Medicare Advantage vs Medicare Supplement Cost Comparison (2024)
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- Опубліковано 20 жов 2023
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✅ Best Medicare Supplement Plans in 2024: • The Best Medicare Supp...
✅ How to enroll in Medicare: • Medicare Sign Up | How...
✅ Medicare Advantage Plans Explained: • What is Medicare Advan...
✅ How does Stephanie get paid? • How Do Medicare Broker...
✅ How to shop for Medicare Advantage Plans: • How to find the right ...
✅ Enrolling in Medicare when you retire - Past age 65: • Working Past Age 65, H...
Medicare Advantage and prior authorization: oig.hhs.gov/oei/reports/OEI-0...
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#medicare #medicaresupplement #medicareadvantage #medigap #turning65
Stephanie, I’ve listened to many Medicare channels and became completely confused but then you came along! You have a wonderful gift in communion that is clear, concise, AND organized. THANK YOU 🙏🏽!!!
Wow, thank you for this compliment!! So glad you are here 🙂
My mom has a Medicare Advantage (HMO) plan. A few of her doctors (not in general, but a few) have a bit of a “herd them through” care-en-masse mentality: Check in, fill out a whole lot of Liability-related forms, wait an hour, see a nurse for 5 minutes, then a doctor for five minutes, then get out of the office so they can treat the next >80-year-old.
Again, only a few are like that, but enough to be a little frustrating. I gather there aren’t many other treatment options.
All insurance plans run by for profit companies sound great.... until you try to collect.... then reality smacks you right in the face.
An advantage plan is ok if your healthy. Last year I had the advantage plan and had so many copays. Also had a lot of test. Very expensive. Went back to Medicare and medigap plan. It was the best thing for me. Thankfully my health had improved. Thank you for helping people like you do. Listening from NC.
Thank you Pam! I’m so glad you are on the best coverage for your needs.
I work at a hospital. We have issues with getting approvals for rehabs, home health companies not accepting them. There are many barriers with them. Not approving lower level of care, denials. Good luck if you go out of network. Stick with traditional Medicare with a supplement. We call them Medicare Disadvantage Plans. Plus you still get charged for your Part B, around $168.00 a month.
My mother was recently in the hospital for 10 days and they wanted to send her to a rehab facility. Mom was familiar with a couple places, because her sister had been in them and they were the best facilities around. A lady from the hospital came in the room and told Mom that she could go to the one that her sister went to. About an hour later, she came back and said Mom's Medicare Advantage Plan didn't include that facility. So, we had to pick one of the lower rated facilities. Bottom line is that Mom only lasted 2 days there and passed away. Stick with regular Medicare, get a supplement like G and D. It seems expensive but your life depends on it, believe me!
So would if you can't afford Medigap?
Does ANYONE believe you?
@@jeffmooney9429You tell a great story! Keep many as possible on old Medicare, it helps me get all the extras AND money also.
I don't no if I believe any of you all!!!! I called my agent he didn't no what I was talking about but I did he kept blowing me off I busted him on the long turn care the big 100 days that they denied u because it's a third party they hire to keep denying u they don't care the lady at the senet with the lady that lost her husband watch they're lying to us old people
Cancer survivor. If later in life I get cancer again, I'll accept my fate as I'd never go through that barbaric cancer treatment again.
Only to have it come back.😮
That’s probably a hard decision. My Dad had many different types of cancer. Kept beating them and passed at 87. I don’t think I would have that strong of a will to live. Hope you’re doing well.
Same here! The sooner I can be with my beloved late husband, the better.
Same here. I chose NO Chemo 6 years ago. So far so good
I think people who've never had cancer don't realize how brutal the treatment is. I consider myself a survivor because I survived my cancer AND the treatment!
The freedom to choose doctors and that the doctor, not the insurance company, deciding the course of treatment is why we went with traditional Medicare. We had enough with insurance companies defining which doctors we could see, having to change doctors when a medical group dropped out of their deal with the insurance company, and insurance determine which treatment we received.
I have been in healthcare 30+ years and hve trained mcare to employees. You did a good job presenting this information.
Thanks!!
Thanks! Your explanation is very clear and easy to follow. I might add that we need to remember that our medical needs will likely increase iver the years beyond 65. I chose plan G for the anticipated greater needs down the road, not for my current needs.
Excellent point.
I have seen a lot of comnents complaining about Medicare Advantage.
In 1995 I helped my 81 year old grandmother switch from her Medigap plan that cost her over $400 each quarter to a $250 per year MA plan with dental, vision and hearing. She kept her PCP and her local hospital. It served her, and my other aged relatives through their lives.
Medicare Advantage plans vary greatly around the country and even within states. You need to see what is covered and additional costs, if any. It pays to research.
Very helpful. I would include in your presentation that there is a penalty for not taking Part D (drug plan) when you first become eligible ( starting on Medicare) and then later decide to take Part D. You would then have the penalty plus the monthly premium for the Part D plan.
If you want to switch from an Original Medicare -Supplement Plan to a different supplement plan you do mention the medical underwriting. The company has several options- they can deny you coverage ( based on your medical needs), they can accept you but in turn charge a higher premium or accept you but delay coverage for the first three months of the year. These were options presented to me when I considered switching my original supplement plan.
Pros and cons, my brother whom started with a gap plan and is now 80 is paying a lot as his premiums have increased over the years
I've been a patient of a Medicare Advantage plan since 2020 and have been treated for my cancer since then. I have had nothing but a wonderful experience with my doctors and treatments.
That is so great to hear!
What state do you live in?
Hi Brian! Do you mind telling me which plan you're on? Thanks so much for your help. xo
That's awesome. Which plan have you had since 2020? I'm searching for a new reputable advantage plan, since my Cigna plan is being sold to another company.
What Medicare topics do you want to see more videos about? Let me know in the comments! 👇
Would like to know on prescription drug plans and if you are a disable person how it affects on costs or discounts. Thank you.
Definitely more on Medicare part D, the best plans. It is very complicated to understand!!!!! The different phases and the donut hole makes no sense!!!!!
It so hard to understand all this information at old age so confusing I'm getting so stressed bc I'm in mess with my health insurance who send me letter that I will not be cover for 2024 .why couldn't found out yet pls help🗽🗽
@@sithbk0075 great idea!
@@123456711751 100% Part D is the most complicated part of Medicare!
Great helpful info. My wife and I are coming up on 10 years on our UHC AARP Advantage Plan and it's worked fine for us. The premium is $19 month each. We're healthy and have very little out of pocket expenses with this plan. And over this nearly 10 years, we've saved thousands on supplement premiums. Whatever meds we've needed have been covered enough to make the cost minimal. And we like the eye and dental coverage. Over our nearly 10 years, we've saved nearly $30,000 versus Plan G. We're comfortable with our ability to meet the maximum annual OOP expense should something bad happen. And we set the premium savings aside should we need it down the road. Everyone is different. There is no one size fits all.
MA plans work best in metropolitan areas where there's lots of doctors and medical groups. If you are in a smaller community you will be stuck with whatever the local MA gives you. Get a critical disease or need specialty surgery or treatment? Good luck, you will be waiting and have limited choices
Jay, Your example is typical of healthy seniors on Advantage Plans. Stay healthy my friend. Hopefully u will never experience the real truth and "disadvantages" of these plans. When you need them the most they will delay and deny you the level of care that you get with a supplemental plan. My sister in law loved the low premiums and saved money til about age 73. Got cancer, was forced to accept old protocols and drug treatments. Constantly delayed treatment because of automatic denials. Had to travel triple the miles to stay in network for subpar specialists. Died at 77 in a filthy rehab that was all Advantage would pay for. The acute rehab care the doctors ordered was denied. Waiting on appeal from her insurer she choked on her own vomit and after spending almost a month in icu was finally placed in an acute long term facility to die 7 months later never regaining consciousness. Advantage plan killed her and left her estate in debt.
Just wait til you get sick or in the hospital.....
@@bennym1956 like I said, we've saved a bundle on our current plan since going on Medicare nearly 10 years ago. And we're comfortable covering our deductibles and co-pays going forward IF something happens. No one path is right or wrong. Everyone needs to make their own decision on what plan to buy and not be influenced by scare tactics or salespeople.
These instructional videos have provided me with incredibly valuable information in making the decision to purchase a Medigap (Plan G) policy with stand alone part D coverage. It's quite amazing how so many people that I used to work with opted for an Advantage Plan, because it sounded "so good." Unfortunately, they did no research. However, I'm certain that an Advantage Plan will be fine, or necessary, for some. Nonetheless, to me, it wasn't worth the gamble with advancing age.
Solid choice!
MA plans, BY LAW, must cover EVERYTHING old Medicare does! AND, they protect you from catastrophic medical bills! ALL have max our of pocket costs, usually around 2700 dollars. Medicare DEDUCTIBLES are MORE than that! Most MA plans put 164.90 BACK into your SS check EVERY MONTH! AND, they have NO PREMIUMS! DO your research!
I agree with you. Too many stories of folks where everything is going fine until it isn't. No one ever thinks it will happen to them. I do my gambling at the casino, not with my health.
Smart choice!
@@joannejohnson85 wrong
Thank you Stephanie this was extremely helpful information btw your white board reminds me of Katie Porter and that is a good thing 😊
Another key item is when you move to another county or state with Advantage you will need to get a new advantage plan that covers the new area. The new area can have restrictions on what hospitals you can go to based on the primary care Dr. This can be bad if the hospital is a low rated hospital and all the approved Dr’s use the same hospital. In contrast, having the supplemental G gap plan you can take the coverage with you and go to any Dr or hospital.
Also, with advantage plans, when you are in the hospital, you may need to wait a long time…some times days while the hospital get approval for procedures, which is bad if you are in pain waiting for approval. This happened numerous times with both my parents, especially on holiday weekends.
This is a very refreshing video and the approach you take to illustrate the information. I’m 54 and I’m a long ways away from making these decisions, but I am gaining valuable knowledge through your east to follow videos, not to mention some of the well thought out comments some folks leave sharing their experiences. Thank you.
All Medicare Advantage plans change EVERY year so NOTHING you are listening to will be the same by the time you get your Medicare! Medicare Advantage plans are CONTRACTED BY MEDICARE. Supplements are NOT. You are protected with a Medicare Advantage plan as they are under contract with Medicare! Medicare Advantage plans have contracts with doctors, hospitals , and pharmacy. That's why they can provide better care for less. Supplements have no contracts with ANYONE so prices are NOT REGULATED. Medicare Advantage plans have groups of doctors, many of whom ONLY treat seniors. They are more knowledgeable about senior care AND you are NOT sitting in a waiting room with a bunch of sick kids! Most of these doctor GROUPS have senior centers which offer MANY EXTRAS! EXTRAS like free transportation , meals, exercise rooms Social Centers, even some have free hair stylists! ALL Medicare Advantage plans are for seniors only!
Glad it was helpful! 😊
Wow!! Thank you for explaining that sooo well!! I am going to recommend your channel to others who I think can benefit. I perceive you as a WONDERFUL human being, so beautiful inside and out!!! ❤❤ Please continue to be you!! :-) Btw do you have agents licensed in North Carolina? Just curious.
Wow, thank you! And yes me and my team are licensed in NC 😊
@@AbtInsuranceAgency You are most welcome!! Awesome!! 😊
So glad to hear someone explain how all this works. That's why I have plan N and not an advantage plan most people get sucked in by rhem than when they get sick which will happen they wonder what happened.
Thank you so much for this. Easily the most clear and comprehensive explanation I've heard.
I love how she's been truthful, transparent and honest. Kudos! Thanks for sharing the difference between the options with such details. You're trustworthy! 😊
You're so welcome!
I’m a diabetic and retired at 62 and AT&T after 34 years of service took away our health insurance, so now I’m looking an affordable care act for coverage. What I find difficult is getting coverage for Dexcom CGM sensors, insulin and Omni pod ( insulin pump). When it comes down to Medicare I understand that I should not use the advantage plan and use A and B for my pump supplies. Plan for the worst and hope for the best….medicare A,B and G looks good. Doe you handle the ACA plans ?
Friends don’t let friends choose Medicare Advantage!
If only money weren't an object in this decision, then I would agree with you. However, personally with my small monthly SS benefit amount, I will probably have no choice but to choose a zero premium medicare advantage plan. I've studied and listened to specialists about this subject for the past year, and if money weren't a deciding factor, I would choose Plan N - hands down. Alas, I'm going into retirement with very little savings and a history of low wages all my working life. Fortunately, I will soon have no house payment which will allow me to retire. My husband has Medicare Advantage and had brain cancer surgery last Dec and follow up radiation treatments for both brain and lungs. Overall, it has been surprisingly amazing to us how little we've had to pay. We're nearing out out of pocket max of $5800...but for the past 10 years, we've been virtually cost free. Individual situations rule in Medicare, so people need to get educated and choose wisely for their own personal situation.
Wow! Excellent information. I couldn't decide until I watched this video. I'm one of those 66 yr. old healthy-as-a-horse guys (thanks to the Marine corps keeping me in shape for 13 years!) and I never go to the doctor (even probably when I should) so an Advantage Plan with zero monthly payments and the occasional higher co-payments will work for me! Thank you so much!
You are so welcome!
I’m totally healthy no issues but I got supplement G because I pay nothing after the deductible and the monthly charge for the supplement
Just because you’re healthy other things can happen
I was stung 15:42 by multiple yellow jackets last summer and had 2 urgent care visits , I Dr visit , steroid shot and I now need an epi pen so thankfully I payed $0 for any of the visits
My prescription plan is minimal since I take no meds so I had to pay for the epi pen but I know that was still alot less than any go pays or deductibles I would have had without my supplement
Texas- 65 years old $146 month for Plan G, Dental $47 month for 2k allowance, all this without the $240 yearly deductible and $174.70 monthly premium. Of course, no hearing, prescription drugs nor vision.
Look very closely at what that dental plan actually covers. You may find that it is not as comprehensive as you might think. If you need a crown, precisely what kind of crown is covered and at what price. For example, I needed a crown on a tooth labeled "First Premolar" (right after the Canine tooth). A very visible tooth. My dentist put in a a ceramic porcelain crown for $1500.00. My dental coverage would only cover a non-precious metal crown (the silver colored type) with a cap of $525.00, and after the deductible was subtracted, insurance covered only $250.00. I was out-of-pocket $1250. So, be very careful.
This is the best explanation I've heard about traditional Medicare vs. Medicare Advantage. I chose Medicare Advantage for my husband and self. We have a very good plan, however; if I had heard your explanation and had your counsel I might have gone with traditional Medicare instead. Traditional Medicare has more moving parts (more options and choices = complicated) than selecting an all-inclusive Medicare Advantage plan. The difference is in the often unexplained details you shared.
Glad it was helpful!
I have some time to decide, fortunately my Oregon OHP will pick up all costs, and Deductibles, not covered by Medicare. ( a few years away, but I sure love Oregon OHP, which covers all costs 100%)
I went with a Medicare Advantage plan because I only go to the doctor twice a year (no out of pocket, no co-pay) plus it comes with Silver Sneakers access, dental, vision and hearing (which I have not used because my hearing is excellent). I have been on Medicare for about 8 years, and my cost each year has been $72 for two prescriptions that I take, but because both of these are tier 2 medications, that will go to $0 starting in 2024. My maximum out of pocket is $5,850 network providers and $8,950 non-network. There is no doctor co-pay and I am responsible for days 1 - 6 hospital stays at $300, with the cost dropping to $0 after that. As this video points out, Medicare Advantage saves me quite a lot because I am not using it much.
My sister has a supplement that is costing her about $175 per month, so for the same 8 years, she will pay 8 years x 12 months per year x $175 per month = $16,800 in premiums, plus she must pay for her own dental and vision care since that is not paid for by Medicare. She is like me in that she doesn't need medical care a lot, probably averaging one doctor visit per year, one dental visit per year (I get two visits per year for free) and hasn't been to see the eye doctor in years. IDK if she has Medicare Part D (drug coverage) or not.
Insurance companies have this worked out to where they are going to make money one way or another. If you are fairly healthy and have a family history that indicates this will probably continue to be the case, a Medicare Advantage plan may be your best option, but if not, a traditional Medigap plan for a monthly fee is probably your best option.
This is an excellent example - thank you for sharing!
Advantage plans for healthy seniors are good until you develop a serious health condition.
One other thing to consider is, Medigap policies go up as you age and can put a big strain on your finances. The company I retired from is offering an Advantage plan, $0 premium, with an out of pocket maximum of $900.00 a year. Seems like a no brainer to me.
Well, just wait until you have a moderate to serious health issue and have the needed procedure denied. Then see how you feel about this being a "No Brainier"!
That sounds like it could be a very good option!
Employer retiree health options are not the same as what is on the open market. It really depends on how the insurance company and your former employer structured the plan. Ask those you know on the plan who have health issues their experience.
@@rosemarybedosky146 absolutely, employer /retiree Advantage plans offer have lower out of pocket limits and “better” prescription drug coverage as well.
@@tomjames5374 What advantage plan is that?
My Medicare premium is $675 per month. My supplemental G plan is $138 per month. I think this is reasonable for the care I get.
Your videos are very informative . Thank you ! Do you cover NJ?
Yes!
Just discovered your videos earlier today as I’m preparing to start training on Monday to become a Medicare Agent. His is the third video of yours that I’ve watched and think you are an excellent source of information! I’d like to note one thing though. In this video, you describe in detail the various parts of Medicare until you get to the white board. At the white board, as you’re totaling up the monthly and annual costs, you added plan G for the first time, and you didn’t explain what plan G was. This is about the 8:30 mark. Hopefully you’ll go into it later in the video and I should have waited till the end to comment. Anyway, love your videos.
This was very informative, thank you!
Glad it was helpful!
Where is the link to the video regarding guaranteed right to purchase mentioned at 14:03?
With advantage PPO, can I choose any doctor who accepts Medicare? Thanks.
can I change my provider of Part D during the year or do I have to wait for new enrollment period?
I wanted to know if I should continue with plan n or my husband thinks that i should go with a medicate advantage plan like he has. Not sure if I should change my plan. Right now I am paying 96.00 a month and I was quoted a cost of 90.00 with another company. Not much of a savings.
Very informative! Thanks
Thanks 😊
Can you change Part D Rx without the insurer being able to say no due to preexisitng conditions?
A Medicare Part G High Deductible plan can cost as little as $28 a month.
You explained this so well thank you so much
Glad it was helpful!
Thank you Stephanie. Your videos are extremely valuable to me, trying to navigate this complex Medicare first enrollment process. 😊
You are so welcome!
I really like all of your videos. So straight forward and easy to understand. It helped me a lot!! From Texas
Thank you! I’m in TX too! 🤠
What is the commission an insurance agent makes on the supplement plan?
Great video, thank you.
I understand that the Medicare part b premium can increase based on your income from 2 years ago. I'm 65. When I retire I'll go from a high salary to a low salary. This sounds like that I'll automatically have high premiums for both myself and my wife that will last 2 years while during that time I'll be making much less. Doesn't seem fair that these premiums will be based on a salary that is a distant memory
Correct - but if you retire and have a “life change” you can appeal IRMAA - ua-cam.com/video/dcxR8QgVGNw/v-deo.htmlsi=7b7yFHbheW_w-RSx
If you get a letter stating you need to pay IRMAA and you have retired and no longer have the high income you had while working, there is a form you can get from Social Security which you can submit stating that you retired. You will also indicate on that form your current income, and as long as that amount is below the threshold set for IRMAA, it will be waived.
Thank you soooo much! I turn 65 in December and am absolutely clueless about all this. I did apply for my A and B and just received my card in the mail. I have watched several of your videos and have a MUCH better understanding of how all this works. You have done an amazing job explaining the different plans, pros and cons....thanks a million 🙂
I am so glad to hear this! If you need help with your Medicare plan, we would love the opportunity to assist you. 888-465-9728 🙂
Stop çonfusing people
@@garymatthews7043on the contrary, she has clarified many points for me
NOW, talk to some MA sales people! Get the TRUTH of MA. You have to contact THEM, THEY cannot contact you...BY LAW! These folks can contact you to sell their plans but the LAW doesn't allow MA sales people to contact you. Don't go to a Chevy sales person to learn about a Ford! MA plans are so much better than original Medicare AND they get better EVERY YEAR.
Beware!
Excellent video. Thanks.
Glad you liked it!
Maryland: 67 Plan N $115.35/ month part D drug $7.30 premium covered my MD SPDAP so no drug premium cost to me
As usual Stephanie you have been very very helpful. Thank you for all you do for us
You are so welcome!
Very helpful thank you
All conglomerate healthcare companies dislike Medicare Advantage since Medicare is utilizing the expertise of the insurance carriers to make sure they're not being overcharged overbuild and that they are not paying for services that are not benefiting the patient. These large companies simply want no oversight and the ability to overbill and overcharge the federal government run Medicare fund. I personally want someone to be looking over the healthcare providers shoulder to assure that what is being done is right, benefiting me and within the scope of what should be done reasonably. The only people you ever hear tell you not to get a managed care or Medicare Advantage policy or people who work in and for the health care conglomerates.
@@misschicka2831 Advantage Plan shill alert!!
Thank You... I'm not stressed. As much.. Now that i understand. Now that i understand i can make my intelligence decision
That is what I love to hear!
I'll be 66yo on December 23rd this year. I've learned a lot since my 65th birthday from watching your videos. I currently am covered by my wife's insurance so I only have Medicare part A. I'll probably be confused all over again when I'll need part B plus extras! Thank you for your help. Keep doing what you do. You're the best!
Thank you! We are always here to help when that time comes!
Don't listen to a Ford salesman to learn about a Toyota! You want to learn about an MA plan....you MUST call an MA agent! They cannot call you! BY LAW!
@@GAderly-fn5ly I am a MA agent and also a Medicare Supplement agent.
What do you recommend for dental and vision coverage if I decide to select a part G plan?
That is a tough question, the one advantage of MAPD is that they undoubtably have better ancillary benefits. I would honestly recommend Aflac. They have a dental/vision plan that improves each year you have it, upto 3 years, but you get like 2,500 in dental with 90% coverage for basic and 80% for comprehensive services for around 30 a month.
A informative video. - I went with a plan n coverage when I turned 65 because of a hip replacement surgery and I wanted to know what I should do if I need my other hip replaced in the future. I do have hip displaysia and have a feeling that I may need my other hip done down the road. Please advise.
Do you mean what to do in regards to your medical plan?
Where can I get supplemental ins. Under 65. Need a surgery?
Yes this information was very helpful to me... still alittle confused and will have money taken from social security monthly i am with United healthcare
Medicare advantage gives the largest commission to the insurance salesman. Also the companies make the largest profit from the advantage plans thus the onslaught of tv advertising and mailings
@@misschicka2831 It is clear YOUR ARE AN INSURANCE AGENT! Offering a trinket to trick gullible seniors into plans that advantage YOUR bottom line. What company do you work for?
Very clear and simple explanation
My father had a heart attack after being released from a facility 3 days prior. He fell when he had a heart attack and suffered 2 compression fractures in his spine. He was unwell for months which is why he was in a facility before the heart attack. He worked all of his life. Medicare is now refusing to pay for skilled nursing in a facility. The man can barely walk, is a fall risk, and weighs maybe 150 lbs soaking wet if even. He is and has been losing strength and weight daily since the beginning of December. He was 'visiting" my brothers in another state when this all happened. His doctor will not clear him to fly for at least another 2 weeks and 4 weeks to go back to his home state. My brother is not able to take care of him 24/7, nor is his home equipped for an aging parent. Medicare does not care. Either my father has to go to my brothers or they throw him out on the streets.
Well presented clear and concise. I've been on Medicare part F for years. I've not been convinced of Medicare Advantage plan advantages other than gym benefits. 75 years old dog here with history of hiv,stroke,heart attack, ckd. For me supplement is a no brainer.
I have an F as well. I was shocked the first time I used it and had $0 walking out the door. Mine is $275 a month. I rarely go to the doctor but figured it will pay off in the end.
??? So confused! Husband is younger, still employed and has excellent insurance thru Stanford. I signed up for parts A and B because I do not want to pay higher premiums later for not opting for Medicare initially. However, after listening to you I suspect it is the supplemental insurance that would have the higher rates.
Would the waiver that SSA keeps referring to be the proof of insurance from Stanford and so long as we apply for insurance 6 months prior to his retirement keep us covered?
Can I choose a Medicare advantage plan now so I have no lapse in coverage while I wait for the underwriting process to see if I qualify for a medigap plan?
This greatly depends on your specific situation
Your annual cost for Supplement Plan (Plan G) does not seem including the extra cost for dental and vision care premium?
Why dental and vision are not automatically considered? Part of a health plan is beyond me. So original Medicare is greatly lacking because it doesn't deal with these 2 extremely important aspects of healthcare of elderly persons.
I really appreciate you videos. You explain things so well.
Thank you! 🙂
It's really sad that the government and insurance companies spend SO MUCH EFFORT to "help" us all... instead of just letting us have a HEALTH SAVINGS ACCOUNT, which we could have initiated at birth... for use or dispersal upon reaching 65 and coud also cover a basic burial cost. But that would be too logical, I know...😒
Am I understanding this correctly: Medicare Part C is contracted with the government so companies get paid a certain amount to offer MA plans (through Part B premiums and tax payer's payroll taxes). That money they get, they manage to control costs (e.g., allowing certain procedures). On top of that they can charge co-insurance and co-pays, right? Is that just pure profit?
This was the best explanation I’ve heard on this subject. Thank you very much.
Glad it was helpful!
Considering getting into the industry. This explainer video was really useful. Thank you.
Glad it was helpful!
Thank you for these videos! All of this is so confusing for someone about to enter the retirement world and these vids are a tremendous help. For those states with the "birthday rule" (I'm in OK), can one start with an Advantage plan and then switch to a supplement plan without underwriting?
Great question - no. The birthday rule is only for those who are already enrolled in a Medicare Supplement plan.
I apologize in advance for this question, but agents generally push plans that pay the highest commissions. Do agents get commissions from Medicare advantage plans? If not or low commissions, how are we as consumers to know if the proposed plans is in our best interest?
Some agents absolutely push the plans with the highest commissions. Medicare Advantage plans pay higher commissions than Medicare Supplement plans in general. The higher premium Medicare supplement plans (like Plan G) pay higher commissions than lower premium plans like Plan N. A good agent with integrity will build a book of business based on doing the right thing and on referrals by helping people with the best plan for their needs. There are still some good Medicare brokers out there - although not nearly as many as their should be.
@@misschicka2831 What are your credentials for making this assertion? Do you sell plans?
AARP/UHC provides dental/vision/gym with supplements, too.
With some of their plans, yes!
UHC is great, I've had it for years.
Hi, I'm 61 and have been listening to your intelligent, helpful videos. Because of the knowledge provided by Abt Insurance I feel a bit more confident regarding tackling my future Medicare enrollment.
I'm sure I will be calling your company in the future. Now, if only I had a lot more money packed away. 😂
Call us anytime! And thank you for watching!
When it comes to any medical procedures in the USA, you had better be rich. 90% of all bankruptcies are to sell your home to pay for your medical bills.
BILL BEEB
I am about to start Medicare in Jan. I have been on full SSDI since Jan 2023. Can get a Medigap plan if I have Medi-cal with a share of cost (SOC) My share of cost is $1300.00 every month
Great content; thanks for your time creating it!
Thank you for watching!!
Military retirees using a Medicare Advantage Plan according to our local MTF you may use the ER and a few other of the facility's entitlements, but they want you to have your own physician, not using the MTF assigned provider. The MTF will no longer be responsible for coordinating referral benefits. It's now all through your Advantage Plan.
I’m switching from plan N to united healthcare Advantage plan (55.00 per month).Being a resident of New York State can I switch back to the plan N without a penalty or denial of coverage.Thanks
That is true. It can also be worth renting an apartment in south carolina, signing up for a medigap there and bringing it back to new york, saves alot of money that way.
Traditional medicaire should pay 100 percent period!!! Then there's no questions and no need to confuse the American people with all this confusion. But, that's right our government doesn't want to take care of its citizens only if you come here illegally and they want you to go broke with medical bills after paying your whole life in taxes, social security, so they can waste taxpayers dollars on other countries and their social issues!!! You did an excellent job on explaining something the government has made confusing and no benefit to its citizens!
excellent information
turning 65 in november 2024.trying to gain as much knowledge as i can before the time comes to enroll.thinking about going with the plan N.
Call us any time! We would love the chance to assist. 888-465-9728.
How can Advantage Plan make money if it does not charge monthly premium? Does the advantage plan cover co-insurance (20%) out of pocket like Medicare supplement plan does?
I am a Connecticut resident and I went to the doctor once a year for the last 5 years. SO, I will take an Advantage plan now and if I get sick I will switch to a suplemental plan, RIGHT?
@@misschicka2831 No medical questions to switch in CT, NY, MA and ME. All other 46 states are screwed. They won't let you change if you are sick. NOT IN MY SWEET CONNECTICUT.
I have heard the AARP supplement plan could offer things like dental and vision have become one of the top choices.
The supplement plan itself doesn’t include dental and vision necessarily, but many carriers (like AARP United Healthcare) offer dental or vision discount programs!
Over 51% of seniors on Medicare are happy with their advantage plan.
but it is extra
Great video. Are you licensed in New Jersey?
Yes!
Do doctors take traditional Medicare? Will I have difficulty finding a doctor who takes traditional Medicare?
Can you move between Medicare Advantage plans if you have pre existing conditions.
You can move plans onto different Advantage Plans during open enrollment times. Special Enrollments are offered for certain chronic conditions. They do not look at your pre-existing conditions.
So confusing for us silver seniors .
Stephanie,
My wife has Medicare and Medicaid.
She currently has bcbs
HMO advantage.
It seems that the bcbs hmo advantage
in some situations is a disadvantage.
Some medical doctors offices
claim her bcbs is her primary.
Is that so? Is my wife better off
without bcbs hmo advantage?
NYC NYS
Thanks
If she has Medicare and Medicaid then she is a dual eligible with different rules on who pays first - www.medicare.gov/sites/default/files/2021-10/02179-Medicare-and-other-health-benefits-your-guide-to-who-pays-first.pdf
@@AbtInsuranceAgencySo its the same
but different. 🤪
My provider (UofU Healthcare) just decided to drop its Medicare Advantage plan. Hope I can pass through underwriting to get Supplemental.
I am 36 and I have been on disability since 2021 I was then diagnosed with breast cancer in march of 2023. I have never been enrolled in Medicare and I just lost my insurance I had through the state. I had a surgery scheduled for today that I had to cancel because of my loss of insurance. I need good health insurance as I just had my double mastectomy and still need atleast 2 more surgeries plus radiation and maybe more chemotherapy. I feel so overwhelmed and don’t know what options I have. Please if you can help point me in the right direction I would greatly appreciate it.
My friend is 50 and on disability and she got on Medicare. She also has a private BCBS plan but it’s very expensive and her family pays it. She looked at Medicaid and none of her doctors take it. It’s a mess for those caught in this system. So sorry you had to deal with such a mess. She has her company phone number on here. My friend got on Medicare through her State office I believe to set it up.
You should have applied for Medicare once you were approved for SS disability. You are also eligible for a supplemental policy to compliment the Medicare. Because of your disability the supplemental policies can be expensive.
Wouldn't you add into med supp dental vision and hearing to be a little more accurate also the moop for med supp ?
Also how that premium goes up every year?
The only reason I would consider an Advantage plan is for the Dental insurance. I currently am on a Medigap policy. They offer "dental discount," but this is not helping me with my implants and dentures. People are cautioning me not to switch only because of that reason. Any body out here is having issues with dental coverage please?
I purchased the dental plan with $2500 annual coverage per person with my husband. Then I also purchased the medigap plan with High Deductible G plan. We are paying less than $100 for monthly dental premium for us and another $100 for monthly medigap premium. Then we understand that we should set aside money for bad year in case we need to be hospitalized.
You can purchase a stand alone dental plan if you need dental coverage and there are also plans that allows you to use your coverage for dental, vision or hearing depending on your needs. I would absolutely agree with the people telling you not to drop your Medigap policy because you need better dental coverage. The medical coverage you get with a Medigap policy is superior to what you get on Medicare Advantage, so as long as you can afford it, you are better off keeping it. Your best bet is to do some research on dental plans and select one that has coverage for the type of dental services you need.
@@MaryBethMcCoy Thank you Sister. I appreciate the "support."
I have a friend who is already 65 y/o with traditional Medicare part A, B and D. But this November...we were surprised that his Medicare suddenly turned to a Medicare Adv plan (Part C)...w/o him knowing it. Are there ppl who experience these type of case?
Sadly, many insurance agents or insurance companies use deceptive practices to get people to enroll in a Medicare Advantage Plan without them fully realizing what they are enrolling in. It’s very likely that an agent or someone from his Part D insurance company contacted him offering “free benefits” or an “all in one” option and then converted him to a Medicare Advantage plan.
Your traditional Medicare benefits can never be “turned into an Advantage plan” without your consent, you must choose to make that enrollment choice, but I’ve seen it happen many times where someone doesn’t fully understand what they are signing up for.
We’d be happy to help him. 888-465-9728.
@@misschicka2831 Lady, it is clear YOUR ARE AN INSURANCE AGENT! Offering a trinket to trick gullible seniors into plans that advantage YOUR bottom line. What compant do you work for?
I found that you need to check how advantage plan pays if you use durable medical goods. The costs will add up quickly.
Absolutely!
I’m looking at a LOT of difference here, my DME is around $3,000 per year with the 20% copay on an advantage plan. 0% on a gap policy.
@kevinr8336 It's cheaper to purchase a medigap plan and have it paid at 100%, if you use a lot of dme.
@@materto2 - thanks. Unfortunately I''m stuck using it for the rest of my life.
Thank you Stephanie for clear knowledge on 2024 Medicare traditionally parts A andB, verses Part C.. I am 66 and concerned to make a wise decision during open season.
Call us anytime for help! 888-465-9728
Great work and explanation on a complex market. As a former licensed insurance person I know this video will be very helpful to the millions of over 65 persons lost in the medical world.
Wow, thank you!
There is nothing complicated about Medicare! These salespeople want to male you think it's complicated...it pits money in their pocket. I attend seminars to research what each plan offers. I go for the one that pays ME the most. Medicare Advantage plans are tightly governed by Medicare itself. Supplements are not governed in any way! There are no standards. Medicare Advantage plans are REQUIRED BY LAW to cover EVERYTHING that original Medicare does. Supplements are NOT MEDICARE so there are no rules about them at all. Medicare Advantage plans are governed BY MEDICARE and are CONTRACTED by Medicare. Medicare has to approve EVERYTHING Medicare Advantage plans offer. EVERY YEAR they are different and a NEW CONTRACT with Medicare has to be signed. There is NO SUCH CONTRACT by Supplements with Medicare. You are FULLY PROTECTED with a Medicare Advantage plan. EVERY Medicare Advantage plan has a CONTRACT with Medicare.....so NO SURPRISES. You are on your own with a supplement. With a Medicare Advantage plan you get a contract and a booklet that tells EXACTLY what all they do for you. You go by the book and you will have NO PROBLEMS. I have asked to go out of network on several occasions, with good reason, and my Medicare Advantage plan did EXTREMELY WELL for me. One time was when I needed my cataract surgery and my plan offered the surgery too far away for me. They allowed me to choose a location close to me. There were NO COPAYS except for the one time normal specialist copay of 20 dollars. Another time was concerning glasses. Walmart wouldn't honor the transition lens part even though they were a provider for glasses. We purchased them anyway but complained and my Medicare Advantage plan set us up with another provider and paid far above the limit for our glasses even though we had already used our yearly allowance at Walmart. They paid almost three times what our allowance was for the glasses.