that aren't covered by Medicare. Another interesting thing concerning traditional Medicare plans that have a supplemental insurance plan is that the supplemental plan will not cover Medicare denied testing. But in this instance, the patient won't be billed but the facility will be responsible for denied charges. I retired 4 years ago and these were the rules THEN, from my experience processing denials. I am unaware of any changes that may have occurred since. I did not get a Medicare Advantage plan specifically for these reasons and have traditional Medicare with a supplemental. My advise for retirees living on a fixed income with little savings would be to go with a traditional Medicare and a supplemental. Medicare Advantage would be more suitable for those retirees who are more financially secure with significant savings to pay those additional charges that you will receive.
I have lab work done every 3 months, and have never once been denied payment for coverage of labs under Medicare Advantage.
Is a dental plan alone part of supplement?
The person living on a fixed ss income cannot afford the additional charges for a supplement plan, prescription drug plan and a dental plan.
Supplement plan is only good if you can pay all the extra charges.
It sounds like these were rules under the Medicare Advantage Plan you worked for. There are many, many plans and I think the competition among them is putting a stop to these practices. You can change MA plans every year, so angering people will make you lose their business. About 50% of retirees have MA plans. If they were really bad, I think we'd be hearing about it all over the news. 60 minutes and other news shows would probably have big stores at this time during annual enrollment.
@@roadrunner40 I agree. My folks were going into debt paying for their supplement, to the tune of $900 to $1000 a month, along with prescription plans and dental. Above that, mom would have to pay out another couple hundred every 3 months, for the last half of the year, for one of her medications because of the cap on the policy she already paid $130 a month for. I am happy that some folks have more than SSI to fall back on, but many don't.
Like the U S tax code and an average telephone bill, these “plans”, and bills with so many rules, regulations and “if you do this, you need to or can’t do this” scenarios, are intentionally convoluted and confusing to the average person, in the hopes you will just grow frustrated and give up searching for the best price, plan , or tax advantage, ultimately costing folks way more than they should. All the result of rules and inclusions inserted for and by special interests, by a bloated, corrupt and inefficient government bureaucracy.
I work for a hospital doing pre authorizations. So many people get the cheapest plan. They don’t realize that those plans don’t cover everything or they have a huge deductible. It is so confusing for the average person and many the brokers signing people up with will say anything to get sale.
Medicare DIS advantage plans should be outlawed. Maybe saving up front but if you actually need care you are very, very likely to be denied. As an NP I’ve seen lots and lots of buyers remorse
I've said this before and I'll say it again (until I die): Medicare advantage plan sales people should be required BY LAW to tell prospective customers that it may be difficult or impossible to switch back to a medigap/supplement plan once they enroll in an advantage plan. I am presently enrolled in an advantage plan and have had very good coverage up to now. But down the road, if my cancer gets worse or some other unpredictable disease comes up, I'm terrified by the prospect that some pencil-necked accountant at an insurance company may determine my fate.
The one thing that would help seniors is if Advantage plans were not called Medicare Advantage Plans. Seniors hear the name and assume they have the same rules as Medicare. They are just optional Insurance Companies who can and will deny certain things deemed unneeded. A panel of non doctors look at doctor suggested treatments and decide if it is needed. Well guess what there whole job is to make money and they can choose what is not deemed necessary even though your doctor says it is.
Yes! I can't tell you how hard it's been to help my elderly aunts, uncles, in-laws understand this!!
I recently turned 65. I have a pre-existing condition. I'm healthy, but was born with a birth defect that I need period 'maintenance' and equipment. I went with part A & B and chose G+ high deductable. The math works that if I use the supplemental G, paying the deductible and the low payment was CHEAPER than the regular G. This works for me. Typically I need expensive equipment/treatments every couple years, the rest of the time I just do annual physicals. BTW .. the company with the G+ said I had to wait 6 months before they would cover a pre-existing condition.
For my situation I wouldn't touch the Medicare Advantage plan with a ten foot pole. Reasons: 1) you have to take a doctor in network. What if I need a specialist not in network? Not covered. 2) Every treatment has to be APPROVED. They can say no to a treatment you need. That right there is the reason to stay away from this.
Insurance companies doing the Advantage plan are paid a set amount by the government for your care. It's in THEIR best interest not to get you treatment and incur costs.
When a commercial for Medicare Pt. C came on the TV and the actor said, "I enrolled to get everything I'm entitled to," my dad used to say, "That's what I'm afraid of."
😱
🤣 Yes. Total misrepresentation.
This is so complicated, why don’t they make simple for older citizens 🤦♀️
Because private corporate insurance is involved
Because people in America are brainwashed and keep electing wrong people which is GOP.
Agree 100%.
Because the confusion benefits the con artist companies selling you these products
it pisses me off how confusing they make things. just take care of our elderly... why does it have to be all convoluted! I'm so angry.
When I was new to Medicare, I researched everything thoroughly. I called up an agent and went through everything. I wanted to reverify my research about not being able to keep switching plans and he lied saying that I could change my plan every year. (I am not in one of the states where you can do this). He was really pushing me to enroll in the Advantage plan. Beware folks, agents are not unbiased. They get paid to sell you these plans. Thankfully I had made the right choice for me and picked the traditional Medicare where I can go anywhere for my healthcare. Advantage plans are like a HMO’s whereby you cannot go anywhere. IE: can’t go to the Mayo Clinic in some states. Thanks for the video.
That simply isn't true for all plans
I am a recipient of Medicare and I totally agree with agents trying to push you into plans that they make money off of. My Medicare has to coordinate with a state paid coinsurance and a federal program that is specific to one of my major health conditions.
I called one of those mailers to see about switching to a different Medicare plan, and the agent had never heard of the program. Had I switched, I would have been ineligible for the program and my coinsurance.
The moral of the story is, don't just assume that these "agents" have your best interests at heart. They're trying to make money.
It’s so sad how many agents don’t know this or simply lie to make a sale. It is infuriating.
Medicare Advantage plans are just like insurance you get at work. Yes, there are some HMO's, but there are also PPO's as well. which are far less restrictive than HMO's. Many Medicare Advantage plans allow you to see specialists within their network without any prior authorization.
I have used my Medicare Advantage plan at many University teaching hospitals in the area my plan covers. I haven't found anyplace yet that will not accept my Medicare Advantage Plan. And if you have United Health Care and live within an area where there is a Mayo Clinic, they will accept it. Please make sure you completely understand MA plans before you speak. Obviously, if a Mayo Clinic is not in your area or network, MA is not going to allow you to fly halfway across the country to get to one. That defeats the whole purpose of the Medicare Advantage Program, which is to keep costs down.
I am older and bogged down in my current day to day business and listening to this video makes me feel like I could lose my life savings if I check the wrong box, at the wrong minute, or the wrong category. The words "Gotcha" and "Tricks" makes me nervous. All I have to say is keep this lady in your favorites.
Advantage plans have a maximum out of pocket that is not egregious. If you are healthy and paying premiums for a part G or whatever, you will pay a huge amount over the years for zero coverage. Most people don’t take control of their health and then expect pills etc will suffice. So 1) prioritize health 2) look at the total costs over the years.
Again, a tale as old as time, some people will say the “free” advantage plan will save you thousands! And everyone has a friend or family member that loves their Advantage plans, but do you have a crystal ball to say how healthy you will be? Advantage plans are for people that want to take risks. Supplements are for people that want to be prepare even if they are healthy now. Saddest thing to see is someone’s advantage plan deny claims or make you go though hoops to get coverage. Good luck with you maximum out of pocket on the PPO advantage plans.
Why are insurance companies so corrupt in America?
Because it’s a huge unregulated money grab, with lots of lobbyist and politicians in pocket to keep it that way.
ask Florida's Rick Scott
30 years in executive healthcare finance I've see it all. My suggestion is to stick with traditional medicare along with a great supplement. EVERY TIME I've reviewed an insurance company try to sell you something that looks to good, smell it carefully. Do your best due diligence. They almost ALWAYS try to sell you the products that give them the best commission and their company the most profitable products and it usually causes the customer the worst financial outcome after the sale. I've had many 'lively' discussions with insurance companies who told their clients they were not covering some hospital charges. My response was "these incredible Drs, Nurses, and All the Ancillary staff worked around the clock to save your life and restore your health! If you need medical attention in the future; do you want a trained HEALTHCARE professional to treat you? Or do you want a professional insurance company to treat you?" Research these companies products and know what you're buying. And remember another critcal point: What transpire with your insurance company's reimbursement policies is between You and Them and not between Them and the Medical Professionals. In the end is the Patient's (Your) responsibility.
The entire medical system in the US is absolutely ridiculous, insanely expensive and purposefully made confusing and cumbersome. If you are totally irresponsible and do not work you are put on a pedestal and everything is FREE for you... What a joke.
why bother working when you have corrupt fraudulent supervisors, dept managers who screw you on hours, have their favorites, favor the gays, let the psycho narcissist gay step on your face and livlihood daily, jealous co-workers who stab you in back to earn favoritism...then theres the A-hole customers their petty complaints that get you written up n push you out ...yep if the world is going to mistreat me then i'll just sit back until i see the shii show take a turn for the better
Social security benefits for seniors are an essential safety net for many, but it's also crucial to plan ahead and invest wisely for your retirement. Diversifying your investments across can help build wealth over time. It's never too early to start saving and investing for a comfortable retirement. I’m 63 and my husband 65 we are both retired with over $3 million in net worth and no debts. Currently living smart and frugal with our money. Saving and investing lifestyle made it possible for us this early even till now we earn monthly through passive income.
Alright phyllis, speaking in general terms, investing requires a good amount of knowledge. That's why it's essential to have a solid support system like a financial counselor, especially when picking out assets. I've been working with Regina Louise Collaro, who is an investment advisor at a registered wealth management company. I can't recommend her enough; my financial journey has been fantastic thanks to her. She's quite well-known for her services, and she helped me achieve financial stability through investments. Now, I benefit from her passive income strategies every month. So, I'd strongly suggest finding a reliable investment advisor for yourself
Regina Louise Collaro is based in the United States and can work with anybody wherever they stay. If you would like more information about her, you can conduct a search online.
personally, I'm blessed and realizing I'm not the only one working with Regina Louise Collaro. I will consider myself lucky. I've been able to feed and make a living through her advice and great work. For such a person as Regina, I owe her gratitude, support and endless prayers as it is not easy to gain access to such a competent and reliable adviser. Who isn't just wise but has all it takes to handle an investment and is good at what she does..
Thanks stephaniefythm.I have had the intentions of starting investing. But I always thought it was late and I think I need to stop procrastinating. I will definitely 🔍 Regina Louise Collaro and see what she can advise .Thanks a lot . This was of so much help to me
well bless your hearts
They will either get their money up front (Supplement Plan), or as you go (Advantage Plan). You will pay. These companies get around $10,000 to run your benefits, and its just a fight for them to see how much of the $10K they can keep.
I'm even more confused now. The US medical system is just insane.
and immoral.
"In Chaos, there is profit!" the motto of all medical insurance providers. ;-)
@@stephenschroeder6567 Absolutely true. Sadly, that also goes for medical providers as well.
Watch the video again and you will eventually understand all of this. I spent many hours watching these types of videos before going on Medicare and pretty much thoroughly understand all of this now.
"Advantage" may not describe reality. I have seen several patients die while finding the primary care doc on a Saturday when the patient is visiting a rural area a couple of hours from tertiary care. Some plans are so loosely designed and funded, hospitals in plan may not have the needed specialists in plan so needed transfer for a broken neck, heart attack, stroke or complicated trauma doesn't happen because no hospital will accept the patient. Small plans will say, "Just fly the acute appendicitis patient back to Nashville." The profit margins just don't make sense in managed care and there are too many billion dollar executive suites all around the country.
I got an insurance advantage medicare plan.... a broker helped me chose it,... it DID NOT COVER MY AREA... I'm disabled I don't travel out of town... I had no usable insurance that year.
REGULAR MEDICARE IS FANTASTIC!!!!
Wow.
Yes, I had to field some of these calls too. They call to see if we participate with this Medicare Advantage plan that advertises constantly on TV during the enrollment time. I tell them that plan is not popular here and they are restricted to network providers only. They now know they have a useless plan. I tell them to switch to a local Medicare Advantage plan that most providers participate, if they can.
"When going on Medicare for the first time....." How many times does the average person go onto Medicare?
Big fan of our Original Medicare plus Supplement. We had a couple hundred thousand dollars in medical bills a few years ago, and outside of the Part B deductible and a few hundred for some medication that was only partially covered by our Part D plan, everything was covered. We were told by more than one case manager that we were really fortunate to have the coverage we had because they are constantly fighting with Advantage Plans trying to get coverage, due to bean counters who insist on pre-authorizations, chosing the cheapest options (even when they are not the best option), and down right denying coverage.
Yes, it's a bummer that eye and dental aren't covered, and you have to pay three premiums, Part B, Suppliment and Part D, but it pays off when something really happens.
For several years, providers always asked me if i had a suppliment.
I saw a video for medicare suppliment G.
For 4 years, i have never had a copay or any out of pocket expenses at all. Get the supliment G, never pay any fee again.
And i have have a lot of surgeries, and out patient procedures.
preach brother Perry.
How much a month do you pay for G?
Laws have changed and G is no longer offered to new enrollees. Only those already grandfathered in can still enroll in G.
@InSearchofTruththruJesusChrist nope. It's F that is no longer offered. G is Still available to new enrolees. I know tjis because I turn 65 this year.
@@terribolan2010 thank you. I stand corrected.
When I first signed up for Medicare, I thought that the Part B premium was $164.90 per month and I set up a checking account to automatically pay the premium. What I didn't know, and what Medicare did not tell me, was that the first $742.50. Fortunately, there was enough money in the checking account to cover the first premium. I feel sorry for people who are not prepared for that.
Hi, why was there $742.50 due? Why not the $164.90 per month as you thought? My husband is signing up soon so just wondering what to expect.
@@joans5619the amount is because Medicare requires paying for three months at a time.
I'm paying it, too and the plan N supplement instead of the advantage plans.
I don't want to get stuck with small numbers of doctors and the insurance company in charge of my care. Don't forget the advantage plans also sock it to ya with huge deductibles.
Just to be clear, if you get Social Security benefits, each month's premium will be subtracted from monthly benefit. If you self-pay (not collecting SS), you will get quarterly bills for 3 months of premiums. Social Security online docs do mention the first bill may be higher to collect for prior months. There's more to the story here as the amount due is not a multiple of $164.90 in this instance.
I found out somehow (can't remember the details), that I could opt out because I get all my health care at the VA. It's a little complicated, but I was given specific instructions to follow before the end of the month in order to not have that first payment ($134.00 I think it was) taken out of my SS check, which I did follow, and they still took it out! I googled and found out that is actually like a gov't scam kind of thing or something that they do and get away with a lot. If anyone cares to look into this to see what I'm talking about, feel free. I'm just glad I did end up opting out because I get pretty good care at the VA, and I only pay a small co-payment for everything, and I get to keep that $134.00 every month.
No where does Medicare tell you they bill that quarterly. There is no option to pay monthly. Why not? A lot of other companies give options to pay quarterly OR monthly. I am glad I didn't set up auto pay.
Wow as an insurance broker for 35 years I applaud you for doing this. After reading some of the comments it is quite clear that most people listening to you just don't get it. Your best advice ,work with a professional broker. Our services are 100% free people
My question is how much are brokers getting paid when they sign someone up in an Advantage plan ? If they are earning a commission, then they have a vested interest in signing someone up, and do they have your best interest at heart? It’s all very confusing.
@@rbnhood39 Thank you for your great question. Compensation will vary depending on the plan and the state. Brokers will also earn a commission signing up someone on a Medicare Supplemental plan. Look, a good broker will do what is the best for their clients. Personally in my 35 years I don't pay attention to how much I am getting. It is all about making sure my client has access to the doctors and care they need. There are "bad" sales people in every profession this is no exception. However, Sorting through this Medicare stuff on your own is like doing surgery on yourself. Please take time to find a good broker and work together to get the best plan for your needs.
Part C plans ("Advantage plans") give control of your care and medical benefits to an insurance company.... never a good thing.
Advantage Plans prevent patients from getting needs due to many providers not accepting their plans!! I have seen it happen!
Why do they have to make the selection process so convoluted? At the age of 65 or older, all of these “If/Then” questions and time constraints only provide more stress to the retiree. We all know that stress is the number one killer. Maybe this is the ulterior grand plan - to kill off the masses with stress
Someone felt you needed to have market choices. Let Grandma shop like when she's in a grocery store.
I happily worked with the Abt team when I turned 65 last March. Settled on Medicare with supplement plan N. I was VERY healthy, on no meds. 20 days into March, despite having no symptoms, a standard test led to diagnosis if a very aggressive stage 4 cancer. So now I am in chemotherapy and immunotherapy. The lesson here? I am still super happy with my decisions! I am approved to get the most effective treatments, and I pay $20 each month when I go in for infusions. No prob. If I was on an Advantage plan I very likely would be denied some treatments, and I would pay more for what I did get. 😊
uh no your wouldn't, anyone told you that is lying!
@@bobbear4437 She’s more right than you think. While it may not be your personal experience, Advantage has been called out to answer for denial of services for more people requiring expensive treatment than it’s allowed. Advantage makes it’s money managing one’s care. The less allowed or denied, the more money they make. Advantage is NOT in the business of seeing you get the care you need; they’re in the business to make as much profit as possible by denying care and services.
The medicare managed plan is designed to deny coverage and/or make money on both the doctor and the patient. The doctor takes the copay, but thats it and sometimes is penalized for too much care. The scam is that they tell the doctor they can make money on volume. The patient gets scammed by substandard dme, limited medication, and lack of facilities. The mansged care plan gets more than the 80 percent to “administer “ the program.
I truly wish there were public statistics on complaints around the Advantage referral process for specific Advantage plans in any given state, THAT is the primary decision factor which seems to be what is truly unknown for people. Or at least state rankings around complaints for such.
Thank goodness i have Tricare for life as a vet so that covers the Medicare gap!
My 73 yr old disabled husband got frustrated by the increasing premiums of his supplemental insurance, so he thought he would try a Medicare advantage plan instead.
I was very nervous about his decision because he has had numerous surgeries and would never pass underwriting w any company 🤦♀️.
I shared a few very informative Utube videos w him and showed him that he had given way too much power to the company rather than his Dr.
Fortunately he is within the 1 yr trial period so he decided to get out asap.Whew!!!
We’re both relieved 🙂 1:35
I got the hard-sell on the 'Advantage' plans ..... but did not desire an HMO-type plan. Very happy with Traditional Medicare with Supplement. Not restricted by Network or plan manager. Free to see who I want .... where I want.
I have been disabled for long time, would have to check how long , I was totally ignorant. Got a Humana advantage plan. I am now worried that I should have gotten a supplement plan. Is it too late for me now, I turn 65 in October the 8th . I don’t know what I should do or could do at this point. I believe I need a supplement plan , is there any thing I can do now 😢? Help please
@@rubymckee8123 Medicare open enrollment happens from October 15 through December 7 every year, giving you a dedicated time period called the GUARANTEED ISSUE PERIOD to change your Medicare coverage. The fall enrollment period gives you the most flexibility with which changes you can make. During Medicare open enrollment, sometimes called the Medicare annual enrollment, you can change Original Medicare, Medicare Advantage or Medicare Part D plans, including changing your coverage, switching between plan types and adding prescription drug benefits. If you're unhappy with Original Medicare or Medicare Advantage, you can switch between the two during open enrollment.
At any time, you can switch your Medigap plan or add a supplemental Medigap plan to your Original Medicare. If you change your Medigap plan during a guaranteed issue period, the insurance company won’t consider your age or medical condition. Making changes during a guaranteed issue period gives you better protection from high prices, and it gives you more freedom to select the coverage you want.
Never ever get a Medicare Advantage Plan.
My sister is stuck in Advantage.I have Plan F supplement. It's so good, they don't even sell it anymore. It has saved me $$$$.
@@janetsmiley6778 yep the supplemental plans have gotten worse over the years.
I did a lot of research before I retired and chose Medicare plus a Medigap supplement plan. I have a separate Part D plan for drugs also. The thing I didn’t realize was that fact that Medicare Part D is not permitted to negotiate drug prices like the private insurance I had while employed. My wife has RA and has been on a drug called Enbrel. I had a $50 copay for a months supply thru my insurance at work. When I retired, the same one month supply was $1000. That’s insane but I have to pay it. I learned that the drug companies are responsible for getting some sort of anti-trust legislation passed years ago to prevent Medicare from negotiating prices. The drug company lobbyists contribute millions of dollars each year to keep the legislation alive.
And that's exactly why many people buy their medications outside of the U.S.
Half the ads on TV are from Big Pharma , we are paying for those ads in the drug prices, stopping those ads would be a step in the right direction
Might want to mention what particular political party are the ones responsible and also who kills TV he Medicare for all(wiped out the mandate for Obamacare)
We need to vote out politician who are anti healthcare. 50% of American vote against their own economic interest.
@@elisemiller13 The drug costs here are the highest in the world. Canada is about 45% less, Denmark is about 75% less. But, those countries have higher tax rates than here in the USA. At least they get something for the taxes they pay. In my case, it would probably be cheaper to pay a higher tax rate than pay for the extremely high drug prices.
The GOTCHA is when Medicare Advantage refuses to pay your medical bills when you finally really need them to.
I just found out that the government gives over 1000$ per month to the insurance carriers to sign up and cover customers on advantage plans plans!
Yup!
Then the sickening gov should give the money grabbers $800 a month and make medicare premium FREE!! Its disgusting. I paid nothing for Insurance when I was under 65, now simply cuz of my age I'm forced into this joke of medicrap!! I'm in good health. This should be a factor in what one pays just like it was before. I didnt magically become some sickly decrepid person when the calendar went from me being 64 to 65! Medicare is a rip off we are forced into, having no alternative makes it a monopoly!!
Retired a couple years ago and went with the Medicare Advantage plan, big mistake if I needed a specialty doc like ent, gastroenterologist.
They tell me the doctor is no longer accepting new patients but the other specialty doc’s in the advantage plan suck.
I’m going on regular Medicare after this year.
Btw, I called Mayo Clinic in Scottsdale and they only take regular Medicare, they will not accept anyone on an a Advantage plan….. Wow!!
I'm eager to hear if you're successful going back. My understanding of the fine print is once you're on Advantage, you can never go back.
@@coleramus561 that’s good to know, so essentially they baffle the consumer with bs and then after a couple years in the advantage plan it’s too late to change and now I’m stuck with it.
And on top of that because of my retirement income, my premiums go up and my SSI check goes down. 👇
@@coleramus561 That is the impression I had, too.
@@coleramus561 Just an update, I did call the main Medicare number on the back of the card and asked her that question and she did say I can transfer back to straight Medicare and leave the advantage plan if I choose during the normal enrollment period….for what that worth.
I opted for an Advantage HMO because I could not find a doctor in my area who was accepting new Medicare patients. And my own doctor refused to see me for the same reason. I guess Medicare doesn't pay doctors enough to make up for the paperwork burden?
Took me years to learn my health insurance lesson. Medicare supplemental G plan allows me not to waste time with a primary care that has limited knowledge. I choose specialist anytime I want any State anywhere and sometimes out of the country. It does cost you more but it is definitely worth it. Medicare advantage locks you into your neighborhood and you can't get out, and they dictate your doctor referrals😢
Not all medicare advantage plans are like that. I have one, no referrals with my plan as of 2023, more dental coverage. I love it. In a life and death emergency I too can go to the nearest hospital that is in network or out of network, anywhere.
Why go with a plan that pays profits out of your money? I want my money to go to my care not profits
Love, love, love your information.
Here are some (approx.) dollar amounts:
Medicare Part A = free, Medicare part B = $160, Medicare part D (prescription) = $12, Medicare's Medigap part G = $170.
These four items add up to (approx.) $342/mo. per each person that needs insurance.
The average Social Security monthly check, per person is $2,485 and when people see that $342/mo. insurance premium they panic and pass up the great opportunity that is in front of them.
The sharks move in and call themselves Advantage Plans. The only advantage to for the Sharks and they have the right to DENY your doctor's recommendations for coverage, until you eventually die from the ailment, which the doctor has said was there all along. The doctor isn't going to treat you, if the Advantage Plan denies your problem exists, but your teeth will be clean.
😁
@@MikeAnn193
Advantage Plans are okay if you only need dental, vision, and pills, but once your doctor tries to keep you well or cure your sickness you'll have to file a law suit against the Advantage provider and they'll wait you out, until you die.
Medicare part B 164.90
@@angelawhite4795
I use rounded off numbers for quick math.
The sad part is that half of the people getting Social Security receive less than the $2,485/mo. average and $342/mo. (for insurance) is too much of their budget.
If your career has been in the food service industry or hospitality industry, your monthly benefit will be way, way less than the Social Security average.
If you've been a minimum wage earner your entire life, your benefit will be even less.
These are the poor people, which Advantage Plans prey upon.
@@MikeAnn193 Go with a PPO plan instead of an HMO plan, and you are almost limitless in the number of doctors you can see.
I have part A but I'm not taking part B I'm not paying $165. per month, for something I only use like once every 5 years or so. If you pay cash there is about a 40% discount. If your on Medicare then the bill is inflated 40% and your stuck paying 20% of that bigger amount. Have you ever been hounded by sales people in your life and they were trying to do you a favor.
I've had similar experiences, with much bigger discounts for cash pay.
You do realize this issue would go away if our federal government would simply require the health care industry to accept as payment in full the Medicare Part B fee schedule...
The problem with that is there are fewer and fewer doctors who accept Medicare only. Most of them are private practice, so the government cannot tell them otherwise.
@@bvm3925 Agreeing with that statement, I would table that the tax exempt status many of these "private practices" and their parent facilities currently enjoy should be "re-evaluated"....
Traditional Medicare and Plan G . Plus a drug plan. See any Doctor or go to any Hospital no network . Pay the 240 part B deductible and all other charges that are Medicare Approved are paid.
But what if it's on a Tuesday and I have a ginger cat?
@@ts-900?
@@JDStaffylover I'm being facetious. Their rules are so convoluted and nonsensical that they might as well add such stipulations.
I still can't believe anyone takes any of this seriously. It ALL needs to go NOW.
@@ts-900well... if it's 30 days hath September you might be ok.
@@terribolan2010 Well okay then, because it hath.🐈Ginger cat is happy.
Daughter of a elderly mother:
NEVER EVER GET ON ADVANTAGE CARE!!!
Or MANAGED CARE PLAN!!!
Get a “social security supplement” plan and NEVER get turned down for anything your doctor says you need in any state and some overseas!!!
It’s worth it if you just use it ONCE!!!
Correct 💯👍
Outstanding video. I originally signed up for traditional medicare but also for a very inexpensive supplement that only covered 50% of the 20% that medicare did not cover. I was okay with that, because I was/am very healthy. This year, I decided I wanted better coverage, and found a good price on a supplement that provided much better coverage for the 20%. What I didn’t know, was that I had to be approved by underwriting because I was going to a supplement with better coverage than what I originally enrolled in. I had NO idea that I had to pass underwriting to go to a better plan. I thought I could switch supplement plans to whatever I wanted, once per year. NOT SO! Luckily, I am still healthy. But I am so glad I now have the better supplement, and luckily at a good rate.
How much is your supplement?
So glad I live in a country where healthcare is free.
Lucky you! I would just as soon leave sooner, than later, so I don't need to worry about it!
Nothing is free anywhere in the world.
Never get an advantage plan.
Agree 100%
I’m 75 with good health and no chronic problems. I don’t have a PCP by choice. I have Advantage plan which gives me a free gym membership. I exercise everyday. I get my blood analyzed every now and then to check my health. If I had a problem then I’d go to urgent care. I’m going to die so I really don’t need a doctor to treat symptoms with meds or get vaccines.
Me too I am 75 no meds or vaccines! I have a advantage plan never paid any doctor bills since.
I work in a sector of healthcare that requires pre-authorization for patient stays. We call Medicare Advantage plans Medicare Disadvantage plans. Its tough to get those patients into our unit. Many end up in a nursing home with all the attached “blessings.”
I have Medicare advantage with Connecticare and I’m very happy with it. I do pay 23$ a month for dental which I think is a great price. Compared to the high deductible plan I had thru work before I was 65, I’m thrilled with my insurance. There’s a one a year hospital copay of around 400$ if you go in hospital. So cheap. I don’t know why people don’t like advantage. I love it.
In some areas they can be great!
One trick they use on prescriptions is to have an "in-house rule" which caps how much of certain prescriptions you can have per month. The doctor writes you a script, not knowing about this cap. So Medicare denies coverage for lIfe-saving meds FOR THE REST OF THE YEAR! They dont contact the doctor and explain that if she fills out the script differently, that the original amount would be covered but you have to use specific wording to breech this cap. So your loved one suffers for months and months because to pay cash for the script is around $28k PER MONTH! Months later, after dozens of phone calls, someone with a brain in customer service at THE PHARMACY says "Hey, I think if your Dr. re-writes this script with these specific words, you can get coverage again". So you call the doctor, she takes TWO MINUTES to rewrite the script and her assistant sends it in. A day later, it's approved. By now, your loved one is exponentially more ill than 11 months ago, but at least we've got something. IT'S A NIGHTMARE. And for some people a death sentence.
During droughts, animals are drawn to the watering hole where the crocodiles lay in wait...
So to do the Healthcare and Insurance companies lay in wait, waiting for us to age... and present us with a complex and shifting maze where each wrong turn subtracts a decade of savings from the 'patient'.
I am 62.
This is all extremely easy to understand.
I'm 64 and I don't have a problem understanding it either. You can't see the future, so just buy what covers what you want.
The rules are so ridiculously complicated. The worst is that virtually everybody who gives advice on the topic has a vested interest in selling you something and so you never know whether you are getting real advice or you are getting a sales pitch disguised as advice.
Where can some approaching 65 go for real - no special interest - objective advice? Even paying for that advice would be worth it... if it can be trusted.
I understand why you feel like you have to shield yourself from greedy people; they are in all professions and sales is no exception. I'm a salesperson for 50 years and I love it. My job is to help people get what they want. I always conduct myself in the best interest of my client because I understand the Law of Sowing and Reaping. I believe the vast majority of salespeople are like me.
I often assist people with my time and expertise even when I know I won't get paid. Why? Because of that sowing and reaping law. Corporations often don't like salespeople because they have to pay us but they know that the Salesperson is the eyes and ears of the company. We work for YOU and develop that relationship the corporation can never have with you. Most salespeople are like me. Our "special interest" is YOU.
@@joeysplats3209 I never really worried too much about it, but I moved to Florida which is easily the sleazebag capital of the US. Here you really have to be extremely paranoid, especially because the laws have been setup precisely to enable businesses and those selling services to fleece customers.
That is why I'm hoping to find someone in the profession of giving advice to individuals without having ANY association with the businesses that I will have to select or buy from. Sadly, so far everyone I found that gives advice is employed by or gets commissions from those businesses.
The system we have is designed this way for a reason so we will pay, and continue to pay for what should be good healthcare. I considerate a disgrace, that we can't do better.
Bottom line, when the US government and private insurance join forces it is a bad day for “We The People “
So who do you trust? Just the government, or just private entities?
Got that correct! ACA totally screwed my medical coverage.
@@answerman9933 Damn good question in light of the medigap/ advantage, current examples.
@@answerman9933 neither, we need to get government and insurance companies out of our healthcare, all they do is add to the cost, If you want government to have a role then they should go after big pharma for price grouching, in a true free market We The People will do a far better job of holding these companies accountable
@@denniss3980 Boy, you sound like an ideological idiot with your "We the People" all the time. You likely live a life full of dogma.
Anyway, without any insurance you would be willing to pay directly, out your own funds for any health care cost? I understand some religious groups pay for health service without the benefit of insurance. Both they pool their money within their group. So it is a form of mutual insurance. By the way, I have had medical insurance as far back as I can recall. I am 60 years old now. But I hardly ever use health care services. I have never had a primary care physician; I take care of my own personal health. I have only visited a physician maybe four times in my adult life. I say all that to say this, I am not too concern about health care insurance.
My wife and I paid for supplements for two years until I retired at 67. Then we switched to an advantage plan. We were paying over $800 a month and have been paying $0 for the past three years. That's $28,000. All of the hospitals in our area accept our carrier. We pay $20 to see a GP and $35 to see a specialist. I just had surgery with follow-up for $35. We get all kinds of screenings and diagnostics at no charge. I don't understand why people think it is a scam.
I agree. We had original Medicare with a supplement plan. We were paying for Part B, about $165 each. Due to it coming out of Social Security some forget to add that amount into their monthly total. Next, you have to keep $400 each aside. That is out of pocket before the supplemental plan will pay your 20%. Next, the cost of the supplemental plan. We paid $700 a month, $350 each. I added up our yearly cost and it as way more than what we pay for our Advantage Plan. We only go to the doctor for our yearly physical. Thankfully, we aren’t sick very often. We take supplements, which we use or OTC card to pay, We exercise or walk and try to eat healthy. I realize there are some who need to go to the doctor for serious medical issues and the original Medicare with a supplemental would be of benefit for them. You need to get what is best for you.
i work for the state gov with really good healthcare. When retire we can keep our healthcare coverage. When we turn 65 and get on medicare, if we want to stay with a low cost plan from our employer we have to choose the medicare advantage plan they offer. If we don't we are dropped from their insurance provider. This seem unfair and like emotional blackmail to me. I'm slowly accepting when that day comes in 5 years I will have to leave the comfort of my employer plan and go find a medigap plan on my own. I think they should offer at least 1 medigap option to retirees but they don't. it either take the advantage plan or walk. So I guess I will be walking. and they are quick to tell you if you walk you can never come back in. ... emotional blackmail. My father died at 80 with cancer and medicare with a BCBS medigap plan was awesome! My mom is 95 with dementia and again her BCBS medigap plan has been a life saver for her in home hospice care. So I want a medigap plan and no amount of free gym memberships etc. will convince me otherwise. I have seen it from my parents care and for me, medigap is the way to go.
Bravo, you've seen the difference !
That S----s!
I have a Medicare advantage plan. I would really like the medigap but being poor I can’t afford it. I do get the free gym membership. The gym is close to my house, it gives me something to do without spending money and the $250 a month tuition scholarship for the grandkids is kind of my motivation to show up at the gym. Plus in the summer I can go to the gym at the hottest part of the day and turn off my home air conditioning. I trust my health insurance broker. I’m hoping he’s put me on the right path. I’m still broke but with the no premium payment at least I can afford other luxuries, like food.
Wait until you actually need health insurance. You will see how much is lacking with your "no cost " plan.
@@door2416 maybe.But right now I can’t afford the premium. I also have some other kind of plan, similar to Aflac, or whatever that commercial with the duck is, which pays me something towards catastrophic illness.
$0 up front, pay later !
I am 75, been on an advantage plan for 9 years. I have had health issues and am extremely happy with my plan. Just a few of my benefits: Primary care is free, Tier 1 drugs are free, specialist are 30$ copay, 60$ every quarter for OTC drugs, 2000$ per year dental, 10$ per month reduction in Medicare payments. These are just a few of the benefits. I have had total knee replacement, hernia repair, melanoma surgery, and my advantage plan has been outstanding in all cases. Approval for treatment was immediate and I have never been denied a claim. I am covered for emergencies if traveling. Advantage plan has a 5 star rating. My wife is a retired nurse practitioner and we both have advantage plans.
I too am happy with the advantage plan. My first 2 months on reg. Medicare I had to pay more than 200.00 for diff. services and since the 1.5 yrs. I have paid nothing .
@@joyceknight9568 but what are you paying for the plan?
I've had both now. I'm currently on Original with Blue Shield plan G extra and Wellcare part D. I'm turning 73 soon. I had SCAN Classic Advantage Plan for almost 8 years. Both plans have advantages and disadvantages. Just know your decision at the beginning is extremely important and you must understand the differences in them. Use a good experienced agent who specializes in Medicare. There are many resources to help guide you. Stay sharp and healthy. It's always about the money unfortunately, but good health care is extremely valuable as one ages.
Great input!
Good advice shared in this video. Don’t go down the Advantage plan path without fully understanding what you are signing up for. Need to think long term when deciding your health care insurance needs post 65.
You should say, right off, insurers (eg, and the health care system behind the plan) receive payment for every person who chooses Advantage plans. They get paid up front, then profit by limiting your use of the benefits!
Very true! Covered here:th-cam.com/video/nMEU6IEkf7Y/w-d-xo.htmlsi=0nZQV29Z6JUXlXWJ
My biggest shock after taking Medicare, was that I had to keep paying for it, after I paid 1.5% of my income (as did my employer) my entire working life. I thought the taxes/payments would stop when I took Medicare, like you stop paying for Social Security when you start getting it. Instead, your Social Security payments are reduced (by about $135 per month; you can look it up) to pay Medicare. To to forthright about Social Security payouts (when planning for retirement), every discussion should mention they will be reduced permanently. The estimates the SSA puts out should include this shocking information, otherwise they are misleading every single recipient. Shameful!
I’m 72, on SS since 62, working part time and SS is still being deducted from my paycheck.
This has been true since 1965.
You believed a fairy tale.
That's on you.
Not a shock if you do the research and stay informed. Retirement planning is a very important part of life.... unfortunately folks will spend more time researching the purchase of a TV or vacation then their retirement.
Your taxes being deducted from your paycheck were paying for Part A, the hospitalization part of your healthcare. Nowhere did it ever say your Medicare deducted taxes paid for everything you’d ever need that fell under medical. Researching and understanding what you have and need BEFORE retirement, lies squarely on the recipient.
@@susans8093 I failed to make my points, that 1) you continue to have to pay Medicare, and 2) that you don’t get the SS amounts that they promise you, and 3) that no financial planners tell you this.
We don't have this problem in Canada. We're covered cradle to grave by government health insurance.
And that's why most Canadians come down to the US annually for their health care and dental needs! 😂
So how do you like your communist health care?
@@dawnfoster6530 An absurd lie. Why am I not the least but surprised. Propagandized much?
@@dawnfoster6530 actually Canadians polled are much happier with their medical then Americans!
@@KenJackson_US you get 'SOCIAL' Security ???
You are good. I had a Medicare advantage plan and after 9 months wanted to switch to original med. and get a supplement. I was told by 3
agents that I would have to go through underwriting. THEN, I found an agent who told me about the trial period which I was eligible for.
You are good. You are honest.
First choice of insurance you do not have to underwrite. This is another reason to not get an advantage plan. Go to traditional medicare through the government directly. Then if you get kicked out of your advantage plan because you are costing them too much money you don't have to worry about underwriting because government medicare will not kick you out. Stay with your original plan. Get straight government medicare A, get a quality medigap provider B and medicine provider D. Ask a medical provider what they would do before you make a choice. Asking an insurance provider is not your best advice. It is like trying to get dental insurance on the internet. Ask a dentist what they would get. They will tell you who pays the best. That is what you want. I used to work for a lab company and learned insurance providers that were downright worthless.(take your premiums and give you very little in return)
Ur comparison of discussing the cup holder instead of the performance of the vehicle was right on. I have never been more frustrated and stressed than when Aetna took over my health care (or lack of it)
I screwed up and got on an Advantage Plan! They turned down everything, even a chest X-Ray. I was very lucky at 70 and got underwritten and OK’d for a supplement plan. Plan G. It is expensive, but worth every penny. Have to pay dental, prescription, hearing. So that’s extra.
Around $200.00 a month total! Boy, was I lucky to get on!!!!
$200 for all of that ?? Wow that is very cheap compared to most others. Some people pay over $200 just for their supplement plan. I’m just turning 65 and my total will be around $320/month
I’m 78 and my husband is 86. We both have been on regular Medicare A and B since turning 65. We also have AFLAC cancer policies. For years We also joined a Christian share care group long before Medicare, but decided to keep it instead of a Gap plan. They covered some things that Medicare didn’t. Eventually as we needed more medical care, I got tired of all the paperwork for the Christian group, so was advised to buy the G plan. It is more expensive but no hassle for me. But we had to undergo underwriting and I was turned down by AARP so we are both with Blue Shield of CA. Our regular Medicare costs around $150 a month each, I think, and the G Plan costs around $650 now but goes up every year. I love not having to do all the paperwork, and can go to any doctor and get almost any procedure I need, however between the two of us we are paying nearly $1000 a month. My husband, however, just finished his third issue with cancer. If it were true that an advantage plan pays 100% as she says, there would be no copays for anything.
I hear what you're saying Stephanie. It's like those commercials for cell carriers that say "you get to keep your same phone, and your same phone number!"
Well, yes - that's by law. Everyone gets to do that.
I've had a great Medicare Advantage plan for 15 years in the suburbs where there is competition and plenty of providers, but friends further out in the country do not have very good options.
A big downside to advantage plans is that you're on your own for medical coverage if you plan to travel outside your home state.
Not with Kaiser Permanente. They have joined up with Cigna to provide medical coverage outside of their area.
RN here- NEVER take an advantage plan. I am forever baffled by people working their whole lives and finally getting Medicare only to turn around and give their benefits to an insurance company! Advantage plans are a SCAM.
@MaryMeola..Then what
It is but some places will not accept straight Medicare, such as Bend Oregon. It’s criminal that my mom has to pay for advantage plan and out of pocket has been horrid. Biggest scam ever on retirees
@@sharonkincaid6565 Sometimes, as difficult as it is, relocating for economic or healthcare needs is necessary.
@@sharonkincaid6565 - and there are some that won’t take Advantage plans. This is not unique to Bend, OR. It’s a nationwide phenomenon.
@@imxploring - sometimes it means giving up your trusted healthcare provider for one that’s accepting the insurance plan you have.
Interesting comments on Advantage Plan....I went within Advantage Plan....the cost of a not doing an Advantage Plan was way MORE than I was paying for my Health Insurance prior to turning 65....what I have chosen is what I have chosen....if you trust the Medical system in this country now after the insanity of harmful vaccines, ...well,your call...I Trust God....be very careful...you can either be part of the problem...or part of the SOLUTION...
What harmful vaccines are you referring to?
now after the insanity of harmful vaccines, omg you're one of those people ! All the people I know. never had a problem with COVID vaccines.
@@hooker9453
You really don't know what harmful vaccines I am referring to?....
@@hooker9453Covid. Very harmful.
Good info. Unfortunately with Medicare Advantage plans the "free dental care" often covers very only basic services for fee, such as 1 exam and 1 cleaning per year, and fillings. If they pay for crowns, bridges, inlays, onlays, endodontic care, and implants, it is often only partially, and in limited amounts per year. For example need a root canal treatment? They'll pay 1/2 the cost maybe, and only one per year. Also, this is a lovely opportunity for a dentist to raise his fee a bit. She'll normally charge the patient, say, $1000 for a tooth with 1 canal, but if insurance is contributing, they might raise their fee to, say $1,300, making your half of the bill $650 and the insurance company's half $650. So by having an Advantage plan you've saved only $350 on the cost of the treatment, instead of saving $500.
I am on Humana HMO Plus and had 3 crowns and a filling and never had to pay anything! Plus 2 regular exams and cleanings. I was pretty shocked. I pay nothing for the plan. I also get paid for working out, get over the counter allowances, and get paid for all my preventive care like mammograms, DEXA scans, etc. And I get to go to very nice fitness centers for free that include sauna, hot tub, indoor and outdoor pools, and beautiful shower and dressing areas. My medications are either free or very reasonable. My primary care doctor visits are free and specialists only $20.
And I also had MOHS procedure that only cost me $20! I have had multiple skin cancers removed and didn't pay anything but copay and my doctors are all excellent.
Like getting a windshield for your car with insurance. I have a $500 deductible and paid that for a windshield for my car with insurance. Turns out if I had just purchased the windshield without insurance it would have cost me only $265.
Rip off.
Most dental plans - Medicare or not - are ripoffs.
And only two dentists in my urban area accept Advantage insurance and, by reputation, they are the worst dentists in the area!
At a multi-specialty clinic every time MC changed a rule, we had to send our MC billing staff to a 3-4 hour seminar to learn how to comply. I can't imagine how the patients can keep up.
I just found out about all this absurdity i feel like going to go work for a medicare supplement company or take a course..im so upset ..
Medicare Advantage plans have a maximum out of pocket expense per year which is usually about four thousand or five thousand per year.
These complicated insurance things are infuriating. How much needless time, red tape, and extra expense it takes to deal with it. Money that could be directly going to medical care, instead of into the pockets of insurance companies. And how much anxiety, worry, and confusion it causes to people.
I live in Pa and have a highmark bc bs med adv plan.I had a triple bypass and paid nothing.I pay nothing for pcp and specialists visits. Zero for lab work.zero for tier 1 And tier 2 drugs.very low copays for mri, outpatient surgery and so on.I am in a hmo and I guess the trade off is lower costs for staying in network.also I have a zero premium. W.Pa is pretty good for medicare Advantage Plans.
I will be going on medicare in 3 months and I also live in western Pa, can you tell me / post the plan name that you have, I am looking at the Highmark BcBs Is it the COMMUNITY BLUE MEDICARE HMO SIGNATURE plan ???
Impossible
I ended up going with a Humana HMO plan and it has been pretty good. A year and a half ago I ended up in the hospital for 2 weeks and had 2 surgeries, initial bill was 98k I had to pay 2% of that. A few months later I had another surgery (follow up to the previous ones) and spent 4 days in the hospital and only had a $350 copay for it (no idea what the cost was on that one). Dental is not great but few plans cover much.
Interesting! At 63 I dread this. Have to study so insurace companies don't kill me.
They won't kill you. Stop being so dramatic.
@@jimroscovius No, only the refusal for needed care can
Just turned 63 last month and have a lot to learn in a short time. Extremely confusing and ridiculously complex.
Absolutely. Hopefully the videos on my channel can help, and if you have any questions please call us at 888-465-9728.
I would suggest a drug plan. If you don’t you will pay a penalty to get on one latter. This penalty is life long every month. Sign up for a drug plan or advantage plan that has the drug plan in it when you start. Yes you might not need drugs today but you will.
I manage a mental health practice with a provider who specializes in seniors so most of her client base is Medicare. I can’t tell you how many of our clients have accidentally changed their Medicare coverage to Advantage plans without even knowing it had happened and as soon as that change is made we’re no longer in their network. I don’t know exactly how it happens but if you’re already on Medicare be *very* aware of what you’re signing up for during open enrollment periods. Don’t sign anything that says Advantage or references other insurance companies unless you actually *want* to be switched to them managing your plan.
These Medicare "advantage" plans have television ads that emphasis the dental and vision coverage and do not explain that you will have a small group of physicians and higher co-payments. If you travel, any medical service will be "out of network" and very expensive.
The TV ads are constant and deceptive.
@@swindewhile traveling, if you’re on Advantage, you can only use urgent care in order for your insurance to pay for it. If urgent care refers you to a doctor, Advantage will pay. Personal experience.
Advantage plans can change providers annually so you have to change doctors, hospitals etc.. Advantage plans are charging the government exorbitant fees for those little perks like gym memberships, vision, dental, hearing, etc.. which is affecting the cost of regular Medicare. Advantage plans might not cover nursing home stays. Advantage plans are not your friend, they just plain suck! We DON’T AGE HEALTHIER BUT SICKER! I worked in Long term care for over 20 years and I’ve seen some horrible things Advantage plans have done to people. Regular Medicare is the only way to go.
Avoid advantage plans
This lady is clearly worthy of our business and i just hope other people can see this as much as I have been able to. Not everyone out there is a scam artist but there certainly are plenty of these types. I am glad to see this lady is so honest and informative. I predict she will do most excellent in her endevors!! I will be calling them asap.
I will tell you my wife on Medicare and recently had emergency surgery. The bill was very high but I was pleasantly surprised Medicare paid all but an amount that I consider fair. Everyone shoots down Medicare but I can tell its better than alot of employer health insurance.
I'm definitely medical insurance challenged. I better figure this stuff out. I'm 71 and in good health thank God. I'll try and educate myself with your videos.