📌Get your free Medicare Advantage vs. Medigap guide: boomerbenefits.com/medicare-advantage-vs-medigap-guide/ 📌Join our exclusive Medicare Q&A Facebook group to have your questions answered by Danielle and her team: facebook.com/groups/BoomerBenefits 📌New to Medicare? Attend our FREE Medicare 101 Webinar: boomerbenefits.com/medicare-101-webinar/
I have been in the insurance world since 1998.I have trained hundreds of agents.I have to admit this lady is the most knowledgeable agent.If I was not in the industry I would buy from her.
Very clear and comprehensive comparison of Medicare Advantage and Medigap plans. I think the presentation was extremely fair to both plans. I think most people could benefit from watching this video at least two times. My takeaway is that Medigap plans are the best approach if you can afford it, but Medicare Advantage plans can still give very good coverage if you can't afford Medigap. Superb job. Incredibly helpful. You provide a very useful service. You are a very good teacher.
Those TV ads are all trying to get seniors to sign over their Medicare to for-profit insurance companies so they make a profit then ‘manage’ what healthcare you can get. Medicare proper doesn’t do TV ads.
Wow...wow...wow !!!! Should have studied these at age 25 and not 65 !!! Such confusion and feel like going to school to study it's complications. I'm 69, beginning to use its benefits....boy oh boy...tough to Wrap my brain around it. THANK YOU FOR SHARING THE INFORMATION. GREATLY APPRECIATED.
You're very welcome! Be sure to subscribe to our channel to stay up to date with all Medicare info! If you're a client of ours, don't hesitate to give us a call if you have any questions or concerns!
I recently worked in a hospital; advantage plans always denied their members to go to acute rehabilitation, even if the attending MD thought it was the most appropriate level. They would only approve nursing homes, and only a few days. All discharge planners where I worked dreaded making referrals for patients on advantage plans because of tiling approval process (closed on weekends) and the frequent denials. Then, the patients a f families could not understand why the delay. It was their crappy insurance that they were conned into taking. They never knew the down side because the insurance states they cover everything that Medicare covers (lie). That has been my observation. I recommend to my family and friends to stay with traditional Medicare with a supplement.
I'm turning 65 in January 2022. I am disabled so I've been on Medicare for a few years. I currently am in a Medicare advantage plan. My income is very low. I only get $840/MO so what is the best f way for me to go? My one time open enrollment chance will end I believe three months after my 65th birthday. Am I correct? I need a plan that gives me the best coverage with the least out of pocket. I'm so confused.
@CatLady I live in Missouri. I've tried applying for medicaid along with my social Security disability but becausrbim married and they go by both of our incomes i dont qualify for SNAP benefits or medicaid, except medicaid does help with a small portion of my prescription costs. That's the only help I get. My husband is also disabled and our combined monthly income is under $1700. By the time we pay our rent and utilities and other monthly bills. We have less than $200 for food, gas, prescriptions, and doctors office copays. It's getting harder and harder. We have to depend on local food pantries if we want to eat. Somebody really needs to do something to fix our country. I don't care if it's the Democrats or the Republicans. Jystvas Ling as SOMEBODY does something. We senior citizens who worked our entire lives ( I've worked since I was 14) and now because we are older and have disabilities we are forgotten about and they've made it impossible for us to get any help. Yet they talk about helping people pouring into our country from other countries. What about the loyal Anetican people who were born and raised here and worked all their lives and paid their dues?
As I understand it, a switch from traditional Medicare + supplement (mine is Plan G) to any Advantage plan is a downgrade, so is always possible. But a switch from Advantage back to traditional Medicare + a supplement is an upgrade, which subjects people to medical underwriting. Be careful what your original choice is, upon first eligibility, because downgrading to Advantage is pretty easy, but upgrading to Medicare + a supplement (MegiGap) can be difficult and expensive.
This is a great explanation of Medicare Advantage. Most channels I see covering Medicare mostly talk about the medigap plans only vaguely mentioning the Advantage in a negative fashion. That said I have trouble understanding how people don’t understand the hmo/ppo aspects of the Advantage plans. Most employer provided insurance are hmo/ppo. Co pays, out of pocket expenses, co insurance and prior approval requirements can’t be a surprise to most people.
Brilliant and professional analysis in every way. The delivery was so congenial, that even this boring subject matter seemed lively and interesting. Thank you!
You explain the pros and cons very articulately. You mentioned prior authorization delays, however, but did not discuss denials. Not all treatment is approved.
The best Medicare in my area is Kaiser's Advantage plan, not just because it saves a huge amount of money, but rather because it is an integrated system where things don't fall through the cracks and the staff are all direct employees so there is no fee-for-service care, nobody is incentivized to perform unnecessary procedures or office visits and a lot of stuff can be handled online. As a retired physician who spent over 40 years in health care, they get my vote.
I will retire at the end of the year and still need to sign up for part B. I’ve been under Kaiser for over 30 years and have wondered about staying with them. This tells me some of what I’ve wanted to know.
@@jameswedel6916 So I too have been with kaiser since I was injured and paralyzed almost 30 years ago. I've started receiving SSDI and will be auto enrolled in medicare come october. I've been seeing how advantage plans are more negative than positive and was swayed to highly consider original medicare. My entire medical history is all through kaiser. I need DME coverage because of my ongoing medical supplies set up through kaiser but I'm looking for a physiatrist with a sub specialty in spinal cord injury. I've been told to check out Sharp. Seems like a no brainer to me now. But I'll continue the research.
Kaiser was great for me until I became disabled with a serious little-known illness. It seems HMOs are great for all people -- because they make more money not treating you. PPOs are better for people who are less healthy -- they make more $ from now much treatment you get.
Thanks so much, You did a great job! It's helping me to understand more and I've learned something with this video. I must share this with my friends, she's turning 65 next year. thanks again!
My Medicare Advantage Plan, an HMO, actually reduced the premium from $35 to $31 for 2022 AND added a free $400 pre-paid debit card, to cover whatever we wish in the way of dental, vision, or over-the-counter medications and supplies. I'm a happy camper.
I just signed up for an Advantage Plan, and have been second guessing myself since. Your video concisely explained the pros and cons relative to advantage plans. Thanks for the information you provided.
Glad it was helpful! If you ever have any Medicare questions or want to see if the current plan you are in is the right one for you, don't hesitate giving us a call at 817-249-8600.
@@BoomerBenefits In my case, I went with an Advantage Plan offered by the same hospital system and covered my specific doctor that I already have. I've spoken with my doctor, and they are aware that I will have to try and stay within the scope of the insurance coverage that I have when available. Right now I am extremely healthy for my age (65 - most people think I'm in my late 40's). But I will monitor my health closely as I age, and may need to make the switch to a Supp. plan if necessary. Of course I know that can be a gamble, but cost is a major issue for us right now... Thanks You.
This was extremely helpful. Watching all those tv commercials the advantage plans seem so attractive. For the first 2 years on medicare I was very healthy and so was a bit miffed at how much I had to shell out for a medigap plan monthly premium, plus the $203 medicare deductible which I never met! I thought I wanted less or 0 premiums, but this year alone I'm now in the process of having to see a knee specialist and quite possibly (probably!) a new full knee replacement by next spring. I've had to see a podiatrist a few times and my primary care a few times for things other than my yearly physical which also included x-rays on one visit. After watching this video and doing a little more research I think I'm going to just stay with my medigap G plan. I also like that I could pick my own specialists to see and that I didn't need referrals.
Medicare Advantage restricts your choices about what doctors you can see and in HMO type plans you need referrals. You are at the mercy of an insurance company, not Medicare.
@@Lysander-Spooner Nope, I'm in an Advantage HMO Plan and we don't have to have referrals for anything. And the vast majority of good doctors in my area accept my Advantage Plan. I've been on it for 5 years and like it. However, I do sort of wish I could go to say, the Mayo Clinic for a hip replacement if I ever need one. (Though in truth, I could always ask them.)
@@commonsense6967 it’s the opposite here in Vegas, in fact if I try to make an appt with a specialist dr, they will not even set the appointment until I get a referral from my pcp.
@@commonsense6967 I'm on an Advantage HMO plan and I do have to get referrals. I don't like that part of it at all. Haven't had any problems except my doctor suddenly retired. Now I'm worried a new doctor may not send referrals I need.
Advantage plans are great for healthy people. Medigap plans are great for sick people. Can't simplify it more than that! Since most people get sick sooner or later (unless they simply keel over and drop dead), IMO, since it is complicated to make the switch to Medigap (medical underwriting, exams, pre-existing etc.), it is wise to suck it up from the beginning (when you turn 65) and pay the extra premiums so you have the coverage when needed. The biggest downside of Medigap is the lack of dental and vision, which is what younger, healthier retirees use the most. But that will matter less down the road when you have some serious, chronic illness that is sucking away deductibles, co insurance and out of network costs. You would be surprised how often in network just doesn't "provide that service". All I can say is if you are a retiree, are going to be one soon, or just care for someone who is, vote for people in November who support expanding original Medicare to cover vision and dental. No excuse that it doesn't, except private insurance lobbying.
I've had a 5 star-rated (by CMS) Medicare Advantage Plan since turning 65 and going on Medicare, and I (mostly) like it. Have had it for 5 years. BUT, if you get an Advantage Plan, don't get less than a 4 star plan. 5 Star is the best, but there are only 2 of them in my state. THESE RATINGS ARE SO IMPORTANT AS QUALITY INDICATORS, yet most people don't pay attention to them and choose a Plan only by premium! My opthalmologist actually remarked to me recently, "You have very good health insurance!" (I was surprised at his remark because I don't think we were even discussing insurance at the time, lol.)
Assuming that all five star rated Advantage Plans are actually up to snuff, are they ubiquitous; which would be necessary from a medical standpoint for seniors.?
So, question?? You said 10-15% of BB clients opt for a MA plan. The national average is substantially higher. Is that because of a better educated clientele or is sales team either on purpose or inadvertently swaying customers to traditional Medicare? Great video! It’s about time.
Your explanations about Medicare Advantage and Supplemental plans were excellent. I wish I had found you back in September when I was signing up for all this. I'm normally someone who doesn't get freaked out about stuff, but I was really stressed out when it came to signing up for Medicare, and because I was so freaked out about it, I just wanted to get it over with. I ended up signing for an Advantage plan. I'm still not sure if I made the right decision or not, but I've decided to just live with my decision. Life is a crapshoot and I know that. So far so good, but I'm only 2 months into it.
Hi Elizabeth - If this is your first Medicare Advantage plan right out of the gate of turning 65, you will likely qualify for a Trial Right 1. Trial Right 1 gives you 12 months to try out a Medicare Advantage plan. Within that 12 months, you can drop your Medicare Advantage plan and return to Original Medicare and pick up a Medigap + Part D plan without underwriting. Please feel free giving our team a call at 817-249-8600 if you have any questions on this! Check out our UA-cam video, Medicare Advantage Plans: Try Before You Buy
@@9liveslisa Heck, you are not alone...As a retiree, thousands of my colleagues did just like that, sticking with the company provided retiree plan, which is basically an Advantage PPO plan. We have to pay drug D and dental premium separately, though it is the maximum out of pocket limit is $2000. So not all is bad, at least when bad lucks strike. If you are healthy, the advantage plan maybe just fine for you, and you may not feel any inconvenience or out of pocket costs. If you are not quite healthy, and your budget allows, maybe you want to consider swiitching to the original plan and medigap plan.
Absolutely, the most clear, thorough and useful explanation of this subject that I have seen! All UA-cam Creators could learn a lot from you! Thank you so much! i do have one question: If I've had a recent catastrophic health event, but am not ready to begin Medicare, (other than Pt A), because I'm continuing to work and receive employer health insurance, will the health issue prevent me from qualifying for a Medicare Supplement later, even if the condition is well-managed?
Hi there - We're happy to hear you found our video to be helpful! You're very welcome :) To answer your question, the best time to apply for a Medigap plan is during your 6-month Medigap Open Enrollment. This enrollment period is based around your Part B effective date. When you apply for a Medigap plan during those six months a private insurance carrier cannot ask you health questions on the Medigap application. Therefore, you can purchase a Medigap plan without a problem. However, if you apply for a Medigap plan outside that six month window, you will go through medical underwriting in most states. If you cannot answer no to the health questions, then you will likely be denied a Medigap plan or be charged with a higher premium. Be sure to check out our UA-cam video titled, Your One Time Medigap Open Enrollment Period
@@BoomerBenefits Thank you for your quick and thoughtful response. If I stop working and start Medicare Pt B at, for example, age 72, will I have another 6-month Medigap Open Enrollment period, at that time, or do I only get the one at age 65?
Your 6-month Medigap Open Enrollment is based around your Part B effective date! So when you enroll in Part B at age 72, then that is when your Medigap Open Enrollment will begin.
Thank you for making what seemed like a perplexing maze of details into something I can understand. I can now begin to search for what will best work for me.
medicare advantage plan though is notorious in discharging clients too early when they are still unstable such as physical therapy. i see a lot of these happening in our rehab...
Yes, no surprise. Of course. They have a fiduciary responsibility to their shareholders on Wall Street. That is the case with all health insurance companies. The old mighty dollar and health insurance CEO salaries first, and patient care somewhere down the line.
Although I'm not yet enrolled in Medicare (turning 65 this year; I have done some MA research), thanks for clearly explaining the Pros and Cons of MA plans. Your video was excellently designed. The graphics clearly helped accentuate your detailed explanations. As a veteran, however, I would've liked more explanation around how I can best use my chosen MA alongside my veteran's coverage to help reduce my overall out-of-pocket costs (deductibles and copays) when using MA. Maybe that's a different video I haven't seen yet, so I'll reach out via your website.
Hi Milton, we're thrilled to hear you enjoyed our video and that you found it to be helpful! We do have a video that discusses how Medicare works with the VA. It's titled: How Does Medicare Work with VA Benefits? But yes, please give our team a call at 817-249-8600 or fill out one of our online forms on our website, and we would be more than happy to chat with you about your options :)
@@BoomerBenefits Thanks for your reply! I watched the recommended video and I've scheduled an appt. to speak to and work with one of your agents: Billy Wessel. Thanks!
When in an advantage plan you deal with an insurance company, medicare no longer oversees your health. Insurance companies make money as their primary goal, not your expensive health needs. Stay with Medicare!
Medicare don't have dental vision or hearing aids don't cover eyeglasses and you have to have Dr and specialist copays also you have to buy a separate drug plan With a advantage plan it's a all in one plan and no specialist copays no doctor co-pays The drug plan is included All of my medications are covered blood work and x-rays they are covered myself I have no emergency room companies if I am a midget into any hospital for whatever reason I do not have to pay a co-pay tell me can your plan beat this
As a provider I find Medicare Advantage plans will deny authorization for many services. This is particularly true for physical and speech therapy for stroke patients. The insurance must make a profit somehow. The savings can come from denying care to the most “expensive”patients. Nothing is worse than opening a new patient chart and seeing they have an advantage plan. We know right then and there that we will have to request authorization over and over again. And the request will take time to get and then only a little bit of treatment will be authorized. And then we start all over again. This is why we call it Medicare Disadvantage
With respect, if you think govt employees don't see you as a money maker for them and their excessively generous taxpayer-bennies, then you don't understand gov't at all. You can't get crappier service with a crappies attitude than from gubmint.
If it sounds too good to be true, it probably is! MA can have some very serious pitfalls ,as you discussed. If you can afford it, get the Medigap plan of your choosing at the best price offered.
Enjoyed video. You help me confirm my decision. I'm in a retirement system that has a stipend pall for health insurance. I would have appreciated it if my pension plan had picked you guys. Dealing with AON has been a nightmare. Again thanks and I will be sure to send my friends to you should they be in the position of having to select their coverage. Again Thanks.
Anyone that is on regular Medicare Don't change it to Medicare Advantage they will only pay what is on their network. I have made biggest mistake in 2018 by enrolling in Medicare Advantage .
Thank you for your informative videos. I’m in a slightly different situation with Medicare advantage. I’m currently covered by my former employer (retired) and will be moving to Medicare next year. My current benefits are great and when I turn 65 employer offers two Advantage plans. One, via Anthem Blue Cross allows no cost out of network visits, all 50 states, part B premiums are reimbursed and copays (except for $5) as well. Clearly it’s not like the advantage plans offered to public…so I guess my question is, have you had experience with employer/union negotiated Advantage plans? I’ve read entire benefits/coverage document and it appears to be pretty comprehensive. One can take a payment in lieu of coverage but I think it makes sense to go with the employer negotiated plan.
Drug coverage is typically stronger (look for lower Rx copays, no donut hole / coverage gap?) through employer sponsered coverage ED. Go with employer coverage all the way. Always check with the employer about use it or lose it. If you leave it, can you get it back? Cheers!
@@jdwhitty6035 I agree with the previous person, use your employer plans rather than Medicare Advantage plans (or Part C). In my opinion, Part C plans are trickier to navigate and I think most insurers count on that confusion to hoodwink people into believing they (you, the consumer) have done all the due diligence necessary and they have found the "diamond" of all Part C plans. I imagine there are some who can afford the high out of pocket caps, but I can't. I don't know many who can. That's my two cents. :-)
Great information and thank you for sharing this information. Can you please explain going from medigap to Medicare advantage for the first time and going back to medigap plan after realizing the Medicare advantage is not meeting your needs. Is there a time frame for this and can you go back to any medigap plan?
@@MediaMaverick_ I think youre correct a 6 month window after that you will need to go thru underwriting meaning health questions that can keep you from ever going back!
If you joined Medicare Advantage when you first became eligible for Medicare, but decided to switch to Original Medicare within the first 12 months, you have Medicare Supplement guaranteed issue rights for 60 days before your plan ends and 63 days after you switch. If you dropped a Medigap plan to enroll in Medicare Advantage, but decide within 12 months to switch back (known as “trial right”), you have Medicare Supplement guaranteed issue rights for the same four-month period described above. You can do it only once, and it has to be with the company that you had your medigap with, unless they no longer offer it , in which case you can go with any other company.
Hi there - Our UA-cam video, "Before You Drop Your Medicare Advantage Plan For a Medigap Plan, Watch This!" should be able to help answer your questions! Watch here: ua-cam.com/video/3bwwXqFPjpI/v-deo.html
Insurance is really quite simple. It's only complicated by agents and companies. I elected to have a PPO UHC Advantage Plan almost a decade ago. It has literally cost me nothing. I have been fortunate that I have to date had no real health issues. Therefore, I have saved many thousands of dollars in premiums. I consider this being ahead when I do have a problem one day. No choice is ever perfect. It all centers around your level of acceptable risk. You look at your choices. Balance the pros and cons and then pick the one that gives you peace of mind. Supplements work for some while Advantage Plans for others. Supplements cost you up front for coverage you may or may not ever use. While a PPO Advantage Plan generally cost zero and you only pay small deductibles when you do require care. Quite simple.
Choosing the proper plan is mind boggling and brain wracking all because there won't ever be one perfect plan. So nicely said about mentioning that it all comes down to one's acceptable risk.
@@keilana6 I'm not sure where you are located but I think a United Health Care PPO plan is one of the best. Zero premium in most cases plus zero primary care and $35 specialist. You can go anywhere in the country.
Thank you for this video! My husband and I have a 0 cost Patriot PPO Advantage plan and TriCare. We only go to the doctor once a year and we have no prescriptions. I am seeing a hand specialist soon, I’m not required to get pre approval, the doctor is in my network. I am not sure how TRICARE works with this Patriot PPO. Does TriCare cover whatever the PPO doesn’t? Our plan changes for next year includes a much lower out of pocket and other improvements that seem too good to be true for a plan that costs 0 dollar’s and I want to make sure we aren’t making a mistake by staying with the PPO. Thanks for any advice you can give me.
When you enroll in a Medicare Advantage plan, that plan is primary. However, TFL is unique in that it will often pick up the copays on your Medicare Advantage plan anyway, leaving you with little out of pocket. We recommend contacting your Advantage carrier and ask how your plan coordinates with TFL!
All I need is the gym membership, healthy foods benefits and a nutritionist or dermatologist. Medical Doctors are just sales representatives for big pharmaceutical companies. I do not use pharmaceutical drugs and never will. I am healthy and will stay this way. What Medicare plan is for me?
@@BoomerBenefits My phone is for family use only. Businesses on line tend to give my number to every over seas Scammer from Pakistan to distant island in the tropics..
My Advantage Care Plan is now not doing me any good ever since the pandemic and we had a hurricane. Docs started charging co-pays. I have restrictions and I do not care to be hassled by group nurses/employees. I am going to purchase policy and get rid of them.
y employer provides an EGWP option. When considering this against Supplements, should I consider it to be an Advantage plan in determining the pros and cons? I find very little information about EGWPs anywhere.
Some hospitals still need to have that IME # since some hospitals are teaching facilities, they need the new number to show Medicare they are properly approving patients and paperwork is properly done.
As a disabled vet, I use the free VA for all my medical needs and drugs. I have a civilian doctor that I've only seen one time for my initial consultation. I have medicare parts B, N, and D. Maybe an advantage plan would save me money seeing I don't plan on using it.
I assume that letter N stands for Medicare Supplement Plan N? If that's the case, based on your circumstances this is an overkill. You don't need it, nor do you need a Medicare Advantage plan. If you want to continue seeing your civilian doctor for follow-up visits, those are covered by Medicare and your copays will be anywhere from $5 to $10, assuming you already met your Part B deductible. You will pay more for those visits with your Plan N. I believe the copay for an office visit is $20?
Ron you don't need to spend any money outside of Part B. Look for a zero premium medicare advanatage plan. you can set your self up with options (network access, additional benefits) and not have to pay for it. Trust. Thank you for your service! God bless
I joined a Medicare advantage plan for the first time last year and am very disappointed with it and am wondering how hard it would be to switch back to original Medicare? I’m in Arizona.
I just signed up for the advantage plan. None of this was explained to me by the agency on aging in my county. I am sick about this knowledge. I hope I am not locked into this for life. I am waiting for my call to be returned.
Hi Rose - We're sorry to hear you did not have Advantage plans fully explained to you! Did you sign up for your Advantage plan at the same time you applied for Medicare Parts A and B?
I applied part B after I retired from my job last year. I don't have a clue about Medicare. I told the HR employee benefits that I don't want anything added and I don't want to pay anything extra beside my regular part B deduction that my employer reimburse me. Insurance coverage from my employer covers me for life. I got part B because by law once I get off my job and over 65. I barely use my coverage or Medicare. I don't know a thing about Medicare.
The important thing to know is that Medicare Part A (inpatient hospital coverage) and Medicare Part B (outpatient medical coverage) make up Original Medicare and will be primary to your retiree plan. Most retiree plans help cover costs after Medicare. You can see any provider that accepts Original Medicare. You can create a MyMedicare account to help track your deductibles, premium payments, and claims. Our other videos in our channel will be helpful as you learn Medicare!
Make sure your Medicare Advantage plan is a PPO and includes your doctors and hospitals you may need. If you are healthy you will save a ton of money with an Advantage plan. More than 40% of people choose Medicare Advantage plans and that is rising every year
@@BoomerBenefitsYes. moved to a new State, the "Doctors " who were actually nurse practitioners that my Advantage plan sent me to caused me a lot of trouble. I have PPO and found a real Physician out of network who spend a full hour WITH me and it's providing actual medical care. I only now am exploring insurance options and will call your office soon. Thanks for this video.
I believe it is $800- $1000 EACH MONTH! More $$ for companies who "claim" they have expensive high-risk member patients. Not all but some insurance companies can and are "gaming" that provision.
Turning 65 in Oct ‘22. Planning to never retire. Work for large university but group insurance deductible so high and so many hidden costs I’ve stopped seeing docs for several years now due to bills in the thousands even for preventable such as skin cancer checks etc. Fairly low monthly premium and my college-age son is on my plan. He can now get college student insurance at his university. Can I leave employer insurance and go full Medicare with Medigap? Do I have to stay on large employer (1,000s of employees) insurance even though I’m too scared of costs to use my work insurance?
Hi Catherine - If your employer does not require you to stay on their insurance plan, then yes, you can drop your employer insurance and enroll in Medicare and a Medigap plan! You can apply for Medicare during your 7-month Initial Enrollment Period through the Social Security office. Your IEP begins 3 months before your 65th birthday month and ends 3 months after your birthday month. The time to apply for a Medigap plan is during your 6-month Medigap Open Enrollment window, which is based around your Part B effective date. Please give our team a call at 817-249-8600 and we can help you with this transition!
You can change Medicare Advantage plans during a qualified election period, such as the Annual Election Period or the Medicare Advantage Open Enrollment.
My full retirement age is 66 and 4 months which I will be in January 2023 just a few months away I plan on start collecting my social security then and also applying for Medicare part b and dropping my employer health coverage and getting a local supplement plan and plan to keep working full time for a while and yes my employer has more than 20 employees and I am on Medicare part a since September of last year and yes I know I could just skip b for now until I am ready to fully retire problem is I don't know for sure how much longer I am going to keep working past my full retirement age that's why I want to start everything at the same time so I can walk out at anytime what's your thoughts on this plan also could I delay part d and just get part b and and supplement in January my full retirement age
Is there a plan that is valid out of state? For example, I'm 64 and my AK/WA Blue Cross does not cover us while we are in VA for 3 months except for emergency procedures.
Medigap plans travel with you! So, if you were to purchase a Medigap plan once you turn 65 years old, you can visit any doctor in the U.S. and use your Medigap plan as long as the doctor accepts Medicare. If a doctor accepts Medicare, they must accept a Medigap plan. Check out our video, Are Medigap Plans Worth the Money?
I’m 62 years old and I will be eligible for Medicare in February. First I had a hard time finding anyone to help me. I’m on disability. I live in Ohio. And I was told l could only get an advantage plan. Is that true? Also if it is true, can I switch to a medigap policy when I turn 65? I appreciate any help.
Hi Jo Ann - Not all states require insurance companies to sell Medigap plans to those who are under age 65. If you were to apply for a Medigap plan while under 65, you will find that the premiums are way more expensive compared to a 65-year-old rate. Due to this, many seniors enroll in a Medicare Advantage plan until they reach age 65. Once you do turn 65, you will be given a second 6-month Medigap Open Enrollment window, where you can apply for a Medigap plan without underwriting and you can receive a 65-year-old rate. If you have any questions about this, give our team a call at 817-249-8600. Also, check out our UA-cam video, Medicare for People Under 65 | What You Should Know
"The first thing to know about Medicare Advantage . . . blah, blah, blah." Dude. The first thing to know about Medicare Advantage is that it's a system of for-profit insurance plans, NOT real, government run Medicare. This should be stressed and repeated, not buried in an avalanche of words.
The government has not planned for fairness of equal care for all its citizens,Those who cannot afford the Supplement are stuck with Medicare Advantage. Government getting involved with healthcare, although initially a good idea, brings about beaurocratic regulations which often do not make common sense and seem to be for the benefit for insurance compamies. Medigap works well but why should those with modest income be penalized monetarily? Insurance companies appear to be taking advantage of those who cannot afford the Medigap premiums. Seems like government should devise equal care for all its citizens. And then there is the the ridicuous Pharmacological rules which for some incmprehensible cannot be included in the policy.
Very informative but it only covers advantage plans through insurance companies. Kaiser Permanente Advantage is a stand alone plan that has their own doctors, hospitals, labs, imaging, etc. In this plan there is no insurance company or concern about a provider leaving the network. Copays are paid at point of service so no surprise bills later. Kaiser Advantage is unique and easier because all your health information is shared in one database and there is no insurance company to deal with. Another thing to keep in mind is what she said about providers dropping out of insurance plans. There is no law requiring insurance companies to keep their provider directories updated. My wife who is not on Medicare went to a doctor listed in the insurance provider network and discovered that he dropped out. This was several months back and even though we reported it to the insurance company he is still on their directory today. We complained to everybody including the Better Business Bureau, California Dept of Insurance and California Department of Managed Health Care and to put it simply they said too bad we can do nothing. That's why I despise insurance companies. Keeping them out of the loop makes my life so much easier. You just can't trust them.
Art here again I plan on getting back to work how will that turn out if by chance after 24 months and get Medicare and loose Medicaid and want to try to get back working.
What is the best plan for me that I go only for a doctor's checkup ,blood test twice a year,I taking only a maintenance medicine for my thyroid and high blood pressure?
Hi there! The best plan for you will depend on a couple of things. If you are one who visits or might visit the doctor often, then you could look into a Medigap plan. If you are wanting to find the fullest coverage, then you can find that in a Medigap Plan G. If you do not believe you will visit the doctor often and would like added benefits such as dental and vision, then you can look at a Medicare Advantage plan. If you need any help with deciding which Medicare plan might be best for you, please feel free to reach out as we are a Medicare brokerage that represents 30+ carriers. Our phone number is 817-249-8600.
I'm confused. Do I only need a cancer plan if I choose advantage? Is the backend cost on advantage above or additional to your maximum out of pocket with advantage? Thank you
Hi there - You can purchase a cancer plan whether you enroll in a Medigap or Medicare Advantage plan! You can purchase a policy that gives you a lump sum and therefore, you can use that for your Part D cancer drugs if you are enrolled in a Medigap plan or you can use it for any cancer-related out-of-pocket costs with the Advantage plan. In 2022, the Medicare Advantage maximum out-of-pocket (MOOP) is $7,550. However, a carrier can lower the MOOP, but cannot make it higher than $7,550. To learn more about cancer plans, check out our UA-cam video, Why You Need a Cancer Plan with Medicare Advantage
Danielle has said this for years but it's not what people want to hear. Nearly 48% of beneficiaries now choose MA plans - that $0 premium is just too enticing.
Can you explain the city of newyork is starting a Medicare advantage plus , we as New York HHC workers (unionized don’t need part C) it’s new and we don’t know much about it.
Hi Sara - The two states we are not licensed in are New York and Massachusetts. Since we are not familiar with the plans in New York, we do not have any information on the plans in that state.
Hi Nemo - As long as your doctors are in your network and you are okay with your plan's Summary of Benefits, then you should be okay! However, if you would like a second opinion on your plan, please feel free to give us a call as you likely still have other options! Our phone number is 817-249-8600.
My primary care physician, whom I really like and have seen for many years, does not accept Medicare. I am turning 65 and have hard choices to make. There’s very limited choices in my area for AP, (2) and I know now my oncologist doesn’t accept one of them. That is a real problem out there! Many good docs do not accept Medicare and others won’t take your AP. I will be forced to choose an Advantage plan if I want to continue with my current primary doc and then find a different oncologist. 😢
Hi there - Only 1% of doctors do not accept Original Medicare! With that said, Original Medicare does not have a network. Therefore, you can visit any doctor in the U.S. that accepts Medicare. Whereas with an Advantage plan, there are network restrictions, and doctors are not required to accept your plan. If you plan on working with our Boomer Benefits team, we can research and find the doctors in your area that accept Original Medicare.
Oh my goodness. My must healthcare be so complicated? Why must, we the people, start the conversation by answering the question what is my budget, and what are my goals for my healthcare coverage? Minute 27:00. Shouldnt the answer be to solve my medical problem. full stop. Money seems only to be a necessary consideration because there are companies in this system that are out to make a profit, which means they charge as much as the market will bear for the motive of enriching themselves.
@@genox3636 Your answer is not an answer. No one denied that. The problem is profit driven healthcare, where the money, much of which comes from the US taxpayers, goes to the corporate headquarters.
@@SandfordSmythe welcome to planet earth, and to the United States. Glad you finally came out of your slumber. The more dependent you are on the system, the harder it is to be free from the drug barons.
@@SandfordSmythe haven't you considered traditional medicine, now called "alternative medicine? " if the current medical system is your only way to manage your health, then your dependence on drugs is going to indebt you to the system.
Hi Sean - The Affordable Care Act has nothing to do with Medicare, Medigap, or Medicare Advantage plans. Medicare cannot turn you down due to health conditions, and Medicare Advantage plans no longer ask any health questions on its application. Now, you have a one-time 6-month Medigap Open Enrollment window to enroll in a Medigap plan without underwriting. If you apply for a Medigap plan outside that 6-month window, then a private insurance carrier could deny you a Medigap plan. Learn more here: boomerbenefits.com/medigap-underwriting/
Thank you for this video suggestion! In the mean time, feel free checking out our Tricare & Medicare article here: boomerbenefits.com/tricare-and-medicare/
What happens when the person is limited to only 1200$/mo social security. She living in a home one of her children own currently. Does this become a Medicaid + Medicare type situation?
📌Get your free Medicare Advantage vs. Medigap guide: boomerbenefits.com/medicare-advantage-vs-medigap-guide/
📌Join our exclusive Medicare Q&A Facebook group to have your questions answered by Danielle and her team: facebook.com/groups/BoomerBenefits
📌New to Medicare? Attend our FREE Medicare 101 Webinar: boomerbenefits.com/medicare-101-webinar/
0
I have been in the insurance world since 1998.I have trained hundreds of agents.I have to admit this lady is the most knowledgeable agent.If I was not in the industry I would buy from her.
We truly appreciate that, Gary :)
Very clear and comprehensive comparison of Medicare Advantage and Medigap plans.
I think the presentation was extremely fair to both plans.
I think most people could benefit from watching this video at least two times.
My takeaway is that Medigap plans are the best approach if you can afford it,
but Medicare Advantage plans can still give very good coverage if you can't afford Medigap.
Superb job. Incredibly helpful. You provide a very useful service.
You are a very good teacher.
Thank you for your comment - so glad you enjoyed the video!
Danielle, you do SUCH a great job of explaining these pros and cons. Thank you!
very fair breakdown, unlike the mind numbing commercials on TV.
Those TV ads are all trying to get seniors to sign over their Medicare to for-profit insurance companies so they make a profit then ‘manage’ what healthcare you can get. Medicare proper doesn’t do TV ads.
Wow...wow...wow !!!! Should have studied these at age 25 and not 65 !!! Such confusion and feel like going to school to study it's complications. I'm 69, beginning to use its benefits....boy oh boy...tough to Wrap my brain around it.
THANK YOU FOR SHARING THE INFORMATION. GREATLY APPRECIATED.
You're very welcome! Be sure to subscribe to our channel to stay up to date with all Medicare info! If you're a client of ours, don't hesitate to give us a call if you have any questions or concerns!
I recently worked in a hospital; advantage plans always denied their members to go to acute rehabilitation, even if the attending MD thought it was the most appropriate level. They would only approve nursing homes, and only a few days. All discharge planners where I worked dreaded making referrals for patients on advantage plans because of tiling approval process (closed on weekends) and the frequent denials. Then, the patients a f families could not understand why the delay. It was their crappy insurance that they were conned into taking. They never knew the down side because the insurance states they cover everything that Medicare covers (lie). That has been my observation. I recommend to my family and friends to stay with traditional Medicare with a supplement.
Good info on denials within an Advantage plan. Plus I learned you cannot simply go back to a medi-gap plan (underwriting) issues
What do you mean by a "supplement" isn't that what Medicare advantsge plans are? I'm still confused
I'm turning 65 in January 2022. I am disabled so I've been on Medicare for a few years. I currently am in a Medicare advantage plan. My income is very low. I only get $840/MO so what is the best f way for me to go? My one time open enrollment chance will end I believe three months after my 65th birthday. Am I correct? I need a plan that gives me the best coverage with the least out of pocket. I'm so confused.
What would it cost to stay with traditional Medicare abd add a supplement? By supplement do you mean med gap plan,?
@CatLady I live in Missouri. I've tried applying for medicaid along with my social Security disability but becausrbim married and they go by both of our incomes i dont qualify for SNAP benefits or medicaid, except medicaid does help with a small portion of my prescription costs. That's the only help I get. My husband is also disabled and our combined monthly income is under $1700. By the time we pay our rent and utilities and other monthly bills. We have less than $200 for food, gas, prescriptions, and doctors office copays. It's getting harder and harder. We have to depend on local food pantries if we want to eat. Somebody really needs to do something to fix our country. I don't care if it's the Democrats or the Republicans. Jystvas Ling as SOMEBODY does something. We senior citizens who worked our entire lives ( I've worked since I was 14) and now because we are older and have disabilities we are forgotten about and they've made it impossible for us to get any help. Yet they talk about helping people pouring into our country from other countries. What about the loyal Anetican people who were born and raised here and worked all their lives and paid their dues?
As I understand it, a switch from traditional Medicare + supplement (mine is Plan G) to any Advantage plan is a downgrade, so is always possible. But a switch from Advantage back to traditional Medicare + a supplement is an upgrade, which subjects people to medical underwriting. Be careful what your original choice is, upon first eligibility, because downgrading to Advantage is pretty easy, but upgrading to Medicare + a supplement (MegiGap) can be difficult and expensive.
Medical underwriting is not allowed in MA (and perhaps in some other states).
Well, lucky you in Massachusetts!
She does a good job of answering a lot of questions about medicare. It comes down to budget and health of the client.
We're always here and happy to help in any way we can!
This is a great explanation of Medicare Advantage. Most channels I see covering Medicare mostly talk about the medigap plans only vaguely mentioning the Advantage in a negative fashion. That said I have trouble understanding how people don’t understand the hmo/ppo aspects of the Advantage plans. Most employer provided insurance are hmo/ppo. Co pays, out of pocket expenses, co insurance and prior approval requirements can’t be a surprise to most people.
Most people really don't think about it ahead of time. I've been amazed at how stupid most people my age are (76).
I still like my 5 star Advantage Plan, it 's saved me a bundle over the last 6 years. No complaints.
We're happy to hear that!
Brilliant and professional analysis in every way. The delivery was so congenial, that even this boring subject matter seemed lively and interesting. Thank you!
Thank you for your kind words, Arthur!
You explain the pros and cons very articulately. You mentioned prior authorization delays, however, but did not discuss denials. Not all treatment is approved.
The best Medicare in my area is Kaiser's Advantage plan, not just because it saves a huge amount of money, but rather because it is an integrated system where things don't fall through the cracks and the staff are all direct employees so there is no fee-for-service care, nobody is incentivized to perform unnecessary procedures or office visits and a lot of stuff can be handled online. As a retired physician who spent over 40 years in health care, they get my vote.
Spot on. Exactly what I said in my comment. These agents always refer to the insurance plans and never discuss alternatives like Kaiser.
I will retire at the end of the year and still need to sign up for part B. I’ve been under Kaiser for over 30 years and have wondered about staying with them. This tells me some of what I’ve wanted to know.
@@jameswedel6916 So I too have been with kaiser since I was injured and paralyzed almost 30 years ago. I've started receiving SSDI and will be auto enrolled in medicare come october. I've been seeing how advantage plans are more negative than positive and was swayed to highly consider original medicare. My entire medical history is all through kaiser. I need DME coverage because of my ongoing medical supplies set up through kaiser but I'm looking for a physiatrist with a sub specialty in spinal cord injury. I've been told to check out Sharp. Seems like a no brainer to me now. But I'll continue the research.
Kaiser was great for me until I became disabled with a serious little-known illness.
It seems HMOs are great for all people -- because they make more money not treating you.
PPOs are better for people who are less healthy -- they make more $ from now much treatment you get.
Absolutely love my Humana Advantage plan. Best health insurance I've ever had.
Prominence is better
Glad to see some Are pleased w Medi advantage plan. 👍
Thanks so much, You did a great job! It's helping me to understand more and I've learned something with this video. I must share this with my friends, she's turning 65 next year. thanks again!
You're very welcome! :) If you or your friend ever have any Medicare questions or need guidance, feel free giving our team a call at 817-249-8600.
Such a great explanation of a complicated topic. Great job and thanks so much.
Always happy to help!
My Medicare Advantage Plan, an HMO, actually reduced the premium from $35 to $31 for 2022 AND added a free $400 pre-paid debit card, to cover whatever we wish in the way of dental, vision, or over-the-counter medications and supplies. I'm a happy camper.
Great seminar info- in the comfort of my own home and I made my own steak dinner. Thanks!
I just signed up for an Advantage Plan, and have been second guessing myself since. Your video concisely explained the pros and cons relative to advantage plans. Thanks for the information you provided.
Glad it was helpful! If you ever have any Medicare questions or want to see if the current plan you are in is the right one for you, don't hesitate giving us a call at 817-249-8600.
@@BoomerBenefits In my case, I went with an Advantage Plan offered by the same hospital system and covered my specific doctor that I already have. I've spoken with my doctor, and they are aware that I will have to try and stay within the scope of the insurance coverage that I have when available. Right now I am extremely healthy for my age (65 - most people think I'm in my late 40's). But I will monitor my health closely as I age, and may need to make the switch to a Supp. plan if necessary. Of course I know that can be a gamble, but cost is a major issue for us right now... Thanks You.
This was extremely helpful. Watching all those tv commercials the advantage plans seem so attractive. For the first 2 years on medicare I was very healthy and so was a bit miffed at how much I had to shell out for a medigap plan monthly premium, plus the $203 medicare deductible which I never met! I thought I wanted less or 0 premiums, but this year alone I'm now in the process of having to see a knee specialist and quite possibly (probably!) a new full knee replacement by next spring. I've had to see a podiatrist a few times and my primary care a few times for things other than my yearly physical which also included x-rays on one visit. After watching this video and doing a little more research I think I'm going to just stay with my medigap G plan. I also like that I could pick my own specialists to see and that I didn't need referrals.
Medicare Advantage restricts your choices about what doctors you can see and in HMO type plans you need referrals. You are at the mercy of an insurance company, not Medicare.
@@Lysander-Spooner Nope, I'm in an Advantage HMO Plan and we don't have to have referrals for anything. And the vast majority of good doctors in my area accept my Advantage Plan. I've been on it for 5 years and like it. However, I do sort of wish I could go to say, the Mayo Clinic for a hip replacement if I ever need one. (Though in truth, I could always ask them.)
@@commonsense6967 it’s the opposite here in Vegas, in fact if I try to make an appt with a specialist dr, they will not even set the appointment until I get a referral from my pcp.
@@commonsense6967 I'm on an Advantage HMO plan and I do have to get referrals. I don't like that part of it at all. Haven't had any problems except my doctor suddenly retired. Now I'm worried a new doctor may not send referrals I need.
Advantage plans are great for healthy people. Medigap plans are great for sick people. Can't simplify it more than that! Since most people get sick sooner or later (unless they simply keel over and drop dead), IMO, since it is complicated to make the switch to Medigap (medical underwriting, exams, pre-existing etc.), it is wise to suck it up from the beginning (when you turn 65) and pay the extra premiums so you have the coverage when needed. The biggest downside of Medigap is the lack of dental and vision, which is what younger, healthier retirees use the most. But that will matter less down the road when you have some serious, chronic illness that is sucking away deductibles, co insurance and out of network costs. You would be surprised how often in network just doesn't "provide that service". All I can say is if you are a retiree, are going to be one soon, or just care for someone who is, vote for people in November who support expanding original Medicare to cover vision and dental. No excuse that it doesn't, except private insurance lobbying.
I've had a 5 star-rated (by CMS) Medicare Advantage Plan since turning 65 and going on Medicare, and I (mostly) like it. Have had it for 5 years. BUT, if you get an Advantage Plan, don't get less than a 4 star plan. 5 Star is the best, but there are only 2 of them in my state. THESE RATINGS ARE SO IMPORTANT AS QUALITY INDICATORS, yet most people don't pay attention to them and choose a Plan only by premium! My opthalmologist actually remarked to me recently, "You have very good health insurance!" (I was surprised at his remark because I don't think we were even discussing insurance at the time, lol.)
Assuming that all five star rated Advantage Plans are actually up to snuff, are they ubiquitous; which would be necessary from a medical standpoint for seniors.?
That's the problem. Some states don't have 5 star MA plans so seniors end up on a low rated plan and regret it later on.
So, question?? You said 10-15% of BB clients opt for a MA plan. The national average is substantially higher. Is that because of a better educated clientele or is sales team either on purpose or inadvertently swaying customers to traditional Medicare? Great video! It’s about time.
Be sure to get Danielle's new book on avoiding Medicare mistakes: It's a classic and is a top five best ever financial book to read!
Thank you, David! :)
Thank you for the clear information that will help me with my choice of plan. Great post!!
Our pleasure!
Your explanations about Medicare Advantage and Supplemental plans were excellent. I wish I had found you back in September when I was signing up for all this. I'm normally someone who doesn't get freaked out about stuff, but I was really stressed out when it came to signing up for Medicare, and because I was so freaked out about it, I just wanted to get it over with. I ended up signing for an Advantage plan. I'm still not sure if I made the right decision or not, but I've decided to just live with my decision. Life is a crapshoot and I know that. So far so good, but I'm only 2 months into it.
Hi Elizabeth - If this is your first Medicare Advantage plan right out of the gate of turning 65, you will likely qualify for a Trial Right 1. Trial Right 1 gives you 12 months to try out a Medicare Advantage plan. Within that 12 months, you can drop your Medicare Advantage plan and return to Original Medicare and pick up a Medigap + Part D plan without underwriting. Please feel free giving our team a call at 817-249-8600 if you have any questions on this!
Check out our UA-cam video, Medicare Advantage Plans: Try Before You Buy
@@BoomerBenefits Thank you for that information. I appreciate it.
@@9liveslisa Heck, you are not alone...As a retiree, thousands of my colleagues did just like that, sticking with the company provided retiree plan, which is basically an Advantage PPO plan. We have to pay drug D and dental premium separately, though it is the maximum out of pocket limit is $2000. So not all is bad, at least when bad lucks strike. If you are healthy, the advantage plan maybe just fine for you, and you may not feel any inconvenience or out of pocket costs. If you are not quite healthy, and your budget allows, maybe you want to consider swiitching to the original plan and medigap plan.
This is great information! Can't wait to share this with others!
Absolutely, the most clear, thorough and useful explanation of this subject that I have seen! All UA-cam Creators could learn a lot from you! Thank you so much! i do have one question: If I've had a recent catastrophic health event, but am not ready to begin Medicare, (other than Pt A), because I'm continuing to work and receive employer health insurance, will the health issue prevent me from qualifying for a Medicare Supplement later, even if the condition is well-managed?
Hi there - We're happy to hear you found our video to be helpful! You're very welcome :) To answer your question, the best time to apply for a Medigap plan is during your 6-month Medigap Open Enrollment. This enrollment period is based around your Part B effective date. When you apply for a Medigap plan during those six months a private insurance carrier cannot ask you health questions on the Medigap application. Therefore, you can purchase a Medigap plan without a problem. However, if you apply for a Medigap plan outside that six month window, you will go through medical underwriting in most states. If you cannot answer no to the health questions, then you will likely be denied a Medigap plan or be charged with a higher premium. Be sure to check out our UA-cam video titled, Your One Time Medigap Open Enrollment Period
@@BoomerBenefits Thank you for your quick and thoughtful response. If I stop working and start Medicare Pt B at, for example, age 72, will I have another 6-month Medigap Open Enrollment period, at that time, or do I only get the one at age 65?
Your 6-month Medigap Open Enrollment is based around your Part B effective date! So when you enroll in Part B at age 72, then that is when your Medigap Open Enrollment will begin.
@@BoomerBenefits Great! Thank you! :)
You're very welcome!
Thank you for making what seemed like a perplexing maze of details into something I can understand. I can now begin to search for what will best work for me.
Glad you enjoyed it! You're very welcome. 🙂
This is a great video. She is great at explaining things. Thank you!!
Glad you enjoyed it!
medicare advantage plan though is notorious in discharging clients too early when they are still unstable such as physical therapy. i see a lot of these happening in our rehab...
Yes, no surprise. Of course. They have a fiduciary responsibility to their shareholders on Wall Street. That is the case with all health insurance companies. The old mighty dollar and health insurance CEO salaries first, and patient care somewhere down the line.
Best explanation I have heard. Really good job. Thanks!
Glad it was helpful!
Thank you for always breaking down the information for us
Although I'm not yet enrolled in Medicare (turning 65 this year; I have done some MA research), thanks for clearly explaining the Pros and Cons of MA plans. Your video was excellently designed. The graphics clearly helped accentuate your detailed explanations. As a veteran, however, I would've liked more explanation around how I can best use my chosen MA alongside my veteran's coverage to help reduce my overall out-of-pocket costs (deductibles and copays) when using MA. Maybe that's a different video I haven't seen yet, so I'll reach out via your website.
Hi Milton, we're thrilled to hear you enjoyed our video and that you found it to be helpful! We do have a video that discusses how Medicare works with the VA. It's titled: How Does Medicare Work with VA Benefits? But yes, please give our team a call at 817-249-8600 or fill out one of our online forms on our website, and we would be more than happy to chat with you about your options :)
@@BoomerBenefits Thanks for your reply! I watched the recommended video and I've scheduled an appt. to speak to and work with one of your agents: Billy Wessel. Thanks!
@@miltonedwards3185 We're happy to hear you scheduled an appointment with Billy. You are in great hands :)
When in an advantage plan you deal with an insurance company, medicare no longer oversees your health. Insurance companies make money as their primary goal, not your expensive health needs. Stay with Medicare!
Medicare don't have dental vision or hearing aids don't cover eyeglasses and you have to have Dr and specialist copays also you have to buy a separate drug plan
With a advantage plan it's a all in one plan and no specialist copays no doctor co-pays
The drug plan is included
All of my medications are covered blood work and x-rays they are covered myself I have no emergency room companies if I am a midget into any hospital for whatever reason I do not have to pay a co-pay tell me can your plan beat this
As a provider I find Medicare Advantage plans will deny authorization for many services. This is particularly true for physical and speech therapy for stroke patients. The insurance must make a profit somehow. The savings can come from denying care to the most “expensive”patients. Nothing is worse than opening a new patient chart and seeing they have an advantage plan. We know right then and there that we will have to request authorization over and over again. And the request will take time to get and then only a little bit of treatment will be authorized. And then we start all over again. This is why we call it Medicare Disadvantage
With respect, if you think govt employees don't see you as a money maker for them and their excessively generous taxpayer-bennies, then you don't understand gov't at all. You can't get crappier service with a crappies attitude than from gubmint.
If it sounds too good to be true, it probably is! MA can have some very serious pitfalls ,as you discussed. If you can afford it, get the Medigap plan of your choosing at the best price offered.
Alot of people CAN'T afford it, and if they can, they are in too bad of shape to pass the exam to get in a supplement.
@@genox3636 No medical underwriting for medigap when aging in.
Enjoyed video. You help me confirm my decision. I'm in a retirement system that has a stipend pall for health insurance. I would have appreciated it if my pension plan had picked you guys. Dealing with AON has been a nightmare. Again thanks and I will be sure to send my friends to you should they be in the position of having to select their coverage. Again Thanks.
Bob, you've been lied to & you believed it. You need someone a little sharper than you are to help you making important decisions.
That was really rude. Didn't you ever learn any manners?
Socialized medicine!!!! Canada has it right!!!
Most country in Europe too
Dumb idea. Care stops at a certain age as determined by the plan.
Most at 75.
Anyone that is on regular Medicare Don't change it to Medicare Advantage they will only pay what is on their network. I have made biggest mistake in 2018 by enrolling in Medicare Advantage .
This was so helpful for me!! 🙌
Explained very clearly!
Glad it was helpful!
Excellent video, thanks for making this informative presentation!
Glad it was helpful!
Excellant Presentation ! What a difference -
Thank you!
You are Amazing, great Information from an intelligent Beautiful orator
Glad you found our video helpful!
One correction is that I believe that AARP Unitedhealthcare advantage has a Nationwide network. Also Aetna??
Thank you for your informative videos. I’m in a slightly different situation with Medicare advantage. I’m currently covered by my former employer (retired) and will be moving to Medicare next year. My current benefits are great and when I turn 65 employer offers two Advantage plans. One, via Anthem Blue Cross allows no cost out of network visits, all 50 states, part B premiums are reimbursed and copays (except for $5) as well. Clearly it’s not like the advantage plans offered to public…so I guess my question is, have you had experience with employer/union negotiated Advantage plans? I’ve read entire benefits/coverage document and it appears to be pretty comprehensive. One can take a payment in lieu of coverage but I think it makes sense to go with the employer negotiated plan.
Drug coverage is typically stronger (look for lower Rx copays, no donut hole / coverage gap?) through employer sponsered coverage ED. Go with employer coverage all the way. Always check with the employer about use it or lose it. If you leave it, can you get it back? Cheers!
@@jdwhitty6035 I agree with the previous person, use your employer plans rather than Medicare Advantage plans (or Part C). In my opinion, Part C plans are trickier to navigate and I think most insurers count on that confusion to hoodwink people into believing they (you, the consumer) have done all the due diligence necessary and they have found the "diamond" of all Part C plans. I imagine there are some who can afford the high out of pocket caps, but I can't. I don't know many who can. That's my two cents. :-)
Thanks for information
Great info Danielle-Thanks for sharing!
Great information and thank you for sharing this information. Can you please explain going from medigap to Medicare advantage for the first time and going back to medigap plan after realizing the Medicare advantage is not meeting your needs. Is there a time frame for this and can you go back to any medigap plan?
My understanding is that you can only do this at the beginning and that you have a 6 month window to switch.
@@MediaMaverick_ I think youre correct a 6 month window after that you will need to go thru underwriting meaning health questions that can keep you from ever going back!
If you joined Medicare Advantage when you first became eligible for Medicare, but decided to switch to Original Medicare within the first 12 months, you have Medicare Supplement guaranteed issue rights for 60 days before your plan ends and 63 days after you switch.
If you dropped a Medigap plan to enroll in Medicare Advantage, but decide within 12 months to switch back (known as “trial right”), you have Medicare Supplement guaranteed issue rights for the same four-month period described above.
You can do it only once, and it has to be with the company that you had your medigap with, unless they no longer offer it , in which case you can go with any other company.
@@lic9863 👍
Hi there - Our UA-cam video, "Before You Drop Your Medicare Advantage Plan For a Medigap Plan, Watch This!" should be able to help answer your questions!
Watch here: ua-cam.com/video/3bwwXqFPjpI/v-deo.html
Blue cross Alabama doesn’t require underwriting if you switch from their advantage plan to their supplemental plan.
Helpful discussion of medicare advantage plans. Thank you.
Our pleasure!
Insurance is really quite simple. It's only complicated by agents and companies. I elected to have a PPO UHC Advantage Plan almost a decade ago. It has literally cost me nothing. I have been fortunate that I have to date had no real health issues. Therefore, I have saved many thousands of dollars in premiums. I consider this being ahead when I do have a problem one day. No choice is ever perfect. It all centers around your level of acceptable risk. You look at your choices. Balance the pros and cons and then pick the one that gives you peace of mind. Supplements work for some while Advantage Plans for others. Supplements cost you up front for coverage you may or may not ever use. While a PPO Advantage Plan generally cost zero and you only pay small deductibles when you do require care. Quite simple.
Choosing the proper plan is mind boggling and brain wracking all because there won't ever be one perfect plan. So nicely said about mentioning that it all comes down to one's acceptable risk.
And co-pays
Thanks. That's encouraging. Have been depressed because I cannot afford Medigap.
@@keilana6 I'm not sure where you are located but I think a United Health Care PPO plan is one of the best. Zero premium in most cases plus zero primary care and $35 specialist. You can go anywhere in the country.
Great video, very helpful. I like how neat your bookshelves are.
We appreciate that, Dane :)
Great job breaking this down Danielle!
This is very informative.
Glad it was helpful!
Great very helpful information
Glad it was helpful!
Thanks for the info
You bet
What is a good cancer plan?
Hi Diana, we sell cancer plans here at Boomer Benefits! Give us a call at 817-249-8600, and we can discuss our plan options.
Thank you for this video! My husband and I have a 0 cost Patriot PPO Advantage plan and TriCare. We only go to the doctor once a year and we have no prescriptions. I am seeing a hand specialist soon, I’m not required to get pre approval, the doctor is in my network. I am not sure how TRICARE works with this Patriot PPO. Does TriCare cover whatever the PPO doesn’t? Our plan changes for next year includes a much lower out of pocket and other improvements that seem too good to be true for a plan that costs 0 dollar’s and I want to make sure we aren’t making a mistake by staying with the PPO. Thanks for any advice you can give me.
When you enroll in a Medicare Advantage plan, that plan is primary. However, TFL is unique in that it will often pick up the copays on your Medicare Advantage plan anyway, leaving you with little out of pocket. We recommend contacting your Advantage carrier and ask how your plan coordinates with TFL!
@@BoomerBenefits Thank you so much! I will check with our plan.
@@deboncariboulake Happy to help! :)
Thanks for sharing this! 💯
You bet!
All I need is the gym membership, healthy foods benefits and a nutritionist or dermatologist. Medical Doctors are just sales representatives for big pharmaceutical companies. I do not use pharmaceutical drugs and never will. I am healthy and will stay this way. What Medicare plan is for me?
Hi Charles, give us a call at 817-249-8600, and we can look at the available plans in your area and see if any match your healthcare needs and budget!
@@BoomerBenefits My phone is for family use only. Businesses on line tend to give my number to every over seas Scammer from Pakistan to distant island in the tropics..
My Advantage Care Plan is now not doing me any good ever since the pandemic and we had a hurricane. Docs started charging co-pays. I have restrictions and I do not care to be hassled by group nurses/employees. I am going to purchase policy and get rid of them.
Some advantage plans do have a nationwide network
You're correct!
Great information
Glad it was helpful!
I'd really like to learn about high deductible advantage plans like LASSO and the MSA that is included with this coverage
Hi Chuck - Give us a call at 817-249-8600, and we can look into this for you!
y employer provides an EGWP option. When considering this against Supplements, should I consider it to be an Advantage plan in determining the pros and cons? I find very little information about EGWPs anywhere.
Some hospitals still need to have that IME # since some hospitals are teaching facilities, they need the new number to show Medicare they are properly approving patients and paperwork is properly done.
Great info!! I was researching pros n cons of advantage plan.
As a disabled vet, I use the free VA for all my medical needs and drugs. I have a civilian doctor that I've only seen one time for my initial consultation. I have medicare parts B, N, and D. Maybe an advantage plan would save me money seeing I don't plan on using it.
I assume that letter N stands for Medicare Supplement Plan N? If that's the case, based on your circumstances this is an overkill. You don't need it, nor do you need a Medicare Advantage plan. If you want to continue seeing your civilian doctor for follow-up visits, those are covered by Medicare and your copays will be anywhere from $5 to $10, assuming you already met your Part B deductible. You will pay more for those visits with your Plan N. I believe the copay for an office visit is $20?
You def dont need D since you get the meds from the VA, Im a DAV and got an advantage plan its all i need
Ron you don't need to spend any money outside of Part B. Look for a zero premium medicare advanatage plan. you can set your self up with options (network access, additional benefits) and not have to pay for it. Trust. Thank you for your service! God bless
I joined a Medicare advantage plan for the first time last year and am very disappointed with it and am wondering how hard it would be to switch back to original Medicare? I’m in Arizona.
Did you join your Medicare Advantage plan when you first joined Medicare?
I love my prominence advantage plan.
I just signed up for the advantage plan. None of this was explained to me by the agency on aging in my county. I am sick about this knowledge. I hope I am not locked into this for life. I am waiting for my call to be returned.
Hi Rose - We're sorry to hear you did not have Advantage plans fully explained to you! Did you sign up for your Advantage plan at the same time you applied for Medicare Parts A and B?
Thank you for the value information. Do you know how the emblem insurance work? Do I have to pay them a premium too?
I applied part B after I retired from my job last year. I don't have a clue about Medicare. I told the HR employee benefits that I don't want anything added and I don't want to pay anything extra beside my regular part B deduction that my employer reimburse me. Insurance coverage from my employer covers me for life. I got part B because by law once I get off my job and over 65. I barely use my coverage or Medicare. I don't know a thing about Medicare.
The important thing to know is that Medicare Part A (inpatient hospital coverage) and Medicare Part B (outpatient medical coverage) make up Original Medicare and will be primary to your retiree plan. Most retiree plans help cover costs after Medicare. You can see any provider that accepts Original Medicare. You can create a MyMedicare account to help track your deductibles, premium payments, and claims. Our other videos in our channel will be helpful as you learn Medicare!
Make sure your Medicare Advantage plan is a PPO and includes your doctors and hospitals you may need. If you are healthy you will save a ton of money with an Advantage plan. More than 40% of people choose Medicare Advantage plans and that is rising every year
Yes, PPO Advantage plans provide you with more flexibility to visit doctors that are outside your network.
@@BoomerBenefitsYes. moved to a new State, the "Doctors " who were actually nurse practitioners that my Advantage plan sent me to caused me a lot of trouble. I have PPO and found a real Physician out of network who spend a full hour WITH me and it's providing actual medical care.
I only now am exploring insurance options and will call your office soon. Thanks for this video.
Well done. My question is: how much does Medicare pay the Advantage plans?
I believe it is $800- $1000 EACH MONTH! More $$ for companies who "claim" they have expensive high-risk member patients. Not all but some insurance companies can and are "gaming" that provision.
Turning 65 in Oct ‘22. Planning to never retire. Work for large university but group insurance deductible so high and so many hidden costs I’ve stopped seeing docs for several years now due to bills in the thousands even for preventable such as skin cancer checks etc. Fairly low monthly premium and my college-age son is on my plan. He can now get college student insurance at his university. Can I leave employer insurance and go full Medicare with Medigap? Do I have to stay on large employer (1,000s of employees) insurance even though I’m too scared of costs to use my work insurance?
Hi Catherine - If your employer does not require you to stay on their insurance plan, then yes, you can drop your employer insurance and enroll in Medicare and a Medigap plan! You can apply for Medicare during your 7-month Initial Enrollment Period through the Social Security office. Your IEP begins 3 months before your 65th birthday month and ends 3 months after your birthday month. The time to apply for a Medigap plan is during your 6-month Medigap Open Enrollment window, which is based around your Part B effective date. Please give our team a call at 817-249-8600 and we can help you with this transition!
This sounds like that once you enroll in one of these plans, it's set for life.
You can change Medicare Advantage plans during a qualified election period, such as the Annual Election Period or the Medicare Advantage Open Enrollment.
My full retirement age is 66 and 4 months which I will be in January 2023 just a few months away I plan on start collecting my social security then and also applying for Medicare part b and dropping my employer health coverage and getting a local supplement plan and plan to keep working full time for a while and yes my employer has more than 20 employees and I am on Medicare part a since September of last year and yes I know I could just skip b for now until I am ready to fully retire problem is I don't know for sure how much longer I am going to keep working past my full retirement age that's why I want to start everything at the same time so I can walk out at anytime what's your thoughts on this plan also could I delay part d and just get part b and and supplement in January my full retirement age
Is there a plan that is valid out of state?
For example, I'm 64 and my AK/WA Blue Cross does not cover us while we are in VA for 3 months except for emergency procedures.
Medigap plans travel with you! So, if you were to purchase a Medigap plan once you turn 65 years old, you can visit any doctor in the U.S. and use your Medigap plan as long as the doctor accepts Medicare. If a doctor accepts Medicare, they must accept a Medigap plan. Check out our video, Are Medigap Plans Worth the Money?
I’m 62 years old and I will be eligible for Medicare in February. First I had a hard time finding anyone to help me. I’m on disability. I live in Ohio. And I was told l could only get an advantage plan. Is that true? Also if it is true, can I switch to a medigap policy when I turn 65? I appreciate any help.
Hi Jo Ann - Not all states require insurance companies to sell Medigap plans to those who are under age 65. If you were to apply for a Medigap plan while under 65, you will find that the premiums are way more expensive compared to a 65-year-old rate. Due to this, many seniors enroll in a Medicare Advantage plan until they reach age 65. Once you do turn 65, you will be given a second 6-month Medigap Open Enrollment window, where you can apply for a Medigap plan without underwriting and you can receive a 65-year-old rate. If you have any questions about this, give our team a call at 817-249-8600. Also, check out our UA-cam video, Medicare for People Under 65 | What You Should Know
"The first thing to know about Medicare Advantage . . . blah, blah, blah." Dude. The first thing to know about Medicare Advantage is that it's a system of for-profit insurance plans, NOT real, government run Medicare. This should be stressed and repeated, not buried in an avalanche of words.
What are your thoughts on Kaiser in California ?
Hi Mark, give us a call at 817-249-8600 and our team will be able to help answer any questions you have about this!
The government has not planned for fairness of equal care for all its citizens,Those who cannot afford the Supplement are stuck with Medicare Advantage. Government getting involved with healthcare, although initially a good idea, brings about beaurocratic regulations which often do not make common sense and seem to be for the benefit for insurance compamies. Medigap works well but why should those with modest income be penalized monetarily? Insurance companies appear to be taking advantage of those who cannot afford the Medigap premiums. Seems like government should devise equal care for all its citizens. And then there is the the ridicuous Pharmacological rules which for some incmprehensible cannot be included in the policy.
Very informative but it only covers advantage plans through insurance companies. Kaiser Permanente Advantage is a stand alone plan that has their own doctors, hospitals, labs, imaging, etc. In this plan there is no insurance company or concern about a provider leaving the network. Copays are paid at point of service so no surprise bills later. Kaiser Advantage is unique and easier because all your health information is shared in one database and there is no insurance company to deal with. Another thing to keep in mind is what she said about providers dropping out of insurance plans. There is no law requiring insurance companies to keep their provider directories updated. My wife who is not on Medicare went to a doctor listed in the insurance provider network and discovered that he dropped out. This was several months back and even though we reported it to the insurance company he is still on their directory today. We complained to everybody including the Better Business Bureau, California Dept of Insurance and California Department of Managed Health Care and to put it simply they said too bad we can do nothing. That's why I despise insurance companies. Keeping them out of the loop makes my life so much easier. You just can't trust them.
Art here again I plan on getting back to work how will that turn out if by chance after 24 months and get Medicare and loose Medicaid and want to try to get back working.
What is the best plan for me that I go only for a doctor's checkup ,blood test twice a year,I taking only a maintenance medicine for my thyroid and high blood pressure?
Hi there! The best plan for you will depend on a couple of things. If you are one who visits or might visit the doctor often, then you could look into a Medigap plan. If you are wanting to find the fullest coverage, then you can find that in a Medigap Plan G. If you do not believe you will visit the doctor often and would like added benefits such as dental and vision, then you can look at a Medicare Advantage plan.
If you need any help with deciding which Medicare plan might be best for you, please feel free to reach out as we are a Medicare brokerage that represents 30+ carriers. Our phone number is 817-249-8600.
I'm confused. Do I only need a cancer plan if I choose advantage? Is the backend cost on advantage above or additional to your maximum out of pocket with advantage? Thank you
Hi there - You can purchase a cancer plan whether you enroll in a Medigap or Medicare Advantage plan! You can purchase a policy that gives you a lump sum and therefore, you can use that for your Part D cancer drugs if you are enrolled in a Medigap plan or you can use it for any cancer-related out-of-pocket costs with the Advantage plan. In 2022, the Medicare Advantage maximum out-of-pocket (MOOP) is $7,550. However, a carrier can lower the MOOP, but cannot make it higher than $7,550.
To learn more about cancer plans, check out our UA-cam video, Why You Need a Cancer Plan with Medicare Advantage
Advantage is fine as long as you never get sick. No thanks.
Danielle has said this for years but it's not what people want to hear. Nearly 48% of beneficiaries now choose MA plans - that $0 premium is just too enticing.
Can you explain the city of newyork is starting a Medicare advantage plus , we as New York HHC workers (unionized don’t need part C) it’s new and we don’t know much about it.
Hi Sara - The two states we are not licensed in are New York and Massachusetts. Since we are not familiar with the plans in New York, we do not have any information on the plans in that state.
oh dear...just turned 65 and I went for an Advantage plan as recommended by an agent. Now I'm worried...
Hi Nemo - As long as your doctors are in your network and you are okay with your plan's Summary of Benefits, then you should be okay! However, if you would like a second opinion on your plan, please feel free to give us a call as you likely still have other options! Our phone number is 817-249-8600.
You have a year to change your mind, so don't sweat it too much.
When it comes to Medicare plans, you get what you pay for.
I've been on an Advantage Plan for a couple of years and just switched to a Supl
a Suamentsl Plan. I'd rather pay more monthly because It was to
cost too much to get any tests done, the copays are very high. They don't tell you that we you sign up?
United health care. My Insurance. Janet Hobson. Thanks.
My primary care physician, whom I really like and have seen for many years, does not accept Medicare. I am turning 65 and have hard choices to make. There’s very limited choices in my area for AP, (2) and I know now my oncologist doesn’t accept one of them. That is a real problem out there! Many good docs do not accept Medicare and others won’t take your AP. I will be forced to choose an Advantage plan if I want to continue with my current primary doc and then find a different oncologist. 😢
Hi there - Only 1% of doctors do not accept Original Medicare! With that said, Original Medicare does not have a network. Therefore, you can visit any doctor in the U.S. that accepts Medicare. Whereas with an Advantage plan, there are network restrictions, and doctors are not required to accept your plan. If you plan on working with our Boomer Benefits team, we can research and find the doctors in your area that accept Original Medicare.
👍nice choice
Oh my goodness. My must healthcare be so complicated? Why must, we the people, start the conversation by answering the question what is my budget, and what are my goals for my healthcare coverage? Minute 27:00. Shouldnt the answer be to solve my medical problem. full stop. Money seems only to be a necessary consideration because there are companies in this system that are out to make a profit, which means they charge as much as the market will bear for the motive of enriching themselves.
Because it takes money to provide professionals and supplies, it's the world we live in.
@@genox3636 Your answer is not an answer. No one denied that. The problem is profit driven healthcare, where the money, much of which comes from the US taxpayers, goes to the corporate headquarters.
@@SandfordSmythe welcome to planet earth, and to the United States. Glad you finally came out of your slumber. The more dependent you are on the system, the harder it is to be free from the drug barons.
@@genox3636 This answer is also confusing. "Dependent on the system"?
@@SandfordSmythe haven't you considered traditional medicine, now called "alternative medicine? " if the current medical system is your only way to manage your health, then your dependence on drugs is going to indebt you to the system.
If you're sickly stay away from advantage plan. If you been healthy all your life then advantage is good 👍
Thanks for sharing your input!
With the Affordable Care Act, the insurance company can still reject people to get Supplemental Insurance? Can you explain?
Hi Sean - The Affordable Care Act has nothing to do with Medicare, Medigap, or Medicare Advantage plans. Medicare cannot turn you down due to health conditions, and Medicare Advantage plans no longer ask any health questions on its application. Now, you have a one-time 6-month Medigap Open Enrollment window to enroll in a Medigap plan without underwriting. If you apply for a Medigap plan outside that 6-month window, then a private insurance carrier could deny you a Medigap plan.
Learn more here: boomerbenefits.com/medigap-underwriting/
How about a deep dive into Medicare plus Tricare For Life?
Thank you for this video suggestion! In the mean time, feel free checking out our Tricare & Medicare article here: boomerbenefits.com/tricare-and-medicare/
What happens when the person is limited to only 1200$/mo social security. She living in a home one of her children own currently. Does this become a Medicaid + Medicare type situation?
You would need to check with her local Medicaid office in order to find out if she qualifies for Medicaid, as it varies from state to state.
You know you live in a dystopian hellscape when "working some overtime to pay off medical debts" is described as a luxury. I hate my country.