5 Reasons NOT to Get a Medicare Supplemental Plan? 😱
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- Опубліковано 29 січ 2025
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In today's video, Marvin from Medicare School is walking you through the 5 REASONS you should NOT get a Supplement plan!
Do you need a medicare supplement plan? Let's cover the truth about Medigap plans and what you need to know before you decide whether you need a supplement plan or not!
Supplemental Plans are something we discuss a lot on the Medicare School UA-cam channel and if you've seen our videos before, you likely think we LOVE supplement plans! Though we feel they provide a very important aspect of coverage for many people, that doesn't mean they're for everyone!
In fact, in today's videos, we will cover 5 reasons you SHOULD NOT get a Supplement Plan, and we'll also discuss determining which Supplement Plan, such as Plan F, Plan G, or Plan N (etc) is right for you and how you can fully understand the difference between each medicare supplemental plan.
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I have a supplement plan and I am so grateful I do. I had stage 4 cancer. I did not need any referrals. The supplement plan has been a blessing
Great to hear that!
Do you have a hormone fed cancer? Reason I ask you may be able to eat a Alkaline diet and kill it or reduce the hormone that feeds it.
Which one?
@@sk8queen I have supplement N
This guy is WRONG !
Sold on Supplemental Plan. No matter how healthy one might be when starting on Medicare life can change in a heartbeat (I've been an RN for 44 years so I know this to be true!) A sudden diagnosis of cancer, heart disease,etc would bankrupt you on an Advantage Plan. I'm not taking a chance!!
Certainly...circumstances can change in moment.
That is just not true for all advantage plans!! Stop the false narratives!!
The supplemental plan my husband had paid for his numerous docor/specialist visits, chemo and radiation trearments, several operations, his last hospital stay. I dread to think what we'd have owed. I have the same plan he had and will keeo it as long as I can afford it.
Also, I've been in Doctors offices that have notices up that state they don't accept all Midicare Advantage plans. You need to check.
👍
You make no sense
I have a supplemental plan and as long as I can afford it, I will never change it. An example, I was in the hospital some years ago, for six days. I had numbers of tests for possible cardiac issues. At the end of all that, and follow up visits, I never saw a bill. I had no copays either. I didn't need to call anyone, I didn't need anyone's approval. I still travel and I have coverage anyplace in the US that takes Medicare patients. Advantage plans are being pushed is because they are working toward privatizing Medicare. I won't be here for that.
Just the fact that Advantage plans are being pushed as hard as they are, puts me off.
I am very confused and worried too. I had an advantage plan. I only had to pay for emergency $99, if not admited and a had a pacemaker. I didn't pay anything else. Only those $188 but I didn't lake the waiting for appointments and referrals. O got Medicare with supplemental now. It costs me over $5,000 a year and now I have problems finding a good doctor. All I find are in the advantage plan anyway and I learned that the doctors are kind of responsible for the delay in sending the request for approval. {then the approval time on top}. And now, I still have to wait over a month to be seen but a doctor anyway. I find I am in a trap. Before many times I offered to pay cash just to see a doctor to try him.or her to be told it is illegal because I have insurance. My former insurance holder reassured it is not illegal if I just want to see if the new doctor and I click. I thought that doctors employees are thinking about people on Medical. But in my case no, I never applied for any goverment benefit. Scare for older people like me....
I wanted to pay cash to see and check out a doctor. They said it was against their policy because I had insurance. I argued, politely. They got a supervisor and I won. You may have to push back a little.
@@lucyp406 No matter how you pay, in many areas of the country it takes a month or more to get an appointment. It just does. Try urgent care if you can't wait. If it warrants they will often refer you to your regular doctor next day.
@@lucyp406 7:28
That is precisely what the insurance industry is shooting for. Private insurance takeover of Medicare would do nothing but add cost and deny service. Why should one have to ask for permission to take care of oneself?
The only reason to go on an Advantage plan is if you need health insurance there is no way you can afford to pay for a supplement plan. If you later want to switch back from an Advantage plan to original Medicare with a supplement, you can go back on original Medicare, but you have to go through underwriting and be accepted into a supplement plan. If you are in good health, fine. But if you have health issues, good luck getting a supplement plan. When you choose at age 65, you could be making a decision that you will be stuck with for the rest of your life. Choose wisely.
Not all states allow for that underwriting.
How serious do the health issure have to be to get declined? Will Low kidney GFR, high cholesterol, etc. cause a decline in underwriting.
@@davenone7312 46 states do allow for that underwriting
I was one of those who lives healthy: diet, exercise etc. Diagnosed in sept with metastatic gastric and liver cancer. The advantage plan would sink me. One thing that’s evil about advantage plans, is that if you go into a hospital that covers you Dr network, there are many separate services that may not be in network, in the same hospital: radiology, specialists, lab. Many of these services work independently of the hospital.
Sorry about your cancer. With an advantage plan aren't you protected because of your maximum out of pocket limit?
@@johnmar6376 You’re correct. As you might have heard, it appears the max OOP cost in network is ~$7000/yr. If you receive out of network care the max OOP is ~$11,000/yr. I’m a retired ICU RN. The anesthesia group in my hospital work independently from the hospital. If out of network, the max annual OOP could jump to $11,000. But this max OOP will depend on the insurance company and the particular advantage plan a person would sign up for. Having seen the workings of private insurance companies first hand as an RN, their prime motive is to make money. I’d be surprised if the insurance company would cut a person any slack when it came to max OOP. Having plan G myself creates a greater sense of security, and lessens anxiety for the circumstance I’m in.
I’m sorry about your cancer too, but this is why an Advantage plan is not a good idea.
Thanks for the information
@@johnmar6376 Yes, but isn't spending $2000 on a supplement better than $4000-8000 out of pocket?
So I worked 45 years for my retirement, and now the government steals it back with all the schemes and penalties.
Thank you for your feedback!
Not really. Without Medicare, most elderly would have no coverage at all. They are too costly. Easily your monthly cost could be $800+ per month.
We all need to follow God and do the right thing, including calling out and exposing evil when we see it.
No, the government facilitates the insurance companies stealing it back from you.
Exactly
I'm on G and very satisfied.
Keep loving your supplement plan if you have it and if you can afford it, my husband changed one year to an Advantage Plan and he almost die, the waiting for the authorization was not bad was around 3 or 4 days but when you feel bad those days are a nightmare plus the VA benefits if your are feeling bad you do not want to be back and forth in those buildings where everything goes slow. So we learned a lesson and we could afford to pay the supplement, so he went back and if there’s a time that we cannot afford it we would buy less groceries or lower something in our lifestyle to keep paying. Have the peace and the help when you are in pain is priceless.
That MAPD plan must have been an HMO and not a PPO
Although I despise the way the Medicare system is organized, I really appreciate this channel because you don't have an agenda beyond providing people with solid information.
Thank you so much!
Right, our Govt should do better by all us US tax paying citizens. They give so much money and things to the Ukraine and the boarder crossers. Its so sad we get the small stick every time. Wake up Govt! We the tax payers are not happy. Again !
Medicare.gov has the info... You just didn't bother to look into it, I guess?
Glad to see you dissected both plans and pointed out the pros and cons of both. Most seniors who can follow this are grateful, as am I.
Thank you! Always better to be educated when making important decisions, and I am very happy to help.
@@MedicareSchool
Y
1st time visit to this channel, and is prayers answered. im gratefully tearing up! this is awesome,. Thankyou
The most honest advice I have ever seen on UA-cam - I am in the industry -Big Respect well done Sir
I appreciate that!
My team would be happy to assist you. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
If you're healthy, Advantage is great. If you get sick, it's an issue of $7000 max out of pocket / year. It's a risk and unpredictable. If one can afford the $300 or so monthly premium, traditional Medicare is more predictable. Keep in mind also Advantage will steer you to low-cost providers, nursing facilities, etc.
The monthly premium is $195.00 and all bills are paid. You can go to any doctor that takes Medicare and we don't need referrals. Yes, the premiums are going up this year but we'll stick with the Supplemental plans. The Advantage Plans make promises they don't intend to keep.
All the supplemental plans ive seen are over $200 a month, add that to the $185 medicare premium, cant afford it, would have to keep working, to pay it! Might just do part a,b, and get a cheap part d plan. Get my own dental. Idk. Some advantage plans are giving $2000 food cards…that would help alot!
And the supplemental plans are guaranteed for life, whereas MA is guaranteed only for a one year at a time. So it's possible your MA plan in 2025 could be gone in 2026 and you have to start all over.
My Part G plan includes a Silver Sneakers gym membership. So at least that perk is not only available in Advantage plans. Thanks for the extremely informative video!
It is available on some Advantage plans
Which company?
Which company
I have G plan with Humana, and it includes Silver Sneakers (Alabama).
AARP offers these perks for supplemental plans
You helped me choose the right coverage for me. AB G and D. Thank you!
Happy to help! You are very welcome! Thank you for watching
I may end up eating peanut butter and jelly sandwiches for dinner, but at 67, I want that Part G in case I end up with something bad (and very expensive). I think I will go with a cheaper Part B plan next time though. My UHC Part G plan includes dental, vision, and gym membership though.
I think you're very clear with the facts WHEN NOT TO GET SUPPLEMENTAL. I think people are so worried about choosing the "right" plan that they just freak out without listening. You are crystal clear in your explanations.
I don’t know if the people complaining on here Don’t realize that this is just another way to look at things. He’s very helpful and I appreciate it he’s not saying you shouldn’t get a supplemental plan he is saying some people should go with an advantage plan under certain circumstances
one of the circumstances being you can’t pay the premium for the supplemental plan
It’s a no-brainer.
At 64 I am healthy and I totally get it. But we are all at risk of one day not being healthy. Some more than others. For me it is all about peace of mind since I can afford the premiums. I will gladly pay my $226.00 and then be totally covered. Also I rather pay up front each month and be done with it, not having to worry about a huge bill if something does happen.
I wish mine was $226. $428 for Part B, and that does not include any of the supps. Penalizing for high income is just wrong.
We paid $750 a month for me and my husband for a supplemental, the Empire Plan. It was deducted from my state pension but the school district I retired from refunds the Medicare Part B. After the refund we paid only $202 each and it includes the medicines.
@@athena3865 Should be glad ya can pay more some not as fortunate.
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. It is not what you pay, it is what you get as in delays, restrictions, inferior care and NO!!!
To be fair he said if you have other coverage such as VA or Government it would be better and in decent health as well. I agree with you and am getting a supplemental plan but I don't have other coverage and do have health issues.
@@georgeedward602 Many people do not have VA or Government coverage. The traditional supplement which people need is expensive too. I have one.
@Albert Marnell Advantage plans are generally at no cost and you get medical, rx, dental,vision and hearing benefits at $0 monthly premium. And a lot of times people pay less on rx meds with an advantage
Some Medical Advantage are open access, so they have large networks. Supplements are great, but people today often don’t have an extra $150 to shell out, plus shelling out for dental & eyeglasses so an MA plan is attractive, especially if you’re healthy. Make sure the network is good & they can be advantageous. Ask your agent “what if I get cancer & want to go to ABC clinic?” Make as sure as you can that there’s a nice backup. Do they offer Cleveland Clinic? Mayo Clinic? EtcThat way you can make a decision that’s comfortable for you. It’d be nice if everyone could get supplement but the truth is that is impossible for a lot of seniors. So an MA plan is often better than just having original Medicare.
One of my main objections to the disadvantage plans is that they have NOTHING to do with Medicare! Yet they use the term to DECEIVE. These are totally privatized plans for seniors that take you off of the governments back and have NOTHING to do with MEDICARE! If they work for some people for whatever reason, that is not my concern. I can go to any doctor I want because I have Medicare....disadvantage plans should not be allowed to use the word Medicare. That alone should tip people off that these plans are a FRAUD! I also don't want to be restricted to an HMO of HORSE DOCTORS! @@noelc2
I think this guy is great. It's apparent to me that he gives his all teaching us about Medicare. I really appreciate his energy and his jam-packed information presentations.
Glad it was helpful! Feel free to Schedule a free call with one of the MedicareSchool.com Certified Guides on our team to go over your plan options, and enroll with ease. 📞
Click here --> www.medicareschool.com/talk-to-a-guide
OR CALL for instant help: 800-864-8890
Yep, he is a born teacher. Too bad he is not teaching full time at a school or college some where.
How can you put a price on medicare advantage placing restrictions on your choice of doctors and hospitals? What if you live part of the year in Florida? Or travel frequently?
One of the big problems for the Advantage plans is that they are trying to pull more profits with their pre-authorizations. My BIL's cancer surgery was delayed a month for no reason. It's not like there were alternatives to him having surgery. I'm having to get preauthorizations on meds where there are no alternatives due to my diagnosis.
All this info is so helpful. I am on medicare, And have a supp. I have plan J because I originally got it because it had prescription pay on it. When they required us to get plan D for prescriptions, I just kept the plan J, but I have to see if I can save money by changing to F orG. Keep putting these informative videos out. You make everything so clear.
You're very welcome. Thank you for watching.
If you have any questions please, feel free to give us a call at 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
An interesting video. One thing I understand about Medicare Advantage plans is that a person is essentially limited to a particular geographic area when one is enrolled in one of these plans. I have a Plan G, and I like knowing that anyone who accepts Medicare in any part of the country can provide the covered services. I travel quite a bit, sometimes spending weeks at a time in 5 other states in different parts of the country, using driving between them, so it's reassuring to be able to do this without needing a referral, etc. I have already used services out of state, and I also like that my Plan G even includes $50K of international benefits.
A question I have--if some Medicare Advantage plans are essentially free, who pays for the various "freebies" associated with them? As I've heard, and sometimes even say, "there is no such thing as a free lunch."
The Government pays the company a fixed amount each month for them to manage your healthcare so they are able to provide little to no premium plans with extra Perks such as the dental, vision, hearing, no cost gym...ect With Medicare Advantage you have to follow the plans rules, such as the CoPay Structure, refferals, prior Auths, networks..ect.
If you have any questions please, feel free to give us a call at 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
@@MedicareSchool Thanks; I guess it's the taxpayer who pays.
I love my plan G in Ohio. It is well worth it. Pays out well.
@@gailcole9913 I got one for Montana, and it is $147.10. I am 67 years old, and I am going to have to scrimp and save to come up with my Part G and Part D, but at my age, I want that supplemental to help pay for things that I may need it for anything that could happen. You never know when you could end up with a condition that could bankrupt you.
They don't really pay for that much "extra perks". It's like getting a free canvas gift bag! For example, you get two free cleanings per year from the dental, but no crowns, etc. The glasses are the cheap kind, with lines between the bifocals, etc.
I will never get another disadvantage plan and I had 2 before. I will never give up the freedom of my original Medicare plan to a third party for a few trinkets. I don't need to get a permission slips from any doctor if I decide I want to see a specialist. When I signed up for the Disadvantage plan I didn't know what I was in for. I quickly changed back after the network doctor blocked me from seeing an orthopedic for my leg issues. He seemed offended and asked why I wanted to see a specialist and said " I'm a doctor ". I have been seeing several specialists since then and my leg condition has been steadily improving.
Yeah and your STUCK with it 2years
Amen
Great video, thanx for all the info.
I live in Ca and currently on supplement plan N its $227 a month probably one of the most expensive states but I will stick with it, cause I like the freedom to go to any Dr I want that takes medicare, plus I can afford it and I do have medical issues that may require surgeries in the future.
Man, you are very knowledgeable...but you talk way more fast than I can think.
They don’t call them short clips for nothing.
🤣
I just said the same thing.
There’s a transcript that you can read.
You can always adjust the playback speed if needed.
I used to get EyeMed insurance thru my employer. It’s not worth the money. The Optician would charge $500 and the insurance covers maybe $100-150. It’s actually cheaper to join Costco and use their optical, they also have sales. I bought a pair of RX sunglasses for $259 progressive, polaroids.
Eyemed is a joke. Costco without insurance is cheaper
My eye doctor told me just do private pay, by the time I pay premiums & get limited benefit it’s a wash. I’ll be on Medicare in November & planning on Plan G
Same happened to me. They paid $150, I paid $550
We have eyemed and it's no charge once a year for doctor visit unless you want a behind the eye picture and that's $25.00 and glasses for me and my daughter is between $80-200 actually love eyemed.
Nope. Can’t go to Mayo Clinic in Arizona if you use a map. Traditional Medicare for me. Map plans often need referrals.
I don't believe I ever hear reasons most people go the Medigap or supplemental route.
1. With advantage plans your drug coverage is ok, but not great. even though with mendigap or a supplement more drug coverage is possible that would not be covered under the advantage I'm talking about drugs that run into thousands a day. advantage plans probably wont cover and that means out of pocket which can be over the top.
2.With medigap, if you travel you'll have better coverage . advantage plans are basically for regional network doctors and hospitals
I'm basically spending 4,400.00 a year same with the wife sure its expensive real expensive but if some catastrophic medical condition comes up were hoping things are covered.
All those high pressure advantage plan ads on TV should tell people its a basic money grab by the insurance companies.
Advantage is a private health care insurance
All of them are HMO's or PPO's. I wish we could just go to a doctor and pay as you go. It was better, much better
I can sum your speech up like a This ! The Rich and famous have no problems .The Poor or middle class dies in medical debt! The Medical institutions is one big Money operation. If you Middle class Taxes and insurance Cost Keeps you in The Poverty category.
Isn't the possible annual cost of a supplemental plan ($320/mo × 12) less than the possible moop/yr of $4-$7k for the Adv plan? Plus, health can change in a moments notice, then you risk not getting through underwriting to switch plans, correct?
You failed to mention the other main problem -- trying to find competent doctors. I have a list of over 6 pages of viable lawsuits (each 1 short paragraph) that I could file, but the board of medical examiners want me to sign a release of liability form for every valid claim. When I struck a deal with the hospital, they agreed to give me free medical care for life. Screw that! Not even for free! They couldn't even properly set a clean break in a broken arm one time! (They used that to scam medicare for all it's worth.) 40+yrs of misdiagnoses, I've learned my lesson. I even had to trick them into giving me CT's and MRI's (& then requesting test results on DVDs) so I could find out the true problem for myself. Best just to avoid ANY "doctors" -- ever!
Addendum(b): re: broken arm.
After they failed to set a broken bone (clean break) & weeks of misery, I had to go through SIX hours on the operating table for them to fix their errors. A person could have had a heart-lung transplant in that amount of time. Then when they found out that Medicare wouldn't pay them for their own hospital-scams, the hospital sued ME. I almost lost my home over their doctor/hospital insurance scams. Heed my warning, NONE of these insurance scams will benefit YOU.
There maybe private practices still around, eating more alkaline diets fresh fruit & veggies if you have good teeth , Salmon, Sardines Chicken organic if possible. It usually isn't more money. It helps alot
@@pattijean3544 ua-cam.com/video/P1fnmN9WOIY/v-deo.htmlsi=qSR-umRcBMce86yt
Honestly, I know not all providers are in a network, in fact, they don't want to be IN NETWORK... I will NOT consider a Medicare Advantage Plan because the people I deal with are always sucker punched by the PLAN... and these people tend to NOT pay their bills... Max out of pocket costs a LARGE percentage of their annual income, if not ALL of their income... AND a Medicare Advantage Plan is basically COMMERCIAL insurance... and you have to beg to get your health care covered....
That's not true and misinformation. I have Humana Choice PPO Medicare Advantage Pay zero premium and I can go in or out network. I have copays and yes a higher deductible should I get sick and into hospital.
Thank you for the explanation i am from the Philippines but i like researching more about this type of topics it would benefit to boost my knowledge at work
This gentleman is awesome. He gives both sides of the coin, both advantages & disadvantages. Really informative.
Thank you for the feedback! Glad it's helpful. If you have any questions, feel free to give us a call at 800-864-8890 or schedule a free appointment here: www.medicareschool.com/talk-to-a-guide?rc
Here’s what some aren’t aware of… Once you go on an Advantage plan, they get your Medicare benefits. You give those up to be on their plan. That’s how they offer those “perks”. That’s why you see so many ads about Advantage plans. These insurance companies aren’t stupid, they’re in it to make a profit, and they do! They pay for all of these ads, and still win… Just like this guy. He doesn’t spend all of this time for free. He’s making a fortune selling insurance. Keep that in mind… It now harvest time for insurance companies during open enrollment, and also when you first become eligible for Medicare… Good healthcare insurance isn’t cheap. It can’t be for the cost of what they’re responsible for… Medicare is here for a reason. Older people have health problems! Do you really want to give that up to at the mercy of an insurance company? ?? To decide what you get, who you can see, and where you can go? The premiums aren’t really that bad. Medicare is going broke doing this. What does that tell you? Before some people with individual insurance are eligible for Medicare, they’re paying $1K a month for health insurance, and the benefits aren’t nearly as good as what Medicare and the gap policies offer. That’s how much the risk is… So $300-$400 a month for pretty much full coverage for those 65 and over, and more as we get older, really isn’t that bad… I think it comes down to part of a strategy of planning for retirement. These facts and figures are out there. Did you do your research beforehand? Did you have a financial plan for retirement? Do you want to complain and blame others for the lack of? This is a part of life. You’ve had 65 years to prepare…. Look in the mirror. That’s the person who’s responsible for you… Thank goodness such a thing as Medicare exist!!!
But you can switch to regular medicare during this enrollment period. Thanks to this channel, I found out that I could change from Medicare Advantage to traditional medicare and get Part G and Part D insurance. By the way, I got the email approving both this morning. I'm sure my upstairs neighbors could hear me celebrating.
@@jleechadwick The state I live in doesn’t allow one to do what you did.
You used to say that advantage is not that great. I have plan F as I am grandfathered in. I also don’t like to be restricted to a company doctor.
Medicare Advantage can put you in the poorhouse. Out of pocket costs are thousands of dollars and reset every Jan. Stay on your plan F plan. I'm confused by this video.
It may depend in what State and county u live in. Fortunately I live in So,Ca. So I have an advantage plan. Thats from Los Angeles to San Diego. 😍
He is very very specific about what circumstances make it unappealing to have a supplemental plan. I watched the whole video without biased as a lot of people did not and got angry because they thought he was just reflecting an opinion he was not the information is very factual and clear. None of those circumstances applied to me and so it did not change my perspective one bit about a supplemental plan being a better choice.
@@tammypelletier3195 to each his own.🤔
He is outlining this very well! it is a financial risk to have a MA plan if you don't have $7k set aside every year for MOOP
Your explanations about the intricacies of the system are clear concise and just overall fantastic. My wife and I are about to go on Medicare and you have clarified many things for us. Your channel does a great service to many people. The way you explain things is just wonderful. Thank you for what you do!
It is our pleasure, so glad that we can be of assistance in some way!
My brother wasn’t covered more than 15 days in a skilled nursing facility by his advantage plan.
Was there a limit to his liability?
What am I missing?
And with my plan G supplement I am covered up to 180 days in a year. On advantage you are NOT on traditional medicare. An insurance Co. makes all the decisions. Poor choice Advantage plans. Agents are also lying to seniors.
@@gailcole9913 I got 6 weeks on just Medicare per 4 months
I opted for the Advantage Plan because of finances and all the perks, only to find out our doctors and hospital are not in the network.
It is crucial to work with an independent broker that will do the research to ensure you can use the doctors you want. The good news is there is still time to switch!
You need to do your homework before selecting a plan. Bring a list of your doctors and your medications to the meeting with an INDEPENDENT, MEDICARE CERTIFIED Insurance broker. The two of you can select a plan that fits your needs.
That's something you need to research before you get it. Make sure your providers are in network.
I seriously can't believe that you're promoting an advantage plan! I have never had anybody present me with an advantage plan that would benefit me.
That means your agent probably doesn't know everything you need..
Advantage works well for some people. Do the math
Advantage plans lock you into an insurance company. Moving to new area? Subject to qualifying if insurance company no longer services your provider.
This video is very well done and is additional backup to convince me that I still need a supplement rather than an advantage plan. Going through each reason was a simple yes or no checkmark. Sadly some viewers have left comments about how confused this video left them, but I surmised they just tuned you out rather than listened completely.
We appreciate that Anita! Unfortunately some people leave comments without actually watching the video sometimes. 😅
I agree. I’m 72 and found the info described thoroughly and easy to follow. Very clear presentation‼️
So very informative, I am sharing with retired family members! Thank you!
Glad it was helpful!
If you choose a Medicare ADVANTAGE plan and decide you want to go back to original Medicare you have to go thru UNDERWRITTING...if you have any pre existing conditions you may NOT be able to go back to medicare and if accepted premiums will cost alot more...
Be very carefull...call Medicare office to get # of a true medicare advisor...not medicare advantage advisor they get paid to sell ins plans
They sound alot like medicare agents...alot of people are picking "C" advantage plans not knowing....be very carefull
You do have a year to switch back which is called Trial Rights. So you can test out MA w/o being stuck.
Keep the advantage gym plan, I just had a triple bypass. Thank God for part G.
Great information! Thank you
I have AARP/United HealthCare Supplemental Plan F. So far, at age 78 and since the get-go, I’ve had annual health and eye checks, prostate cancer and surgical removal, cataract surgery in both eyes, and a bad fall resulting in a badly fractured femur, two operations with titanium nails and clamps plus, plus three-plus in a great constant care facility for daily physical rehab therapy. Also included was a new wheelchair to take home.
My Medicare and the Plan F supplemental covered everything 100%. So, O.K., I’ve been paying the supplemental premiums. But, wow, that’s what insurance is for. I still have my life’s savings for retirement and my heirs if there’s anything left.
Love the tongue in cheek except some may believe you believe what you are saying. Supplemental is the only way to go. If you can afford $7000 out of pocket and don't want to see the doctor you want to see but be assigned whether you like the person or not, those are the reasons to get an Advantage plan. Oh, your therapist would have to be in plan also and your copay per visit might be $50. (Supplement, no copays ever. Never. Ever. Ever. Ever. Does your dental mater if you have dentures? Does cheaper gym matter once you hit 70 or break a hip? You will pay a copay for PT. Supplement? No physical therapy copay and Humana advantage etc can tell you how many visits a year I think. Check out these things.
You have damaged my vision of future. I could see me, in my 80' ,running in silver sneakers to the free gym. And free x-ray of my retaining teeth, all three of them.
Yeah, what if you ever want to travel and need a doctor. You have to go back home and see a doctor in your network. doctors in the networks are sometimes taken three and four months to get you in for a visit these days. Can you wait that long? Should you have to? Finances has a big part of it. I'm going to have to work to pay for the insurance. But at least I'll know I'm covered, completely covered for cheaper when something does happen and I'm needing a couple of specialists already now. You get what you pay for.
It really depends on where you live when it comes to advatage plans. In my area MA covers a region. We actually can cross over into 2 other states because we live near where all 3 states meet. I've had MA for 4 years and I haven't paid more than $3.25 as a copay to any doctors or specialists in that time. I've also not had any issue with picking my own doctors or continuing to see the ones I was already seeing. I pay about $50 a year on medications, paid $90 for my eye glasses this year and nothing so far at the dentist. I only had 1 specialist my PCP referred me to that had appointments 3 months out. I said no thanks, called 2 other offices when I found one who could see me in a week so I called my doctor to send over the referral. And I see about every kind of specialist possible and haven't paid anything the last 2 years to any of them. Nor have I had to get prior approval to see most and haven't been denied for the few I did. I also see a specialized physical therapist for lymphedema that I'm paying $3.25 per visit. In 2020/21 I had 3 hospital stays and 1 surgery....I was billed $0 for any of it.
I don't use the silver sneakers but I do spend almost every penny of my OTC allowance and my food allowance. I also cash in points for having tests run such as A1c, mammogram, colon cancer, kidney function, etc and walking/wearing my fitbit (that was also free) to get gift cards I can use for almost anything. If my only inconvenience is coming home to see my doctor, I'll take it. Actually, I'll continue to plan trips around my appointments so that I can always see my own doctor. If it's an emergency I'll go to the ER where I'm at or even urgent care because MA is required to pay for emergency and urgent care anywhere in the US without imposing additional costs or coverage rules.
Right.
My max oop on my advantage plan is $2300
I'll be Turing 65 next June, thank you so much for this eye opener information.
I'm on Medicaid now, I'm hoping I can have both. If not you opened my eyes to other options.
Thanks again.
Thank you for watching
I'm a pre retiree retiring in 5 years I thank God I found your video. Happy new year.
Wonderful!
pre-authorization for Advantage plans is a topic in and of itself, and deserves great consideration before making a choice. Same for underwriting, which I understand can favor supplemental plans but is worth researching!
The ability to go to the best hospitals and doctors in the US is the reason why original medicare plus the supplemental far superior to advantage.
I was paying $1.00 a mo on Covered CA. Now I am paying $170? For Medicare. If I couldn’t afford insurance before how do they expect me to pay for Medicare? All of these insurance costs are what’s going to make me sick .
Just enrolled in Plan G supplement. Will never switch to MA!
That’s great! You are going to be very happy with that decision!
First time I have seen one of these agents say some good things about advantage plans. I liked Kaiser in my pre medicare days but as an advantage provider they and others have large out of pocket gotchas that can run into many thousands of dollars. As a one time event I could handle this but if it were to reoccur several years in a row it would be very damaging financially for me and likewise for many other people of modest means. I stick with plan N which has predictable and more modest MOOP costs. I pay $100/mo for the supplement and part D plus $164 for part B.
My biggest gripe is actually part D which I consider to be fake insurance. Insurance is not supposed to pay for every bottle of aspirin. It is to prevent drug costs from bankrupting you. Even the lady who sold me my Part D coverage admitted I could be out of pocket $10K+ for drugs and for a permanent condition that could be my MOOP for every year! And their coverage and deductibles are so complex and convoluted one never knows what you will be hit with till you get the bill in the mail. Thats my two cents, anyway
Do not be fooled! Most all other videos he does he is hating on advantage plans!!
Plan N is what I also have great plan will never take an advantage plan, too risky.
I would never get an Advantage Plan. I had cancer twice, and thank god I've been cancer free for 8 years now. I got the F plan. I don't like my drug plan, Wellcare. It was too expensive and didn't pay all my meds. So, I'm going to see how I can get a better drug company. I might call Marvin's company to help me out during open enrollment.
Insurance companies behind Medicare Advantage Plans are about delaying and denying benefits, especially if they're expensive. That's how they make money. The OIG evaluation of these Plans bear this out. I appreciate the nuanced explanation for when MA might make sense.
Thank you for watching!
Doctors often don’t have time or the inclination to petition the insurance companies for preauthorizations.
Your not kidding. I stopped counting the denials from Specialists. They are in Network but only say your Referral is no good.
Can senior get a flex card without changing your Medicare plan. I am on supplement Medicare. I can use the extra money for various things.
The bottom line is if you can afford a supplemental plan and a part D drug plan and dental and vision, it is expensive but you will be COVERED. I have a G plan. If you can not afford a supplemental plan, choose the very best advantage you can afford and hope all the bases are covered if you get sick. With an advantage plan, medicare gives the company you choose around $1400 per month to take care of you. This is why you see all the television ads promising “ more benefits”.
thank you , you make medicare so easy to understand. I already had an appointment with one or advisors and we found it best to stay on my employer plan until I am ready to retire.
Feel free to Schedule a free call with one of the MedicareSchool.com Certified Guides on our team to go over your plan options, and enroll with ease. 📞
Click here --> www.medicareschool.com/talk-to-a-guide
OR CALL for instant help: 800-864-8890
I'm finding with the Advantage Plan, Dr. Offices aren't not calling back when I try to make an appointment. For example, Neurology!
Advantage Plans ARE FOR HEALTHY PEOPLE!
when we retired we were asked if we planned on traveling? we said yes. then were told if we get an advantage plan and we need medical care while on the trip (in the states not abroad) that most of those plans available to us would not cover even an emergency room care. we looked into and yep none of them would. had to be at specific hospitals and in network docs. so before you jump on an advantage plan consider everything not just saving money. plus all the supplemental ones would cover anything if that hospital or doc accepted medicare.
Have to watch this in the morning...with lots of coffee 🤣
Medicare isn’t simple.. unfortunately.. 😂
My dad was a vet, my mom was a teacher. So she had a retired teachers Medicare advanatage plan plus tricare. The best of both worlds. I was so jealous.
I thought I was perfectly healthy and would benefit from Medicare Advantage plans.
Then suddenly one day out of the blue I saw my left eye bleeding, on the inside, and I realized I wasn't as healthy as I thought I was.
Sorry to hear that. If you have any other questions, or need help getting your Medicare coverage set up correctly, give us a call to schedule an appointment: 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
Wow , I am now thinking of going to an advantage plan. No health issues, good family genes.
A doctor's office may turn you away if you owe them too much, but it's the law that emergency rooms have to treat you until you are stable for discharge and they evaluate you and usually you have been seen by the doctor and nurse when the financial advisor comes to get the insurance and ID card and that's why some people live in the ER and hospital in a way and they are called frequent flyers, because they are admitted and treated no matter what amount of money that they owe and the hospital usually knows that they will never be able to collect the debt and they are constantly closing people's medical debt and forgiving it using building money or unused employee salaries budgeted for new employees that they have not been able to find. They have unused budgeted money for a lot of stuff. The hospital may find ways to save money during the year and at the end of the year, they use it for employee bonuses, indigent care, they may add it to the building fund, etc
I am confused about the $1600 and co pays on Original Medicare . My question is if I choose to get an Advantage plan do those co-pays and deductibles under Original Medicare plan follow you to the Advantage Plan
I think it is absolutely disgusting that no one knows all the “rules”. Even my rep at our local Social Security office didn’t think to ask me if my husband was retired. Because he is a Federal retiree, has a Federal Health insurance plan through Blue Cross/Blue Shield I found out after 6 phone calls to Social Security that this is not a qualified plan and I owe the Social Security Admin $10,000 over the next ten years. Who is in charge here? Not once, until the last phone call did anyone think to ask me. So, there you have it. I am so disgusted with my government I could cry.
@@Gzluweez no kidding cupcake.
@@Gzluweez for Christ sake, they couldn’t put 2 and 2 together.
On plan G and never an issue. Thank you Medicare School!
Thank you!
Unfortunately, no matter how physically fit you are now, you can’t predict the future.
I can predict that no one is getting out of here alive. You're welcome.
I need a Medicare supplement plan, want plan G. The price difference in the plans is large, does it matter which one I pick? Do they all cover what original Medicare does pay for in the same amount? Is there any benefit to picking a more expensive plan versus a cheaper plan??
All supplements cover the same exactly. What's important to look at is the rate stability of each carrier, since they are in charge of their premiums you want to go with a carrier that is stable and doesn't raise their premiums drastically every year.
I have a Medicare supplement plan .I have had it for 13 years and have never had to pay a penny in medical bills . What Medicare doesn't pay my supplemental plan pays , and no co-pay .
That is awesome!! Supplemental Plans are my personal favorite if it makes sense in your situation. Since you've been on it, might be a good idea to join a new risk pool, so your rates stay low (if you're healthy enough to switch). If we can be of any assistance call us 800-864-8890.
Which Medicare supplemental plan do you have as I will have to make a decision about Medicare? I'm turning 65 next year.
I have plan F .
@jennyclark2950 Thank you for responding.
I live in Georgia and just hit my qualification date for part A & B. I was interested in the Supp G, the best price I found was over $1,200 a month!!!!! I went with a good Advantage plan.
That doesn't sound accurate. Feel free to reach out so we can go over your options. If you have any other questions, or need help getting your Medicare coverage set up correctly, give us a call to schedule an appointment: 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
We are looking for advice from these videos. You are confusing me, for one, that you usually are in support of supplement plans. Why are you taking the opposite approach now? You should be more consistent with your advice. It's confusing enough without you flip flopping. I know at the beginning when you say that you will never be sick, etc. you are being a bit sarcastic. You had me in favor of supplements, now I'm confused again. Someone who hasn't watched your other videos might take this one seriously and sign up for Med Adv, only to be sorry later. You didn't cover how once you're on MA you're stuck there forever in most cases.
All he is interested in is getting people to watch his videos because he makes money off of youtube. I've watched some of his other videos and he tells how bad an advantage plan is now he tells us how bad a supplement is and that he would not have an advantage plan. All he is click bait.
Exactly.
@@keithgunter1951 I agree with you. So disappointed in this video. Bad advice.
@K M……We are having a tough time affording our supplement plans (I’m on F, my husband is on G), but being on original Medicare with a supplement, allows us to be covered in every state in the country….and we are wanting to move, but are not sure just where yet. So we feel safer going with original Medicare with a supplement, at least until we know where we will be living for the rest of our life. We want coverage that covers us regardless of where we travel to. But Medicare Advantage plans only cover you in the town/county that you live in. Many don’t take this into account when they are traveling….it’s like flying without a net!
I also like how original Medicare allows me to choose which doctor or specialist I want to go to, whereas Medicare Advantage limits me on these choices. Plus, I have heard that Medicare Advantage has a lot of issues with denying coverage and leaving you with the bill! Screw that!
We may be having a tough time affording our monthly premiums, but we would be in a much worse situation if/when we needed to go to the hospital for some serious condition….and our maximum out-of-pocket with an Advantage plan would sink us! So, better to struggle now with premiums, and have our hospital and doctor bills completely covered….than to be sunk later with a humongous bill(s), when a catastrophic illness hits under an Advantage plan…..with also the possibility of not being covered under the Advantage plan too! Again, screw that!
This past year, I had to go to an EAR, Nose, Throat specialist….and also to a gastroenterologist. Being under plan F, I had EVERYTHING covered 100%! Even though the doctors I went to were ‘accepting assignment’, there were still costs that were over and above…..and it amounted to a hefty amount! I would not have been able to pay that overage amount! But my supplement covered all of the costs that Medicare didn’t. If I had NOT gone with a supplement plan, I would be having to pay off over a thousand dollars in medical bills right now! And I would be in collections, as I could not afford to pay that amount off all at once!
So, it is easier for me to tough out monthly premiums in the meantime (at least until we are moved), to insure that I am not slapped with a surprise expense when a health issue arises, that I really cannot afford.
I am hoping that Congress (LOL!) fixes the issues with Medicare Advantage plans not paying people’s bills for coverable expenses, by the time I have moved. I will then have to sock away the money that would have went for the supplement’s premiums, and save it towards the maximum-out-of-pocket for the year, if I do go with an Advantage plan in the future.
But for now, I’m staying with the original Medicare with a supplement….at least I can be seen without getting a referral or prior authorization for a specialist! Heck, that alone is enough to cause me to possibly continue to stay away from the Advantage plans.
As for also having to pay a separate premium for a Dental plan and Vision, I have chosen to go with Physicians Mutual Dental…..but I haven’t gone with their Vision for an extra $6 a month…..it just didn’t seem to cover very much….unless maybe I’m not understanding it? I’m still shopping around for the best Vision provider. VSP seems appealing, but is more costly in the premiums.
This man is a fool!!! I have listened to him for weeks. I am not sure who pays him but I think this week it is Medicare Advantage Plans!! Last week it was supplements. I agree with the person above. Please educate using other people! Thank god I called another person. Stay away from him!!
Is the premium a annual price for b and g or monthly
That would be monthly
I am very confused, I watched one of your presentaion few weeks back, you were strongly against advantage plan, but now you are strongly against Supplemental paln.
I'm retired Navy. Finally got an answer to I had about Medicare Supplemental plans!
Thanks!
I had another question though. As a military retiree am I required to file for Medicare at all? Or do I have to file when I'm 65?
At 65, since you're retired, Medicare will become Primary Insurance so you'll want to enroll. There are plans that are popular and work well with VA or Tricare. We can help you review all your options. If you have any other questions, or need help getting your Medicare coverage set up correctly, give us a call to schedule an appointment: 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
Please address which covers nursing homes
Medicaid or long term care insurance covers nursing homes. The only time your Medicare covers nursing homes is if you must be in a nursing home after a covered hospitalization in order to rehab. Then it’s a restricted time period and only for rehab purposes. Historically it’s been 100 days post hospital discharge. That may have changed since I was working.
Thank you ,good information
Only thing I think you missed was at the beginning, and that's to note the supplemental plans are also called 'Medigap' plans. I checked with my dentist, optometrist, and few other Ds & Os about the Advantage plans' coverage (as I thought it was very limited) and the common answer I got was very few in my area take those as insurance. My dentist even recommended a few insurance brokerages that represent multiple dental insurance plans that I can contact for coverage.
We also off all the top carriers for dental and vision plans.
It’s not worth the money, if few or no one would take that insurance.
I think it depends on your state. Here in SC I find very few doctors, dentists, optometrists, specialists that don't take a medicare advantage plan. And I see almost every specialist there is... cardiologist, rheumatologist, gastroenterologist, allergist, oncologist (cancer survivor), anesthesiologist (for pain management), urologist, dermatologist, endocrinologist, and a pulmonologist. I didn't see 90% of those before cancer, the treatments caused many side effects, then long covid caused the rest. Thank goodness for my advantage plan, I haven't paid more than $3.25 for any dr visit in 4 years. I paid $90 for my glasses this year and 0 in dental because I have $4500 allowance so unless I need something major dental wise it pays for all cleanings and x-rays and will pay for most dental work up to my allowance such as crowns, bridges, dentures.
So far I've only had 1 dentist say they didn't take my insurance, but they don't take any medicare they do however give you the info to file for reimbursement. Everyone else, especially medical doctors are typically on one of 2 major hospital networks in my area and take what the hospitals mandate. Very few doctors aren't a part of the hospital network. My PCP isn't they do take all medicare though. And I've checked some doctors and specialist in both NC and GA since I live almost at the point where all 3 states meet and I've found specialists in both states that take my advantage plan. It could be because so many people will commute into those 2 states or to draw people into driving there which may be a 30 minute drive instead of driving an hour away in SC for the same specialist. We even get flyers for dentists, doctors, oral surgeons, etc from GA in the mail almost monthly all advertising they take most medicare.
@@kdscraftcorner well good luck! Mayo Clinic just sent letters to all patients advising them that as of 1-1-23, they are no longer accepting ANY advantage plans. So hopefully you'll never need Mayo!
@@lindamaskus5142 I don't need luck, I'm not likely to ever need Mayo. The only place I might ever have the chance to need to grace the doors of anything Mayo related might be the ER at the hospital in Jacksonville FL if I needed it while on vacation. But if I go to FL I typically go somewhere along the panhandle, not Jacksonville.
And medicare advantage plans are required to cover ER and urgent care visits ANYWHERE in the US without imposing additional costs. So if I get sick or injured on vacation I'm going to the ER or an urgent care facility. Otherwise, I'll wait and see my own doctors at home. If I need some kind of specialized care I'll more than likely go to MUSC unless it's for burns, God forbid, then I'll go to the Augusta Burn Center.
As I said it really depends on your state and where you live (and the number of Dr's and facilities that accept MA in your area - my area is virtually all of them). It also depends on your needs. I'm disabled, I qualify for my states medicaid service for disabled and low income elderly. Which means I qualify for a dual eligibility advantage plan too. My premiums, deductibles, overages, copays, max out of pocket, Rx and more are set by my state. Medicaid even pays my part b premium. I pay nothing out of pocket for anything other than 2 medications that don't even total $50 for the year and my PT for lymphedema which costs me a whopping $3.25 per visit, which is weekly. I've had 1 emergency surgery for a hernia and 2 hospital stays due to complications from long covid in 2020/21 and I paid $0 for any of it - the hospital stay, surgeon, anesthesia, doctors, tests, ER, medications...ALL OF IT was $0.
I'm also under 65, when I looked at medigap premiums when I was 1st looking into Medicare most of the premiums were 1/3 to almost 1/2 of my income. The cheapest was almost 1/4 of my income but then it had over a $2k deductible. I would be insane to opt for that when right now I pay a maximum of about $100-125 out of pocket for everything - all premiums, deductibles, copays, Rx, you name it. Add to it all the benefits I receive and I'm basically being paid about $3k per year to use medicare advantage. That's a no brainer for me.
So my situation is very different from yours. If I wasn't able to see pretty much any doctor in my area I want to see then I might be better off with a supplement plan. But that's not the case for me.
Which Medicare Advantage plans give a buyback or cash back for Part B of Medicare? I'm on an MA plan because I'm on disability and the supplements are unaffordable to me upwards of five to six hundred dollars per month. I like my ma plan from a local company in Michigan, but they don't give money back on part B and that would help me quite a bit to have that extra cash in my pocket. My particular plan has a high Hospital deductible that amounts to about six or seven thousand dollars, so I'm not happy with that if I ever do go in the hospital it would be very difficult. But one thing you didn't mention is that there are Indemnity plans that can help cover those extra costs of deductibles and co-pays. In fact I just reminded myself I need to look for one of those for next year.
Advantage plans are a scam, the total out of pocket mentioned in not the total liability that you may have with these plans. These guys also make a higher commission on the advantage plans. If you can afford to stay on regular Medicare and add the medical and drug plan that is what you should do. IMHO. Advantage plans are managed plans and you will have to fight for many claims that you may have.
If people can afford it they are often happier with a supplemental
Plan. However, if budget doesn't allow we help many people find the best Advantage plan option out there. There are ones that are much better than others.
@@MedicareSchool are there any plans with low out of pockets max, like none to $1000 max?
Great video, best I have seen. Thank you
Thank you!
This is as confusing as the IRS code. Reagan called Washington DC "The puzzle palace"
For us military retirees. How would you rate Tricare for Life? Did not understand MA plan?
With Tricare for Life we recommend getting an MA-only plan. This will give you dental vision and hearing along with giving you a reduction in your part B premium and other benefits. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
The only reason to enroll in Medicare Advantage plan is if one can not afford the higher monthly premium of Medicare supplement. Dental insurance is more like a coupon and vision once a year not any better. As for free gyms fitness, this is a choice not absolute necessity and there are alternatives at practically no cost for better health such as walking and couple dumbbells, we are talking seniors after all not body builders . Lets don't forget a good diet. How is waiting several days for authorization to receive any type of imaging regarding a serious health issue? Why it is so hard to switch back to Medicare supplement from Advantage plan?
Can you afford the possible $8,000 to 13,000 out of pocket per year with Medicare Advantage?????? I can’t that’s why I have Supp. G.
Greetings, I am about to be 62 in 2024. I may have to work until I am 70. If I wait on Plan B will I have to go through the questions for the health portion to get covered?
He is probably getting paid by advantage plan co. The most important thing is to be able to choose your Dr,
Thank you for the comment. We offer supplement plans and Advantage plans.
I love this channel!
Yes, but I went with an advantage plan last year, and it sucks.
Logically speaking, exceptional information. Valuable lessons. Thank you.
Thank you for watching! If you have questions or need help setting up your Medicare coverage correctly, give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
This presentation is very clear, easy to follow, and well-reasoned. I would add that the very healthy person who is sure (s)he won't have to deal with serious illness should consider a high deductible G plan.
Bad thing about that thinking is no one knows what will happen in the future. 65 years healthy and in a car accident, bust a hip, cancer, etc. Insurance is for WHAT IF. The older we get the more vulnerable we become.
@@tsx3214 HD is an option that might work for some people. Calculate in the HD copay that resets every year.
@@tsx3214 An option for super healthy people for sure.
What do you think about the deductible going up and your premium going up? It doesn’t make sense to suggest somebody to go towards this type of policy because it won’t be long before the deductible and the premium will keep going up more where you would be paying way too much and could possibly never be able to get approved for anything better because of something changes in their health. That is why we don’t, because we don’t believe that it is good for them.
@@MedicareSchool Won't the premiums on regular G plans also increase?
I’m on Kaiser now. Kaiser does not offer any supplemental plans. Do you know if Kaiser covers all the gaps?
Kaiser offers Medicare Advantage plans and you are limited to only Kaiser providers. You would have Copays and Max-Out-Of-Pocket for the year, unless, you qualify for full Medicaid assistance. If not, and your interested in Medicare Supplement or a different Advantage plan, we can help review all your options.
If you have any other questions, or need help getting your Medicare coverage set up correctly, feel free to give us a call at 800-864-8890 or schedule a free appointment here:
www.medicareschool.com/talk-to-a-guide?rc
The worst gap is with Part D. It doesn't cover many expensive drugs until you pay $4500!! It's crazy that you can't get adequate coverage at any price. So I'm staying on my husband's expensive employer plan so I can get my expensive medication.
We completely agree. Part D is lacking in so many ways.
Excellent Points. Thanks.
Glad it was helpful!