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Great information as always. Can you please do one on strokes and long term care? Grandfather had couple of major ones before passing and father suffered over a decade with mini strokes and TIAs. BONUS! At the end of 2024 the Postal Service will be adopting a split insurance plan that includes Medicare coverage for all employees plus something from providers. There’s no solid information yet but it would be a big help if you could explain it when it comes down to the wire.
I will be on traditional Medicare this January after using an Advantage plan for 5 years. The Advantage plan was OK, but I'm healthy. Why did I change? My wife. She is still on work insurance (not Medicare age) and very surprisingly developed a very rare and very serious cancer. We had to move from system to system just to find a doctor(s) who felt that they could treat her. We finally wound up at a university center. She had a 7 hour surgery that involved 6 physicians, including two department chairs. She spent almost a month in the hospital, and had to have 8 weeks of very specialized radiation treatment. At this time our quick estimate is that her total treatment cost is close to a million dollars. I can't imagine that she would have been able to get this level of service with an Advantage HMO plan. Hopefully, I will stay healthy, but I don't want to play around with my medical care so I'm leaving my Advantage plan for traditional Medicare.
You made an extremely wise decision, it could save your life some day. I'm so sorry for what has happened with your wife. It just goes to show that you never know if and when you'll need quality and timely health care.
We have been on an Advantage plan for 3 years, but are switching to Original Medicare with a supplement plan on Jan 1. We could not qualify for underwriting, but our MA plan benefits were reduced in some respects for 2024 and we easily qualified by that route.
I am a nurse and allowed myself to be persuaded to change to an Advantage plan 3 years ago. I want to change back to traditional Medicare but I sm concerned that I can not qualify. What benefits were reduced in you case and how do you plan to cover those areas financially?
There is no plan g. There's a,b,c and d. No g. You'll want a,b,and d. Plan c is just a plan tbat allows to put teo plans together. I would not do plan C, fir nothing. Stick to a,but and d. There is no g.
My wife has Metastatic breast cancer. She has A&B and Plan G. Our out-of-pocket cost other than premiums are very little, considering the extent of her treatments. Had we not been told this by a Medicare professional we would've not gone this way, and it would've bankrupted us.
Love your work! I did all my own research and was overwhelmed with all the various advantage plans "C." I compared everything I could find, and in the end, A,B,G,&D, we're the right way to go for me.
I disagree with that assessment, but I do think it depends on the state and what you live and any state policies with regard to managing health insurance and Medicare. My Blue Cross Medicare advantage plan has been fabulous. I can forward to pay the mid 200s per month fee. That has had minimal increases. Blue Cross page some six figures for my breast cancer care and my only out-of-pocket was my co-pays. I’m not trying to sell anybody on Medicare advantage, I’m just saying that it has worked for me. I tend to be In ordinately healthy, And then at 81, Not on any prescribed meds, nor have I been for years. Most of my drug cost are for yearly vaccines. Knock wood!
As am I. I suggest a Medicare supplement and freezing your FEHB. You can do that by contacting the OPM. It will be cheaper than the FEHB plan. If needed, you can unfreeze your FEHB anytime.
A, B, D, & G I made my decision based on the education I received in part from your videos and doing a lot of homework. I was on an advantage plan and lucky for me when I received my ANOC, Humana cancelled my plan, therefore no underwriting process for me. Thank you for everything you do to educate us! Much appreciated!
i was diagnosed with afvanced prostate cancer one year ago. i have a medicare advantage plan. my health system here in Michigan put me thru 20 radiation treatment and meds. the total cost was $180,000. my total copay was $3,000. the treatment was outstanding. im doing well
Cancer centers have financial help. I live in oklahoma. I go to OU Stephenson cancer center. I called out a application for free financial help. I'm on disability ,66. I was told Ithey never got it. Three times. They sent a paper saying they don't pay on chemo,keytruda immunotherapy. I canceled keytruda after reading how dangerous it is. Finance department freaked out. Called me that they found my application suddenly. That they will pay the 2,400.00 medicare doesn't cover on keytruda. And she took it upon herself to tell them to continue the drug. Uh no. Keytruda is 65,000.00 a session. They wanted me to take 6. Greedy. Manufacturer being sued by families for deaths. My chemo is 2,200 a session. Medicare pays all.I also get a 75.00 gift card for going to chemo . Totaling 350.00 for the year. Next February I reapply for assistance.
So glad that I found Medicare School before I started making my choices as to which programs to enroll in. It saved me from many sleepless nights and from potentially disastrous choices concerning my future healthcare. So glad that I didn't go the cheap route but took the most stable and secure route. And now that so many hospitals are no longer accepting Advantage Plans, I am definitely glad that I paid the cost to be the boss of my health.
I've had a Medicare Advantage PPO plan for seven years. My husband has had his for five years. We live in an urban area where every hospital and the majority of doctors are in network. We have never had any procedures turned down by the insurance company. My husband has a terminal illness with frequent medical intervention needed and he has never had a problem getting the care he needs. Although our MOOP this current year is $4400, he has only used about $1100 for the entire year. My usage this year is under $500. Our MOOP in 2024 goes down to $3400. We have no deductibles and our co-insurance/co-pays are extremely reasonable. He just spent three days in the hospital (got out yesterday) and his entire bill was $250. We get vision care, dental care, and more. The choice is not quite as black and white as you make it seem to be. I love my Medicare Advantage PPO.
@@juliestrauss1782 I couldn't figure out why the bill was so low and they did follow up with another bill in early February. We were billed for three days and they only took the $250 as a deposit. It is $295 a day but the hospital system we use grants a 20% discount for paying up front, so the $250 paid for the first day. We received another bill for the other two days but it did not include the discount, so it was $590. That was the entire bill. No other bills, nothing. All bills were submitted by the hospital and all were paid according to the hospital's agreement with the insurance company.
Thank you so much, Marvin, for providing these fantastic informational videos. You are so good at explaining everything clearly. Your videos are very helpful to the people who need your expertise to navigate these plan choices. I really appreciate what you do. You made this situation so much easier for me.
The 1% of rich people think of how to invest their money to increase their wealth during the recession. While 99% of struggling hard-luck people think of how to survive without food and daily necessities in the recession and the coming hyperinflation
Managing money is different from accumulating wealth, and the lack of investment education in schools may explain why people struggle to maintain their financial gains. The examples you provided are relevant, and I personally benefited from the market crisis, as I embrace challenging times while others tend to avoid them. Well, at least my advisor does too, jokingly.
I don't think I need a finance advisor. I can manage my own money and investments. I don't want to pay someone else to tell me what to do with my hard-earned cash.
That's a risky attitude, My friend. You might be missing out on some valuable opportunities and strategies that a finance advisor can offer. A finance advisor can help you plan for your short-term and long-term goals, optimize your tax situation, diversify your portfolio, and avoid costly mistakes.
I agree with You. A finance advisor can also provide you with objective and unbiased advice, especially when you are facing emotional or stressful situations. They can help you stay on track and avoid making impulsive decisions that can harm your financial future.
I used to think like you. I thought I knew enough about finance and investing to handle everything myself. But then I realized that I was spending too much time and energy on researching, analyzing, and monitoring my finances. I was also overwhelmed by the amount of information and options available. I decided to hire a finance advisor and it was one of the best decisions I ever made. They saved me a lot of time and money, and gave me peace of mind.
I got my cancer diagnosis in Nov 2019. I wasn't on medicare yet, but I maxed OOP for the 7,000$ on my health insurance within the first few weeks. biopsies, MRI, scans, bloodwork, etc even before surgery on Dec 31 2019, was already up to about 50K by the end of the year. Retail cost of cancer care is insanely expensive. Of course my MOOP reset the day after my surgery, and I hit it within the first month. I am fortunate that we were able to afford the MOOP, but wow! It's an eye opener. By the time I finished radiation in 2020 the retail costs were astounding. I was so happy to be able to switch to Medicare during 2020. I definitely chose Traditional Medicare with a G supplement.
@@les0101s When it comes to cancer treatments, it depends on the cancer and the stage of the cancer. A dear friend of mine just went through his cancer diagnosis and treatments from 12/23 to 8/24. One test to verify the biopsy results costed over 5K on employer insurance. Why, because specialized testing can only be performed at certain labs., there typically not a big discount for insurance companies. And that test was worth every penny, because it changed his treatment protocol. You see biopsy results can be suggestive results. Not every test is 100% You need other testing to confirm the staging, diagnosis and treatment that is needed.. The test was a Decipher test, and advantage plans don't cover it. They also don't cover a 2nd oncologist, the best in the country from a different state to perform over 20K out patient procedure either, as part of his protocol. His 5 weeks of radiation treatments was over 55k, but they took a lesser charge of 34K His insurance is contracted, and lesser charges are agreed upon by healthcare networks. Even though Advantage plans are now required to cover a PSMA pet scans, often times they use a lesser test in it's place, then the now considered the most modern up to date testing depending on your cancer diagnosis. It is standard for advantage plans, to use less expensive medications, and lesser procedures/surgeries first, no matter what your doctor is recommending, or ordering for you. That's one the reasons they don't allow anyone to go to the Mayo Clinic. The Mayo Clinic is a world-class medical center that offers diagnosis and treatment for complex conditions. The crazy part he has a PPO employer insurance that also requires authorizations, but yet had no trouble, quickly authorizing every expensive test ordered, and procedure that he and his 2 oncologists agreed upon. That would never happen under any Advantage plan. Advantage plans are not even required to pay the full agreed contracted payment, Healthcare providers can't force Advantage plans to pay their full contracted price. That's is why hospitals are closing in rural areas, they are losing millions in revenue a year. Health care networks have had enough as well. Essentially many advantage plans is ripping off the federal government of your money, and the healthcare networks/hospitals/doctors of their full contracted payment, and thousands upon thousands of people are stuck in the middle. I have been researching all of this for over 8 months. CMS will eventually be forced to change all of this. His insurance plan is not being dropped by any healthcare networks or hospitals like Advantage plans. Believe me when you have a cancer diagnosis, you will want the best most modern care and treatment as possible.
Marvin,you are OUSTANDING!!! I am Ptostate Cancer patient. Have Medicare A,B Plan G and a PDP plan. Excellent. Almost no out of pocket.Only monthly premium and B deducible $240 a year. Thank you Marvin.
I have an employer insurance where it is $50 for urgent care facilities and emergency rooms when not admitted. It's not an excessive charge. Excessive charge is if you happen to the find a doctor, which is less than 1% who wants to charge 15% more. Typically those doctors are not in a managed healthcare systems/hospitals Healthcare networks it's all or none, meaning they do not allow one doctor out of all their doctors to do excessive charge. Some states just won't allow it. It is not an illegal issue. A doctor also must bill you directly, so they will need to inform you of those excessive charges, You can also ask every new doctor you see if they do this. It's not a big issues as some people make it out to be. Its mainly a scare tactic to push you into am advantage plan.
you're right. protocols that heal people instead of mask symptoms and create horrible side effects that create need for more pharmaceuticals would not work for their business model. @@suzyquitno4608
Thank you for this information. I know a lot of it is the same as you have said before but you present it in meangingful ways that makes your channel shine above others.
Good information. I am undergoing treatment for Mantle Cell Lymphoma. Luckly I am still working and have excellent coverage. I am only out less the $1000 OOP. But it's not curable. Right now I am in remission, but in 7-9 years it will come back and I'll have to deal with it again. So, I doubt I'll be signing up for an MAPD plan. Just one treatment of chemo is 20k, and the immunotherapy pills are 7K a month.
Your presentations are absolutely the BEST! Please keep them coming. Your segment on cancer treatment cost was eye opening. The financial and physical toll on both the patient and family can be staggering. Personally, I think that patients with a poor prognosis should have the medical option to opt out of putting themselves and their family thru this.
@itsshepherd5618 AMA. Against Medical Advice. It's still the patient's decision. I worry about the cancer patient who doesn't want cancer treatment who cannot speak for his/herself, has no patient advocate, incapacitated in some way (inability to understand). How would medical providers handle that scenario? Give treatment so they can bill insurance (make money)?
I refuse to go into medical debt that my kids will have to take care of when I pass. I've accepted that if I get any major disease like cancer, I'll just do palliative care & hospice. Not doing surgery or chemo. Not all states go after family members for your medical debt, but I live in a state that does. I have VA medical coverage + regular Medicare A/B.
Marvin is one of two or three people who are the best at what they do online. Take it from an experienced agent, Marvin is giving sound advice and honest advice. If I were in his town, I would be at his door asking to work with his agency. Very smart and ethical in my opinion, and I have watched lots of his videos. Can't say enough about this guy and his dedication to protecting client's rights by explaining the pros and cons of both Medicare Supplement policies, (medigaps), and Medicare Advantage plans. Some of those rights run out if you miss the deadlines.
Thank you for your incredibly thoughtful and insightful feedback! It’s heartwarming to hear such praise from an experienced agent. We’re honored that you find Marvin's guidance sound, honest, and valuable, and that you recognize his dedication to empowering clients by clearly explaining both the pros and cons of Medicare Supplement and Medicare Advantage plans. Navigating the complexities of Medicare, especially with critical deadlines, is a responsibility we take seriously, and it’s wonderful to hear that Marvin's efforts resonate so strongly with you. Thank you for your trust, appreciation, and for taking the time to share your perspective. Your kind words mean so much!
I didn't have a choice if I wanted Medicare. I'm 62 and on disability (symptomatic, will never get better, doc said just don't make it worse). I could not get a supplement, but I got an Advantage PPO plan with 0 cost (still pay $174 to Medicare). Deductible is less than my Marketplace plan, copays are less, and I would have been paying a $302 monthly premium. Until I turn 65, this is the best option.
I had Blue Cross Blue Shield Advantage Plan and they totally paid for heart attack, subsequent stroke, two months in a nursing home and two months of home rehabilitation. I paid 300.00 out of pocket!
Cancer is really expensive. I was diagnosed with an incurable, but treatable form of Leukemia on my 65th birthday. Because of that diagnosis I signed up for traditional Medicare plus an F supplement. My first treatment cost about $250K, my supplement paid about $45K and I paid $0.00. There were no authorizations of any kind required. Since my leukemia has no cure, I am looking at being treated again in 4 to 5 years, which will cost at least as much as my first treatment and maybe much more. I am very glad that I don't have to worry about MOOPs, networks or pre authorizations.
I'm on Medicare and was diagnosed with NHL large B cell in 2017. I had large tumors growing all over my body. I had no idea it was cancer. All I knew is I was in so much pain. It got to the point I had to stop driving because my reaction time was almost zero. I went into have one of the large tumors removed and biopsied and found out it was cancer. The oncologist told me it was treatable. He recommended I go through at least 4 months of chemo and radiation and then go from there. I was in so much pain and was weak, I couldn't walk anymore. I knew if I went through chemo and radiation I wouldn't survive. In 2019 I started taking a dietary supplement and 2 months later the tumors were gone. Nothing left of them now except the indentations on my skin where they used to be. I've been in complete remission ever since. the pain subsided and disappeared. I feel young again. The dandelion root supplements saved me from losing everything, even my life. Thank you God Almighty!
I took plan F when I went on Medicare. It is expensive monthly for a healthy person however, I have had two broken bone experiences, one required surgery. I never paid a dime other than for a prescription. It always pays all of any labs I have needed I have recently received a positive color guard test and after watching your post- I am so happy I never went with advantage plans. I had heard from hospice nurses that advantage plans don't cover many needed services if nursing care is needed short term and a lot is denied. Thank you for your honest and clear approach to Medicare plans!
I'm a hospital case manager. People get so upset when they find out their Advantage Plan won't pay for their hospitalization because they didn't have a high enough temperature, or didn't take 2 injectable pain meds in 12 hours. Or they don't have a code so it doesn't exist. Won't approve skilled facility for themselves or a family member after orthopedic surgery, or a large wound, or so weak they can't get out of bed, but not eligible for staying in an acute hospital because their white blood cell count dropped last night, or the surgery was deemed outpatient regardless of comorbidities or age. The fact no one is there to see that there's food, or care is "not their problem." . Or won't pay for a $700 critical anticoagulant, or the right insulin. One man with UHC waited months for approval for a chemotherapy and it was too late. It had spread throughout his body.
Yet, the US government condones Advantage plans with their goal of putting every Medicare beneficiary into a managed care system by the year 2030. It scares the hell out of me.
@@robertmccully2792 She's a hospital case manager, not an insurance agent, and has to deal with whatever plan the patient has. At this time (when services are needed), it's too late to inform a patient about options.
@@robertmccully2792Mr Mozart is right - don’t kill the messenger, so to speak. The messenger or the hospital case manager is just telling us how these Medicare Advantage Plans are doing the best they can Not to pay, so they nit pick and cite reasons why the poor patient cannot get her chemo in time, for example.
Wish you would talk about these "Corporate Sponsored" Medicare Brokers that large companies partner with when their employees retire and these Partner Brokers pay a monthly "Reimbursement" to the retiree if they choose a plan from this broker... like VIA Benefits. This would be MOST informational to those MILLIONS of retirees that fall for this Advantage Plan push.
I was diagnosed with stage 3 breast cancer about 18 months after I went on Medicare. Having worked in medicine, I knew I wanted a plan G supplement so I could choose any doctor, so that piece was already in place. Yes, there are more up front costs, and if you stay healthy, you could get away with spending less. But my costs when I was diagnosed and treated were minimal--the $200+ deductible for year and a few medications not fully covered. My current status is "no evidence of disease," but the follow up studies are still in the thousands each year, with me paying the deductible only.
Excellent! Great advice and I understood everything..... Now all I have to do is NOT get cancer for another year! That is when I plan on starting Medicare Parts B and D.
I have a “Medicare Advantage” plan as a retired person of LOW income in California (Medi-Medi). I have an ADVANCED case of skin cancer . There’s a cyst on my jaw and a little hard nodule on it. Was scheduled for removal and lab analysis a year ago, but that was cancelled, because I was turning 65 (but still 64) and a pushy Medicare private contractor told me I had to get enrolled in a Medicare Advantage plan. The Medicare enrollment was screwed up and so no analysis of my cyst. And so I went to a dermatologist and got 5-Fluorouracil cream for “solar keratosis” spots. The cream took care of the spots. I did not see the dermatologist again. A year later I found more solar keratosis spots, on my arms, face, and neck. Treated those. But the cream is revealing skin cancer - no diagnosis of skin cancer yet. Can I still get switched from the Medicare Advantage plan I have to a straight Medicare plan?
It's definitely worth a shot, you will likely have to go through medical underwriting. We would be happy to help, you can contact our office at 800-864-8890!
I have United Health Care. I had cancer and all was covered. Im lucky to be able to continue with this plan. No copays even with specialists. Im very lucky and my agent very smart to have sugested this plan years ago.😊
Would a HMO drop a patient if the patient went outside the HMO network to get a 2nd opinion and bloodwork? Why are HMOs paid less than PPOs? Who approves medical underwriting for the states that require it?
You wouldn't be dropped from the plan. You would just be responsible for the bill since you left the network. They are paid less due to the smaller networks with those plans. Each carrier has underwriters, they review all applications and review them based on how you answered the questions.
Thank you for this video. I have had cancer this past yesterday and went through chemo etc. Was so worried which plan to take. It is a mo brainer now. Thanks again for the info. 🎉
Thank you, Staying on Plan G ....it's a no brainer decision for me. I have had issues before (prior to Medicare years) with HMO and PPO not working with doctors of my choice and always costing more.
You don't have to take part b if you have " creditable coverage" thru your employer. Please note this doesn't mean COBRA but active employer coverage. Once you leave/retire you can enroll for part b because you would no longer have that coverage.
As long as your employer has more than 20 employees yes you can. This means that it would be creditable coverage. If you have any questions about that you can give us a call at 800-864-8890.
You mentioned that there's a $50 co-pay for emergency room visits under supplement plan N. I believe this co-pay is only due if you are NOT admitted to the hospital after the ER visit.
@@Michael-o8k7g you should talk to my brother who lives in Canada about that. You may wait a year or more to get at the top of the list to get your desired surgery. It’s horrible. Here you can get your needed care immediately. I would never want socialized medicine.
I was treated for leukemia 6 years ago. I had 8 treatments over a six month period that cost about $30,000 per treatment. My leukemia does not have a cure and it is coming back. I expect to be in treatment again in a year or two. Treatment is more expensive now and will last about a year with a total cost of around $600,000 if there are no complications. I was diagnosed with leukemia when I was 64, which is why I have an F supplement.
Cancer insurance and hospital indemnity insurance take care of some of the problem with MA plans but doesn’t fix the 70-75% of procedures or tests that need preauthorization from the MA companies. No thank you.
@@mey7579 you do realize that if Medicare doesn't approve the procedure you Supplement won't pay either, right? Also, PA only applies to non-emergency procedures. You've been scared into thinking that spending more is giving you something better that it isn't.
@@-Frost-- I’m well aware that the supplement only pays if Medicare does. You do realize that if your “for profit” MAP denies the care your doctor thinks you should have, you don’t get the care. Scared into what? I don’t want an insurance company dictating my care rather than my doctor. Sounds like you’re not as well versed about this as you think you are, while presuming others aren’t well versed. PA applies to most non emergency procedures such as knee replacements, hip replacements, skilled nursing rehab, and most other non urgent care, which is most of healthcare! Again, I don’t want an insurance company telling me I have to follow their medical advice or they won’t cover it. And if you did your homework you’d realize that paying a monthly premium leaves you with no surprises as to what is covered. Right now I get a $4200 a month treatment, most likely until I die, of which I pay nothing. Medicare approved it and the supplement is now paying $850 a month for it. If I had a MAP, the outcome wouldn’t be as favorable for me I’m sure, not with the deductibles, copays, and coinsurance those plans charge their customers. Do you work for an MAP by any chance, because the last person who tried to tout MAP benefits to me and disparage supplement plans was a broker, who gets a hefty commission from selling them. No thank you.
@@mey7579 I represent both options and I am very well versed in this topic, wether you choose to believe that or not. At this point you are convinced of your opinion and no matter what anyone says it will not make a difference anyway. I believe that both options can be suitable depending on the individual situation. You seem to accuse agents that sell MA based on commissions, yet I'm not sure you fully understand exactly how those commissions work. I could probably prove to you how you'd be saving money with an MA plan, but as I said it wouldn't make any difference as you seem to have already made up your mind. There's a good saying for this that goes something like..."a man convinced against his will, is of the same opinion still." The bottom line is that, no matter what evidence of facts, anyone could provide to you, it wouldn't matter. I'm glad you're happy with your current plan and that it's working well for you so far. But don't be an ostrich with your head stuck in the sand either.
Please do a comparison on the Georgia State Health Benefit Advantage Plans versus regular Medicare. I will be a GA TRS retiree with the option to participate in our SHBP Advantage Plan.
Sorry, I had a good friend that had two operations to remove cancer from her lungs. Each of them is was around $250.00us. She also had two hip replacements and just got over a shoulder replacement. I don't think she paid out a $1,000.00us for all of it. Yes, she on the advantage plan in california.
The odds are better to get treatment covered with traditional Medicare vs Medicare advantage. While Medicare advantage worked out for your friend, it does not work out for the majority of seniors who are unable to advocate for themselves while extremely ill.
@@dentalperson7090 Most of those I talk with take medicare part C or advantage. The reason behind them picking it. Is the cost. They can afford the $165.00 per month. With the others plans costing way more.
My agent said 90% of the state were on one Advantage Plan.. So we went with that. Don't know how knowledgeable he was. But, I went to the emergency room twice in 7 years and it cost me nothing. My wife had a stroke last year. Ambulance, air flight, and three days in the hospital and it cost us nothing. I do have secondary insurance. My wife's biggest complalnt is paying for Restasis and NP thyroid. She can't take levythyroxine. But, all in all, no complaints.
In 2024, I had a C (MA) plan that had $0 copays for specialists too, including physical therapy. I had joint replacement surgery and only paid a total of $300 for the year for 1 night in the hospital and the CT scan. For 2025, MA plans are cutting their extras. So I am switching to another one that has $45 copays for specialists, but they refund the $174.20 per month. Since I don't expect to have anything serious this year, I am hoping to stay ahead by having few specialist visits. Almost everyone in my area accepts Cigna MA so I should be fine next year. I have been on MA for several years and have never been denied care that my doctors recommended. That has included 2 joint replacements over the past 4 years.
@@karenkoe7096 The Presenter covers them at approximately 8:27. All of these have monthly premiums that vary by your place of residence (zip code). Plan F covers 6/6 gaps (only available to those born before January 1,1955 or started Medicare before January 1, 2020). Plan G 5/6 gaps (you pay the Part B Deductible currently $240/annually). Plan N 4/6 gaps (you pay the Part B Deductible of $240/annual AND Excess charges (variable) charged by you Doctor). What will happen in the years to come, a Medigap plan that covers only 1/6 gaps or 0/6 gaps and still have to pay monthly premiums.
@@karenkoe7096I think they’ve confused medigap plans with the Medicare part B deductible which the government doesn’t allow the medigap plans to cover unless you’re grandfathered into medigap plan F. The government does allow the Medicare Advantage plans to waive the part B deductible.
Medicare was developed just for medical issues, there are no "Medicare dentists". You can buy standalone dental and vision plans, or some Medical Advantage plans cover them.
I'm surprised at the number of Seniors Who are fighting FIGHTING Cancer... I'm 77 and in good health today... Told my Doc...NO HEROICS I'll live till I cant...but I'm NOT SPENDING MY FINAL DAYS BROKE AND DEFEATED
I remember a show on Advantage in plans.. one rural hospital had to sign 80 different Advantage plan contracts on what is covered. Every dollar spent on administration doesn't go to care! This country needs to rip healthcare from stockholdrrs and get national health care.. stabilize the industry, encourage med schools, replace retiring physicians. Smart countries have it!
I have been on disability for a little over a year. I turned 65 in Jan 2024. I got Medicare A & B with a supplement plan. I just got approved for Medi-cal (Medicaid) full coverage on 03/01/2024 so I have to drop my supplement plan. If a couple years down the road I no longer qualify for medi-cal, can I get a supplement plan again without underwriting.
I'm in NY, and the premium fees mentioned are very low. G plan in NY is 324 and 261 for the N Plan for 2025. It's crazy expensive. In a future video, I would appreciate if you would use New York premiums so that people can get an idea of what we are really dealing with in various parts of the country. I literally have one drug plan that can sort of work for me out of only 12 choices. I would like to hear a discussion of about approximately how much the supplemental plans and the drug plans go up every year because I don't know if in 1, 2, 3 years from now, I will be able to afford it at all
Yes, and they don’t talk about it enough. It’s the most common pre authorization people are likely to run into. I suspect no one talks about it because it doesn’t matter if you have a Medicare advantage plan or traditional Medicare with a D plan you will still have pre authorizations for drugs.
😮😮My disabled husband (62) is a very expensive patient. He exceeds $100,000 every year. We have a Medicare Advantage plan thru my state gov retirement benefits. The most money we have spent for him is $3150 per year which is primarily drug costs. Is this because it is a group employer plan?
Got diagnosed with an very aggressive,high risk form of prostate cancer at 58,thanks that i am a veteran and was able to use the VA for treatment.Cost so far has been $432k. Without the VA i would have been ruined financially and most likely not been able to get life saving treatment.Those who are younger than 65 and not veterans have very little hope of making it.
I am a metastatic cancer patient on traditional Medicare, With chemo and Immunotherapy treatment at Mayo Clinic every 3 weeks. Over one year now. So glad not to be on an Advantage plan.
Hmmm - My health insurance plan calls for a straight $300 deductible each year and then a $700 deductible scaled to 10% of the bill until used up (after $7000). After that, ALL costs for outpatient care are covered. In-patient, all are covered except a $15/day solidarity charge. And that continues until the end of the calendar year, where the deductibles start again until "paid off". So no matter what comes, the most I pay out of pocket is $1000/year plus $15/day if in hospital care. The "gotcha" - I live in Switzerland and not in the health care undeveloped country the USA. Don't come at me with the high cost of health insurance here. You have to factor in the higher income, even in my case, the higher pension plan "income". But more important, if someone for whatever reason, cannot afford health care insurance, there are governmental programs on the Kantonal and Federal level to subsidise this insurance, after the motto "No one must go without". THAT'S the big difference. IOW - we actually get value for money here, be that for health insurance or for our taxes (which amongst other things, go to pay for these subsidies).
@@JoeCooper-b4t somewhere around 25% of the total Swiss poopulation has what is called a "migration background". I myself am an immigrant from the US. But we have volunteered to help refugees from Iraq and Syria get acclimatised to life here, learn German, find their way through the beauracracy, get settled. Although we volunteered to put up Ukrainian refugees, we weren't assigned any, maybe because we live in the country, not in an interesting place. But a friend of the family put a whole family up in his house with him in the Friebourg area. But what are you looking to find out? How high our crime situation has gone due to immigrants? Static. Not totally crime free, but it never was. Gun crime is still virtually non-existent. Muggings and rapes not increased and the same proportion of Swiss muggers/rapists as before. You want to hear about how the schools are collapsing? Well, we are retired teachers and know quite a few. Yes, taking in a goodly number of refugees who don't speak the language presents it's challenges for teachers, but as a general rule, the refugee kids acclimate themselves ver quickly, usually catching up to their Swiss classmates within a few years. Kids learn languages very quickly. What other negative points are you fishing for?
I have a Medicare advantage and pay 171.00 a month for my husband and I both. So we pay for Medicare and the premium - where are these FREE premiums coming from?
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Great information as always. Can you please do one on strokes and long term care? Grandfather had couple of major ones before passing and father suffered over a decade with mini strokes and TIAs.
BONUS! At the end of 2024 the Postal Service will be adopting a split insurance plan that includes Medicare coverage for all employees plus something from providers. There’s no solid information yet but it would be a big help if you could explain it when it comes down to the wire.
Your link is not opening.....
I will be on traditional Medicare this January after using an Advantage plan for 5 years. The Advantage plan was OK, but I'm healthy. Why did I change? My wife. She is still on work insurance (not Medicare age) and very surprisingly developed a very rare and very serious cancer. We had to move from system to system just to find a doctor(s) who felt that they could treat her. We finally wound up at a university center. She had a 7 hour surgery that involved 6 physicians, including two department chairs. She spent almost a month in the hospital, and had to have 8 weeks of very specialized radiation treatment. At this time our quick estimate is that her total treatment cost is close to a million dollars. I can't imagine that she would have been able to get this level of service with an Advantage HMO plan. Hopefully, I will stay healthy, but I don't want to play around with my medical care so I'm leaving my Advantage plan for traditional Medicare.
You made an extremely wise decision, it could save your life some day. I'm so sorry for what has happened with your wife. It just goes to show that you never know if and when you'll need quality and timely health care.
I hope your wife will be okay.
You may not be able to change plans. You must apply and be in perfect health in your application to change plans.
We have been on an Advantage plan for 3 years, but are switching to Original Medicare with a supplement plan on Jan 1. We could not qualify for underwriting, but our MA plan benefits were reduced in some respects for 2024 and we easily qualified by that route.
I am a nurse and allowed myself to be persuaded to change to an Advantage plan 3 years ago. I want to change back to traditional Medicare but I sm concerned that I can not qualify. What benefits were reduced in you case and how do you plan to cover those areas financially?
I'm so glad that I listen to your videos and talk to you before I turned 65. I have A+B, Plan-G, Rx
You are doing a great service. Clear,concise, and grateful
There is no plan g. There's a,b,c and d. No g. You'll want a,b,and d. Plan c is just a plan tbat allows to put teo plans together. I would not do plan C, fir nothing. Stick to a,but and d. There is no g.
This is all too confusing for seniors to figure out!
That's the point. Take the money dupe the ppl.
It's horrible that anyone has to crawl through this Medicare minefield....old or young
My wife has Metastatic breast cancer. She has A&B and Plan G. Our out-of-pocket cost other than premiums are very little, considering the extent of her treatments. Had we not been told this by a Medicare professional we would've not gone this way, and it would've bankrupted us.
Thank you for the info. I am writing down what you said. I hope your wife is NED or on her way.
NO Medicare Advantage EVER!
Love your work! I did all my own research and was overwhelmed with all the various advantage plans "C." I compared everything I could find, and in the end, A,B,G,&D, we're the right way to go for me.
Advantage plans are just that….advantages for insurance companies
I disagree with that assessment, but I do think it depends on the state and what you live and any state policies with regard to managing health insurance and Medicare. My Blue Cross Medicare advantage plan has been fabulous. I can forward to pay the mid 200s per month fee. That has had minimal increases. Blue Cross page some six figures for my breast cancer care and my only out-of-pocket was my co-pays. I’m not trying to sell anybody on Medicare advantage, I’m just saying that it has worked for me. I tend to be In ordinately healthy, And then at 81, Not on any prescribed meds, nor have I been for years. Most of my drug cost are for yearly vaccines. Knock wood!
@@twittertwice You are fortunate, indeed, to be so healthy!
They are for profit???? Do not get suckered in
@@twittertwice That is great news! I'm curious....what state do you live in?
I am one of many many retired FEDERAL EMPLOYEES. Please do a spot on Medicare with FEHB!
As am I. I suggest a Medicare supplement and freezing your FEHB. You can do that by contacting the OPM. It will be cheaper than the FEHB plan. If needed, you can unfreeze your FEHB anytime.
Very much needed yes !!!
Good suggestion.
Please do a training regarding a Federal Advantage plans they are slightly different.
@@correttayoung2019 I didn't know there were Federal Advantage Plans.
Thank you for your clear and honest presentation.
A, B, D, & G I made my decision based on the education I received in part from your videos and doing a lot of homework. I was on an advantage plan and lucky for me when I received my ANOC, Humana cancelled my plan, therefore no underwriting process for me. Thank you for everything you do to educate us! Much appreciated!
So glad that we can could, and you could get the plan you wanted with no problems!
i was diagnosed with afvanced prostate cancer one year ago. i have a medicare advantage plan. my health system here in Michigan put me thru 20 radiation treatment and meds. the total cost was $180,000. my total copay was $3,000. the treatment was outstanding. im doing well
Great to hear that you are doing well and getting the care you deserve!
In Florida your cost would probably be about 100k. MA is to nobody's advantage here.
Glad youre doing well! Which plan do you have?
Cancer centers have financial help. I live in oklahoma. I go to OU Stephenson cancer center. I called out a application for free financial help. I'm on disability ,66. I was told Ithey never got it. Three times. They sent a paper saying they don't pay on chemo,keytruda immunotherapy. I canceled keytruda after reading how dangerous it is. Finance department freaked out. Called me that they found my application suddenly. That they will pay the 2,400.00 medicare doesn't cover on keytruda. And she took it upon herself to tell them to continue the drug. Uh no. Keytruda is 65,000.00 a session. They wanted me to take 6. Greedy. Manufacturer being sued by families for deaths. My chemo is 2,200 a session. Medicare pays all.I also get a 75.00 gift card for going to chemo . Totaling 350.00 for the year. Next February I reapply for assistance.
Thank you very much Marvin! Your education helped me so much in making my decision for what medicare I chose. It has been invaluable.
So glad that I found Medicare School before I started making my choices as to which programs to enroll in. It saved me from many sleepless nights and from potentially disastrous choices concerning my future healthcare. So glad that I didn't go the cheap route but took the most stable and secure route. And now that so many hospitals are no longer accepting Advantage Plans, I am definitely glad that I paid the cost to be the boss of my health.
It shouldn't be called advantage plan. It should be called disadvantage plan.
Advantage for insurer, not the insured
It's a great plan until you need to use it.
I've had a Medicare Advantage PPO plan for seven years. My husband has had his for five years. We live in an urban area where every hospital and the majority of doctors are in network. We have never had any procedures turned down by the insurance company. My husband has a terminal illness with frequent medical intervention needed and he has never had a problem getting the care he needs. Although our MOOP this current year is $4400, he has only used about $1100 for the entire year. My usage this year is under $500. Our MOOP in 2024 goes down to $3400. We have no deductibles and our co-insurance/co-pays are extremely reasonable. He just spent three days in the hospital (got out yesterday) and his entire bill was $250. We get vision care, dental care, and more. The choice is not quite as black and white as you make it seem to be. I love my Medicare Advantage PPO.
Super. You obviously have a great plan.
May I ask which MA company?
Not sure how you got the complete bill that fast.
@@juliestrauss1782 I couldn't figure out why the bill was so low and they did follow up with another bill in early February. We were billed for three days and they only took the $250 as a deposit. It is $295 a day but the hospital system we use grants a 20% discount for paying up front, so the $250 paid for the first day. We received another bill for the other two days but it did not include the discount, so it was $590. That was the entire bill. No other bills, nothing. All bills were submitted by the hospital and all were paid according to the hospital's agreement with the insurance company.
Can i ask what is the name of the insurance plan that you have? I would be interested to see if they have that plan in my zip code area?
God bless you for Honesty.I'm saying a prayer for you.Keep helping the people.
Thank you so much, Marvin, for providing these fantastic informational videos. You are so good at explaining everything clearly. Your videos are very helpful to the people who need your expertise to navigate these plan choices. I really appreciate what you do. You made this situation so much easier for me.
I work in healthcare and the advantage plans are terrible. They have not examined the patient yet the are prescribing care.
The 1% of rich people think of how to invest their money to increase their wealth during the recession. While 99% of struggling hard-luck people think of how to survive without food and daily necessities in the recession and the coming hyperinflation
Managing money is different from accumulating wealth, and the lack of investment education in schools may explain why people struggle to maintain their financial gains. The examples you provided are relevant, and I personally benefited from the market crisis, as I embrace challenging times while others tend to avoid them. Well, at least my advisor does too, jokingly.
I don't think I need a finance advisor. I can manage my own money and investments. I don't want to pay someone else to tell me what to do with my hard-earned cash.
That's a risky attitude, My friend. You might be missing out on some valuable opportunities and strategies that a finance advisor can offer. A finance advisor can help you plan for your short-term and long-term goals, optimize your tax situation, diversify your portfolio, and avoid costly mistakes.
I agree with You. A finance advisor can also provide you with objective and unbiased advice, especially when you are facing emotional or stressful situations. They can help you stay on track and avoid making impulsive decisions that can harm your financial future.
I used to think like you. I thought I knew enough about finance and investing to handle everything myself. But then I realized that I was spending too much time and energy on researching, analyzing, and monitoring my finances. I was also overwhelmed by the amount of information and options available. I decided to hire a finance advisor and it was one of the best decisions I ever made. They saved me a lot of time and money, and gave me peace of mind.
I got my cancer diagnosis in Nov 2019. I wasn't on medicare yet, but I maxed OOP for the 7,000$ on my health insurance within the first few weeks. biopsies, MRI, scans, bloodwork, etc even before surgery on Dec 31 2019, was already up to about 50K by the end of the year. Retail cost of cancer care is insanely expensive. Of course my MOOP reset the day after my surgery, and I hit it within the first month. I am fortunate that we were able to afford the MOOP, but wow! It's an eye opener. By the time I finished radiation in 2020 the retail costs were astounding. I was so happy to be able to switch to Medicare during 2020. I definitely chose Traditional Medicare with a G supplement.
Costs for medical care are definitely much higher before you go on Medicare.
@@les0101s When it comes to cancer treatments, it depends on the cancer and the stage of the cancer. A dear friend of mine just went through his cancer diagnosis and treatments from 12/23 to 8/24. One test to verify the biopsy results costed over 5K on employer insurance. Why, because specialized testing can only be performed at certain labs., there typically not a big discount for insurance companies. And that test was worth every penny, because it changed his treatment protocol. You see biopsy results can be suggestive results. Not every test is 100% You need other testing to confirm the staging, diagnosis and treatment that is needed.. The test was a Decipher test, and advantage plans don't cover it. They also don't cover a 2nd oncologist, the best in the country from a different state to perform over 20K out patient procedure either, as part of his protocol. His 5 weeks of radiation treatments was over 55k, but they took a lesser charge of 34K His insurance is contracted, and lesser charges are agreed upon by healthcare networks.
Even though Advantage plans are now required to cover a PSMA pet scans, often times they use a lesser test in it's place, then the now considered the most modern up to date testing depending on your cancer diagnosis.
It is standard for advantage plans, to use less expensive medications, and lesser procedures/surgeries first, no matter what your doctor is recommending, or ordering for you.
That's one the reasons they don't allow anyone to go to the Mayo Clinic. The Mayo Clinic is a world-class medical center that offers diagnosis and treatment for complex conditions.
The crazy part he has a PPO employer insurance that also requires authorizations, but yet had no trouble, quickly authorizing every expensive test ordered, and procedure that he and his 2 oncologists agreed upon. That would never happen under any Advantage plan.
Advantage plans are not even required to pay the full agreed contracted payment, Healthcare providers can't force Advantage plans to pay their full contracted price. That's is why hospitals are closing in rural areas, they are losing millions in revenue a year. Health care networks have had enough as well. Essentially many advantage plans is ripping off the federal government of your money, and the healthcare networks/hospitals/doctors of their full contracted payment, and thousands upon thousands of people are stuck in the middle. I have been researching all of this for over 8 months. CMS will eventually be forced to change all of this.
His insurance plan is not being dropped by any healthcare networks or hospitals like Advantage plans.
Believe me when you have a cancer diagnosis, you will want the best most modern care and treatment as possible.
Marvin,you are OUSTANDING!!! I am Ptostate Cancer patient. Have Medicare A,B Plan G and a PDP plan. Excellent. Almost no out of pocket.Only monthly premium and B deducible $240 a year. Thank you Marvin.
We're happy that you're finding success with your plan!
I would've loved to have seen this before the open enrollment period ended on Dec. 7th. I'm new to Medicare so still learning a lot. 😜
You have 90 days to change your advantage plan starting Jan 1, You can change your supplemental plan anytime.
To clarify on Plan N you only pay a $50 co-pay for emergency room if you are Not admitted to the hospital. Excess charges are illegal in some states.
I have an employer insurance where it is $50 for urgent care facilities and emergency rooms when not admitted. It's not an excessive charge. Excessive charge is if you happen to the find a doctor, which is less than 1% who wants to charge 15% more.
Typically those doctors are not in a managed healthcare systems/hospitals Healthcare networks it's all or none, meaning they do not allow one doctor out of all their doctors to do excessive charge. Some states just won't allow it. It is not an illegal issue. A doctor also must bill you directly, so they will need to inform you of those excessive charges, You can also ask every new doctor you see if they do this. It's not a big issues as some people make it out to be. Its mainly a scare tactic to push you into am advantage plan.
I would love to see a medicare plan that included covering alternative healing treatments.
Let’s get dental, vision and hearing before we start asking them to cover acupuncture, massage therapy or sticking pins in dolls.
Probably because most of these treatments are bogus.
@@captainkangaroo4301 Not likely to happen.
It would threaten big pharma too much
you're right. protocols that heal people instead of mask symptoms and create horrible side effects that create need for more pharmaceuticals would not work for their business model. @@suzyquitno4608
Thankful I have plan F!
Thank you for this information. I know a lot of it is the same as you have said before but you present it in meangingful ways that makes your channel shine above others.
Good information. I am undergoing treatment for Mantle Cell Lymphoma. Luckly I am still working and have excellent coverage. I am only out less the $1000 OOP. But it's not curable. Right now I am in remission, but in 7-9 years it will come back and I'll have to deal with it again. So, I doubt I'll be signing up for an MAPD plan. Just one treatment of chemo is 20k, and the immunotherapy pills are 7K a month.
Been on a HMO for 9 years. Best decision I made. Will only consider a change when I am in decline.
Your presentations are absolutely the BEST! Please keep them coming. Your segment on cancer treatment cost was eye opening. The financial and physical toll on both the patient and family can be staggering. Personally, I think that patients with a poor prognosis should have the medical option to opt out of putting themselves and their family thru this.
Palliative or Hospice Care.
There is a new growing company.
An alternative to traditional burial.
Recompose, a form of green burial.
Well we do. Medical people are just consultants. You’re not a child and they’re not your parent. You don’t have to follow their opinions.
@itsshepherd5618
AMA. Against Medical Advice.
It's still the patient's decision.
I worry about the cancer patient who doesn't want cancer treatment who cannot speak for his/herself, has no patient advocate, incapacitated in some way (inability to understand).
How would medical providers handle that scenario?
Give treatment so they can bill insurance (make money)?
general statement. no insurance company wants to give up their profits to do what they are paid to do!
I refuse to go into medical debt that my kids will have to take care of when I pass. I've accepted that if I get any major disease like cancer, I'll just do palliative care & hospice. Not doing surgery or chemo. Not all states go after family members for your medical debt, but I live in a state that does. I have VA medical coverage + regular Medicare A/B.
Wow. What state goes after the family? Only asking so I can cross it off my list.
Your kids would NEVER be financially liable for you medical debt.
The estate will be left to pay all the debt I think is what she is saying. So there won’t be much estate left..
Well, that depends on how your estate planning/will is set up. But your kids would never be personally responsible for paying your medical bills.
@@Julz99907 not true. Some states do allow it providers to go after family of the deceased. I live in one.
My wife and I have traditional Medicare with plan G. I would never go to advantage plans.
I’m 65 and have decisions to make by Dec. 7,. I was going to choose A,B plan G. My question is does plan G include medication?
Marvin is one of two or three people who are the best at what they do online. Take it from an experienced agent, Marvin is giving sound advice and honest advice. If I were in his town, I would be at his door asking to work with his agency. Very smart and ethical in my opinion, and I have watched lots of his videos. Can't say enough about this guy and his dedication to protecting client's rights by explaining the pros and cons of both Medicare Supplement policies, (medigaps), and Medicare Advantage plans. Some of those rights run out if you miss the deadlines.
Thank you for your incredibly thoughtful and insightful feedback! It’s heartwarming to hear such praise from an experienced agent. We’re honored that you find Marvin's guidance sound, honest, and valuable, and that you recognize his dedication to empowering clients by clearly explaining both the pros and cons of Medicare Supplement and Medicare Advantage plans. Navigating the complexities of Medicare, especially with critical deadlines, is a responsibility we take seriously, and it’s wonderful to hear that Marvin's efforts resonate so strongly with you.
Thank you for your trust, appreciation, and for taking the time to share your perspective. Your kind words mean so much!
I didn't have a choice if I wanted Medicare. I'm 62 and on disability (symptomatic, will never get better, doc said just don't make it worse). I could not get a supplement, but I got an Advantage PPO plan with 0 cost (still pay $174 to Medicare). Deductible is less than my Marketplace plan, copays are less, and I would have been paying a $302 monthly premium. Until I turn 65, this is the best option.
If you're disabled you can get a Medicare Advantage plan before you turn 65, but not regular Medicare?
I worked in a Cancer Center and When we retired I knew we did not want any Advantage plan!
I am on an Advantage PPO plan and have to keep it that way until I turn 65 since you can’t sign up for a supplemental plan due to my age.
Had a heart attack last year. Two stents and 9 day in the hospital. Fully paid with my N plan.
And how much are your annual Medical and Drug Premiums?
I had surgically removed kidney stones. Paid about
$50.00 total with 5 days in hospital . Plan N all the way.
I had Blue Cross Blue Shield Advantage Plan and they totally paid for heart attack, subsequent stroke, two months in a nursing home and two months of home rehabilitation. I paid 300.00 out of pocket!
Eye opening, thanks so much!
Can you answer me a question if the cost of living is 032% why is Medicare charge us 14% for a Medicare have the nerve to charge us that %
Medicare needs an overhaul. Greed is running rampant with the industry and congress.
Cancer is really expensive. I was diagnosed with an incurable, but treatable form of Leukemia on my 65th birthday. Because of that diagnosis I signed up for traditional Medicare plus an F supplement. My first treatment cost about $250K, my supplement paid about $45K and I paid $0.00. There were no authorizations of any kind required. Since my leukemia has no cure, I am looking at being treated again in 4 to 5 years, which will cost at least as much as my first treatment and maybe much more. I am very glad that I don't have to worry about MOOPs, networks or pre authorizations.
It's _MOORS_ !
I have had Plan F for 11 years. I have never had to pay anything out of pocket. Love this plan.
I'm on Medicare and was diagnosed with NHL large B cell in 2017. I had large tumors growing all over my body. I had no idea it was cancer. All I knew is I was in so much pain. It got to the point I had to stop driving because my reaction time was almost zero. I went into have one of the large tumors removed and biopsied and found out it was cancer. The oncologist told me it was treatable. He recommended I go through at least 4 months of chemo and radiation and then go from there. I was in so much pain and was weak, I couldn't walk anymore. I knew if I went through chemo and radiation I wouldn't survive. In 2019 I started taking a dietary supplement and 2 months later the tumors were gone. Nothing left of them now except the indentations on my skin where they used to be. I've been in complete remission ever since. the pain subsided and disappeared. I feel young again. The dandelion root supplements saved me from losing everything, even my life. Thank you God Almighty!
That is amazing!!! Which specific dandelion root supplements worked for you?
👍🏻✊🏼
I took plan F when I went on Medicare. It is expensive monthly for a healthy person however, I have had two broken bone experiences, one required surgery. I never paid a dime other than for a prescription.
It always pays all of any labs I have needed
I have recently received a positive color guard test and after watching your post- I am so happy I never went with advantage plans. I had heard from hospice nurses that advantage plans don't cover many needed services if nursing care is needed short term and a lot is denied.
Thank you for your honest and clear approach to Medicare plans!
Glad that we could help!
I'm a hospital case manager. People get so upset when they find out their Advantage Plan won't pay for their hospitalization because they didn't have a high enough temperature, or didn't take 2 injectable pain meds in 12 hours. Or they don't have a code so it doesn't exist. Won't approve skilled facility for themselves or a family member after orthopedic surgery, or a large wound, or so weak they can't get out of bed, but not eligible for staying in an acute hospital because their white blood cell count dropped last night, or the surgery was deemed outpatient regardless of comorbidities or age. The fact no one is there to see that there's food, or care is "not their problem." . Or won't pay for a $700 critical anticoagulant, or the right insulin. One man with UHC waited months for approval for a chemotherapy and it was too late. It had spread throughout his body.
Yet, the US government condones Advantage plans with their goal of putting every Medicare beneficiary into a managed care system by the year 2030. It scares the hell out of me.
Give me a break, do your job as a manager and inform them before trouble hits them.
@@robertmccully2792 She's a hospital case manager, not an insurance agent, and has to deal with whatever plan the patient has. At this time (when services are needed), it's too late to inform a patient about options.
@@robertmccully2792Mr Mozart is right - don’t kill the messenger, so to speak. The messenger or the hospital case manager is just telling us how these Medicare Advantage Plans are doing the best they can Not to pay, so they nit pick and cite reasons why the poor patient cannot get her chemo in time, for example.
Regular Medicare doesn't pay for everything either.
My cheapest N plan in Connecticut is 160. For G its 250 or more
Thank you for your honesty.
Nor as "honest" as he should be.... Lots of omissions about benefits of Advantage Plans and he lowballs the MedSupp Rates
Outstanding video on Cancer -- I learned a lot.
Glad to hear it was helpful!
Wish you would talk about these "Corporate Sponsored" Medicare Brokers that large companies partner with when their employees retire and these Partner Brokers pay a monthly "Reimbursement" to the retiree if they choose a plan from this broker... like VIA Benefits. This would be MOST informational to those MILLIONS of retirees that fall for this Advantage Plan push.
The oncology where my wife was had a banner up that read advantage plans are only an advantage while you're healthy
I was diagnosed with stage 3 breast cancer about 18 months after I went on Medicare. Having worked in medicine, I knew I wanted a plan G supplement so I could choose any doctor, so that piece was already in place. Yes, there are more up front costs, and if you stay healthy, you could get away with spending less. But my costs when I was diagnosed and treated were minimal--the $200+ deductible for year and a few medications not fully covered. My current status is "no evidence of disease," but the follow up studies are still in the thousands each year, with me paying the deductible only.
Excellent! Great advice and I understood everything.....
Now all I have to do is NOT get cancer for another year! That is when I plan on starting Medicare Parts B and D.
I don't want cancer, period.
That's for sure
I didn’t want it either but I got it
It's not a choice sweetie!
I have a “Medicare Advantage” plan as a retired person of LOW income in California (Medi-Medi). I have an ADVANCED case of skin cancer . There’s a cyst on my jaw and a little hard nodule on it. Was scheduled for removal and lab analysis a year ago, but that was cancelled, because I was turning 65 (but still 64) and a pushy Medicare private contractor told me I had to get enrolled in a Medicare Advantage plan. The Medicare enrollment was screwed up and so no analysis of my cyst. And so I went to a dermatologist and got 5-Fluorouracil cream for “solar keratosis” spots. The cream took care of the spots. I did not see the dermatologist again. A year later I found more solar keratosis spots, on my arms, face, and neck. Treated those. But the cream is revealing skin cancer - no diagnosis of skin cancer yet. Can I still get switched from the Medicare Advantage plan I have to a straight Medicare plan?
It's definitely worth a shot, you will likely have to go through medical underwriting. We would be happy to help, you can contact our office at 800-864-8890!
I have United Health Care. I had cancer and all was covered. Im lucky to be able to continue with this plan. No copays even with specialists. Im very lucky and my agent very smart to have sugested this plan years ago.😊
Its great to hear happy Medicare stories! If you have any questions in the future, feel free to call!
You say you have UHC…but they do Supplement and Advantage plans…which is it?
@@wandamarkle2642 Do you have UHC advantage plan or Medigap supplement plan ?
Thanks for all the info! I watch your videos religiously so I will know which plan to choose when I turn 65 in April.
That is awesome!
Would a HMO drop a patient if the patient went outside the HMO network to get a 2nd opinion and bloodwork?
Why are HMOs paid less than PPOs?
Who approves medical underwriting for the states that require it?
You wouldn't be dropped from the plan. You would just be responsible for the bill since you left the network. They are paid less due to the smaller networks with those plans. Each carrier has underwriters, they review all applications and review them based on how you answered the questions.
Thank you for this video. I have had cancer this past yesterday and went through chemo etc. Was so worried which plan to take. It is a mo brainer now. Thanks again for the info.
🎉
As a cancer survivor, I know it may come back. After seeing the cost before I was on Medicare. I didn’t even consider an advantage plan.
As always good information
Thank you, Staying on Plan G ....it's a no brainer decision for me. I have had issues before (prior to Medicare years) with HMO and PPO not working with doctors of my choice and always costing more.
That is great to hear, we are always here to help!
I'm 62. Once I reach 65 can I keep my insurance with my job long as I'm working full time? Just don't trust any government insurance period.
You don't have to take part b if you have " creditable coverage" thru your employer. Please note this doesn't mean COBRA but active employer coverage. Once you leave/retire you can enroll for part b because you would no longer have that coverage.
As long as your employer has more than 20 employees yes you can. This means that it would be creditable coverage. If you have any questions about that you can give us a call at 800-864-8890.
Thanks again for your "seminars"!
I like this because this is very detailed. Understandable. Thank you
You mentioned that there's a $50 co-pay for emergency room visits under supplement plan N. I believe this co-pay is only due if you are NOT admitted to the hospital after the ER visit.
Correct
We need socialized medical for all. It's the Christian thing to do.
@@Michael-o8k7g you should talk to my brother who lives in Canada about that. You may wait a year or more to get at the top of the list to get your desired surgery. It’s horrible. Here you can get your needed care immediately. I would never want socialized medicine.
Yes on plan N Excess charges are mainly with mental health doctors
Excellent information. Well presented.
Glad it was helpful!
I was treated for leukemia 6 years ago. I had 8 treatments over a six month period that cost about $30,000 per treatment. My leukemia does not have a cure and it is coming back. I expect to be in treatment again in a year or two. Treatment is more expensive now and will last about a year with a total cost of around $600,000 if there are no complications. I was diagnosed with leukemia when I was 64, which is why I have an F supplement.
So sorry to hear that it is returning, we are happy to hear that you get the treatment you need with no trouble!
@@MedicareSchool Thanks for the good wishes. My leukemia has no cure, but it can be treated. Consequently, I knew it would come back.
Excellent information. Thanks!
Excellent, thank you
Thank you for this valuable Medicare information.
Glad it was helpful!
Two words. Hospital indemnity. Takes care of almost all of those out of pocket expenses you mentioned with advantage plans.
Cancer insurance and hospital indemnity insurance take care of some of the problem with MA plans but doesn’t fix the 70-75% of procedures or tests that need preauthorization from the MA companies. No thank you.
@@mey7579 you do realize that if Medicare doesn't approve the procedure you Supplement won't pay either, right? Also, PA only applies to non-emergency procedures. You've been scared into thinking that spending more is giving you something better that it isn't.
@@-Frost-- I’m well aware that the supplement only pays if Medicare does. You do realize that if your “for profit” MAP denies the care your doctor thinks you should have, you don’t get the care. Scared into what? I don’t want an insurance company dictating my care rather than my doctor. Sounds like you’re not as well versed about this as you think you are, while presuming others aren’t well versed. PA applies to most non emergency procedures such as knee replacements, hip replacements, skilled nursing rehab, and most other non urgent care, which is most of healthcare! Again, I don’t want an insurance company telling me I have to follow their medical advice or they won’t cover it. And if you did your homework you’d realize that paying a monthly premium leaves you with no surprises as to what is covered. Right now I get a $4200 a month treatment, most likely until I die, of which I pay nothing. Medicare approved it and the supplement is now paying $850 a month for it. If I had a MAP, the outcome wouldn’t be as favorable for me I’m sure, not with the deductibles, copays, and coinsurance those plans charge their customers. Do you work for an MAP by any chance, because the last person who tried to tout MAP benefits to me and disparage supplement plans was a broker, who gets a hefty commission from selling them. No thank you.
@@mey7579 I represent both options and I am very well versed in this topic, wether you choose to believe that or not. At this point you are convinced of your opinion and no matter what anyone says it will not make a difference anyway. I believe that both options can be suitable depending on the individual situation. You seem to accuse agents that sell MA based on commissions, yet I'm not sure you fully understand exactly how those commissions work. I could probably prove to you how you'd be saving money with an MA plan, but as I said it wouldn't make any difference as you seem to have already made up your mind. There's a good saying for this that goes something like..."a man convinced against his will, is of the same opinion still." The bottom line is that, no matter what evidence of facts, anyone could provide to you, it wouldn't matter. I'm glad you're happy with your current plan and that it's working well for you so far. But don't be an ostrich with your head stuck in the sand either.
Please do a comparison on the Georgia State Health Benefit Advantage Plans versus regular Medicare. I will be a GA TRS retiree with the option to participate in our SHBP Advantage Plan.
Sorry, I had a good friend that had two operations to remove cancer from her lungs. Each of them is was around $250.00us. She also had two hip replacements and just got over a shoulder replacement. I don't think she paid out a $1,000.00us for all of it. Yes, she on the advantage plan in california.
Yea. He's "Anti-Advantage" and a big Fear-monger
The odds are better to get treatment covered with traditional Medicare vs Medicare advantage. While Medicare advantage worked out for your friend, it does not work out for the majority of seniors who are unable to advocate for themselves while extremely ill.
@@dentalperson7090 Most of those I talk with take medicare part C or advantage. The reason behind them picking it. Is the cost. They can afford the $165.00 per month. With the others plans costing way more.
This is very well explained and helpful. Thank you.
Glad it was helpful!
Thank you for explaining this.
Glad it was helpful!
My agent said 90% of the state were on one Advantage Plan.. So we went with that. Don't know how knowledgeable he was. But, I went to the emergency room twice in 7 years and it cost me nothing. My wife had a stroke last year. Ambulance, air flight, and three days in the hospital and it cost us nothing. I do have secondary insurance. My wife's biggest complalnt is paying for Restasis and NP thyroid. She can't take levythyroxine. But, all in all, no complaints.
In 2024, I had a C (MA) plan that had $0 copays for specialists too, including physical therapy. I had joint replacement surgery and only paid a total of $300 for the year for 1 night in the hospital and the CT scan.
For 2025, MA plans are cutting their extras. So I am switching to another one that has $45 copays for specialists, but they refund the $174.20 per month. Since I don't expect to have anything serious this year, I am hoping to stay ahead by having few specialist visits. Almost everyone in my area accepts Cigna MA so I should be fine next year.
I have been on MA for several years and have never been denied care that my doctors recommended. That has included 2 joint replacements over the past 4 years.
That’s great to hear you found a plan that works for you!
It seems like as time goes on the Medigap plans have more and more gaps in them coupled with a higher cost.
Explain what exactly besides cost has changed with the Medigap plans?
@@karenkoe7096 The Presenter covers them at approximately 8:27.
All of these have monthly premiums that vary by your place of residence (zip code).
Plan F covers 6/6 gaps (only available to those born before January 1,1955 or started Medicare before January 1, 2020).
Plan G 5/6 gaps (you pay the Part B Deductible currently $240/annually).
Plan N 4/6 gaps (you pay the Part B Deductible of $240/annual AND Excess charges (variable) charged by you Doctor).
What will happen in the years to come, a Medigap plan that covers only 1/6 gaps or 0/6 gaps and still have to pay monthly premiums.
@@zombieapocalypse3837 All of that has been in place for years.
@@karenkoe7096I think they’ve confused medigap plans with the Medicare part B deductible which the government doesn’t allow the medigap plans to cover unless you’re grandfathered into medigap plan F. The government does allow the Medicare Advantage plans to waive the part B deductible.
In my area, seems that the dental industry doesn't take Medicare.
Medicare was developed just for medical issues, there are no "Medicare dentists". You can buy standalone dental and vision plans, or some Medical Advantage plans cover them.
Yes, I do have those, even though they are the "High" plans, they don't cover much.
Thank you.
I'm surprised at the number of Seniors
Who are fighting FIGHTING Cancer...
I'm 77 and in good health today...
Told my Doc...NO HEROICS
I'll live till I cant...but I'm NOT SPENDING MY FINAL DAYS
BROKE AND DEFEATED
I remember a show on Advantage in plans.. one rural hospital had to sign 80 different Advantage plan contracts on what is covered. Every dollar spent on administration doesn't go to care! This country needs to rip healthcare from stockholdrrs and get national health care.. stabilize the industry, encourage med schools, replace retiring physicians.
Smart countries have it!
Thank you for your honesty 👌👍🙏
It is our pleasure!
I have been on disability for a little over a year. I turned 65 in Jan 2024. I got Medicare A & B with a supplement plan. I just got approved for Medi-cal (Medicaid) full coverage on 03/01/2024 so I have to drop my supplement plan. If a couple years down the road I no longer qualify for medi-cal, can I get a supplement plan again without underwriting.
I'm in NY, and the premium fees mentioned are very low. G plan in NY is 324 and 261 for the N Plan for 2025. It's crazy expensive. In a future video, I would appreciate if you would use New York premiums so that people can get an idea of what we are really dealing with in various parts of the country. I literally have one drug plan that can sort of work for me out of only 12 choices. I would like to hear a discussion of about approximately how much the supplemental plans and the drug plans go up every year because I don't know if in 1, 2, 3 years from now, I will be able to afford it at all
I'd like to see a video geared towards the disabled on Medicare under the retirement age. They can't get a plan G,N etc.
We do have an video like this, you can watch here th-cam.com/video/hTwF6ME9oeM/w-d-xo.html
Thanks. My decision is easy now.
Glad that we could help, if you have any questions just give us a call at 800-864-8890.
The sad part is many people don't know they are looking at cancer down the road when they sign up at the end of the year...
There are Pre Auths required for medications on supplemental drug insurance
That is ridiculous 😒 People in a business setting making decisions about our health. If the Dr says we need it, give it to us!
@lindathurmond3891 Exactly. For that matter get know- nothing non medical people out of the doctor- patient relationship.
Yes, and they don’t talk about it enough. It’s the most common pre authorization people are likely to run into. I suspect no one talks about it because it doesn’t matter if you have a Medicare advantage plan or traditional Medicare with a D plan you will still have pre authorizations for drugs.
Which is why I’m trying to get my act together on what I eat/drink, and I am growing medicinal herbs for different uses.
@@gracebe235 Go carnivore, save yourself :O)
Who and what do we need to communicate in rwference social security when diagnosed with cancer?
😮😮My disabled husband (62) is a very expensive patient. He exceeds $100,000 every year. We have a Medicare Advantage plan thru my state gov retirement benefits. The most money we have spent for him is $3150 per year which is primarily drug costs. Is this because it is a group employer plan?
Yes it could be that they offer more coverage than other advantage plans. But that is wonderful to hear!
As an HR /benefits pro I would say yes. Group advantage plans are different from the open market ones. Take care
Got diagnosed with an very aggressive,high risk form of prostate cancer at 58,thanks that i am a veteran and was able to use the VA for treatment.Cost so far has been $432k. Without the VA i would have been ruined financially and most likely not been able to get life saving treatment.Those who are younger than 65 and not veterans have very little hope of making it.
If you had regular Health Insurance- you wouldn't have been "ruined"
This is Great Information!
Glad it was helpful!
I am a metastatic cancer patient on traditional Medicare, With chemo and Immunotherapy treatment at Mayo Clinic every 3 weeks. Over one year now. So glad not to be on an Advantage plan.
Thank you 🙏🏼
You’re welcome 😊
Are these sr types of cancer prioritized by most to least diagnosed??
So with colorectal cancer my bills have been $35,000 per month for 2 years now.
Hmmm - My health insurance plan calls for a straight $300 deductible each year and then a $700 deductible scaled to 10% of the bill until used up (after $7000). After that, ALL costs for outpatient care are covered. In-patient, all are covered except a $15/day solidarity charge. And that continues until the end of the calendar year, where the deductibles start again until "paid off". So no matter what comes, the most I pay out of pocket is $1000/year plus $15/day if in hospital care.
The "gotcha" - I live in Switzerland and not in the health care undeveloped country the USA. Don't come at me with the high cost of health insurance here. You have to factor in the higher income, even in my case, the higher pension plan "income". But more important, if someone for whatever reason, cannot afford health care insurance, there are governmental programs on the Kantonal and Federal level to subsidise this insurance, after the motto "No one must go without". THAT'S the big difference. IOW - we actually get value for money here, be that for health insurance or for our taxes (which amongst other things, go to pay for these subsidies).
And on top of that, you live in a beautiful country! I would love to visit.
How's the migrant situation there these days?
@@JoeCooper-b4t somewhere around 25% of the total Swiss poopulation has what is called a "migration background". I myself am an immigrant from the US. But we have volunteered to help refugees from Iraq and Syria get acclimatised to life here, learn German, find their way through the beauracracy, get settled. Although we volunteered to put up Ukrainian refugees, we weren't assigned any, maybe because we live in the country, not in an interesting place. But a friend of the family put a whole family up in his house with him in the Friebourg area.
But what are you looking to find out? How high our crime situation has gone due to immigrants? Static. Not totally crime free, but it never was. Gun crime is still virtually non-existent. Muggings and rapes not increased and the same proportion of Swiss muggers/rapists as before. You want to hear about how the schools are collapsing? Well, we are retired teachers and know quite a few. Yes, taking in a goodly number of refugees who don't speak the language presents it's challenges for teachers, but as a general rule, the refugee kids acclimate themselves ver quickly, usually catching up to their Swiss classmates within a few years. Kids learn languages very quickly.
What other negative points are you fishing for?
I have a Medicare advantage and pay 171.00 a month for my husband and I both. So we pay for Medicare and the premium - where are these FREE premiums coming from?
Most advantage plans are free no premiums. What kind of plan do you have?
@@MedicareSchool I have Humana Medicare Employer PPO with prescription drug coverage. I live in the state of NY