Medicare LIARS! TRUTH told about Medigap Plan G in 2024
Vložit
- čas přidán 31. 10. 2022
- call now 1-844-552-7426
There are so many Medicare liars especially when it comes to advantage plans. This video is the truth told about Medigap plan G in 2023. The supplemental plans for Medicare in 2023 are still the best plans a person turning 65 can get. The Medicare supplement plan n is also one of the top medigap plans for next year. I do plan g vs plan n in parts of this video and explain why you should not get an advantage plan from companies. The best medicare supplement plan g is most likely from top companies including Aetna and AARP. United healthcare and Cigna also have popular plans with coverage that is cost effective.
Please watch the playlist of all Medicare videos:
• All Medicare Videos
Get my free e-book:
medicare-365.com/medicare-wit...
Blog post::
medicare-365.com/2023/01/01/m...
Disclaimer: This video is for entertainment purposes only. If you want advice on Medicare or any of its plans, please speak to a licensed agent, whether it is me or another licensed agent. No advice should be taken from this video. If you don't speak to me about your individual concerns, I can't give you my 100% opinion.
Keywords:
Florida
Pennsylvania
New York
New Jersey
Illinois
California
Michigan
Colorado
North Carolina
Virginia
Texas
South Carolina Medicare supplement plans
#medicare #medigap #medicaresupplement #medicareadvantage #medicaresupplements #medicareplang #medicarecoverage #medigap365 #brianmedicare
Do you think Plan G is the best?
Probably. But what about a high deductible plan G? Is there such a thing? Thanks.
I respect you for NOT pushing Medicare Advantage…..there aren’t many agents aren’t!
I found only one when I was looking.
Plan G or Plan N would be a great plan depending on one’s affordability each month. Some seniors can’t afford to pay more so Plan N is a good choice.
@@RealSlopeDude I believe so.
@@cindyrose4155 I think plan N might be the best. Even though a larger group might help keep premiums lower, I heard something about more sicker people going on plan G, since plan F has become so expensive. This might make for even higher premiums over time. I think a few possible co-pays of $20 every now and then is better than the extra $40-$50 every month forever. In most circumstances you should be able to check with your doctors to ensure they take medicare assignment, so I don’t worry about %15 excesses charges. Maybe 6 in one hand, and half a dozen in the other. Either G or N seems like best way to go if you can afford it. Just get with a good agent and a good company.
The year before my mother passed away she switched to an advantage plan. It was wonderful to manage costs for her meds and routine Dr visits. But when she fell and broke her leg, it was a nightmare! Finding a rehab facility and home health that took her insurance required FIVE extra days in the hospital - and the care she got in the one that finally took her was abysmal! When my time comes, it's traditional Medicare with a gap plan all the way!
Advantage plan sucks bad at end when you really need it
Advantage is only decent with routine things. If you get cancer or have anything major, forget it.
Either you are lying or just ignorant.
All the way!!!!!
I agree.
In my second year on Medicare, I was diagnosed with breast cancer. Prior to that, I'd been the person who sees her primary once a year, and had a mammogram...that was it for about the previous 20 years. Because I had chosen a Plan G, I was able to go out of my small city to a large cancer center near where my daughter lived. I had a total of 4 surgeries, 16 "rounds" of chemo, and 33 radiation treatments plus numerous visits. During the second type of chemo, visits were 3 times a week. The workup included a PET scan, CT, MRI, etc. My total cost outside of the premium was the $203 deductible. If I had chosen an advantage plan, I would have had to stay in my area and undoubtedly would have hit my max OOP of over $6K on that plan. No question, for me, Plan G was the best. I did compare F and G. F had no deducible bu the premiums were $400 more. G had a $203 deductible, so I was saving $197 with G....besides being advised that plan F costs could be expected to go up more than G as it would soon have only older people on that plan. And that gym membership on an advantage plan doesn't mean anything when you are so sick that you can barely get from the bedroom to the bathroom due to chemo!
Glad you chose the correct plan. Great story for others to hear. Thank you sharing.
I'm like you as I went to gym 5 days a week, eat right and never had health issue until 64. I had a knot come up under jaw and it was neck cancer on submandibular gland. Went thru 35 sessions of radiation and chemo for 7 weeks. I just retired and will start Medicare on 1-Jan 23 and absolutely went with plan G at this time. Everybody's different and needs are different depending where you live (city or rural) and how far to travel for healthcare. I live in Greemville, SC and we have great facilities, but I have family in Oklahoma who have to drive 100 miles for better care. I hope you live cancer free in the future.
America should have universal health care….they could learn the pitfalls from other countries who have it and make adjustments to make it better…..you pay for Medicare throughout your working life….and your employer also takes money from your pay for their company insurance….at best, Medicare should be made not to be so confusing and complex…..people work their whole life and then are duped with the high prices of medical care. Big pharma also uses a lot of your tax dollars for research….your paying them tax dollars so they can charge you excessive fees for the medicine you helped fund….in every aspect of life…there’s greed….
@@davidyearout7897 Totally agree, and in retrospect, I've probably paid more for Medicare thru the years than private insurance would cost...but at this point in my life, I like my coverage.
Dear Kathryn...I wish you a total recovery from your breast Cancer diagnosis. I've been there too. I had my cancer diagnosed, when I was 55, and had some outrageously expensive medical bills. At the time I was employed and had group coverage from work, which covered most of my expenses. My radiation treatments alone were more than 35,000. Now I'm retired and I chose Plan G also, because if I get sick again Plan G will help me get the best care. My problem now is my primary care doctors keep leaving the practice or retiring, and a lot of doctors won't accept new medicare patients. I hope you continue to get well and all good blessings will be yours.
One huge oversight in your presentation is that with an Advantage Plan, you don't have a choice as to what Dr.'s or specialists you can see. All treating physicians must be a part of the particular insurance companies plan. Go outside that and its the subscriber that pays the entire bill. One other little caveat is that many of these Advantage Plans require prior authorization from them before they'll pay. And sometimes they will slow walk that decision. At zero cost for many of these Advantage Plans, I still wouldn't take one. There's a reason why they don't cost you anything. Only after you really need the coverage will you find out the true cost and it won't be pretty.
This is true. I’m sure I covered this in some of my other videos. You do have to be very careful with advantage plans. Some are good, some are horrible. Thanks for the comment
I have Medicare advantage and it is a PPO so I don't need pre-approval. Some advantage plans will cover out of network service if that service is not provided by somebody else in the network. Also if you are in the hospital or some other service it is expected that the service is in network even if someone out of network gives you a service. As long as they are doing it at the in-network facility.
The Advantage Plans are basically HMO plans which is what most working people have through their employer. I don't see what the big deal is.
It's not an oversight because your statement only applies to HMOs, not PPOs. With PPOs, you can go in or out of network. Many PPOs, like C-SNP, Dual and LIS plans pay the same in or out of network.
@@surfrunnerd8457 Which is all well and good if you live in or close to a metropolitan area. More rural area's won't have the health care services and choice of providers.
Be thankful if you have no health issues. Remember. the older you get, the more health problems you will have. I used to be in excellent health. But after age 65, I have had to have surgeries but was thankful for Plan G. In 2024, the only payment I owe as a deductible is $240. Anytime I go see any doctor I pay nothing. And I can go to any doctor in the U.S. that accepts Medicare. And no pre authorizations to wait for if you need treatment. No referral needed to see any Specialist. Plan G is great!
Not everyone has more health problems as they get older.
Many stay healthy on no meds well into their 90's.
*Stay active, eat clean (carnivore) get proper rest and maintain a healthy mindset*
@@afisanaa I am turning 65 in September and going thru all the info. re medicare and/or keeping my Kaiser. Too overwhelming for me right now. But thankfully, right now, I am doing good re health problems. Tomorrow, going for doctor appointment just for regular labs (not by the doctor, I am doing voluntarily). Ive had Kaiser for 45 years and now I've to deal with turning 65 and Medicare. IMO rather than make it easy for older people, I feel its overwhelming. But I agree with you, stay active (I do my daily walks), eat pretty good (but treat myself once in a while, its a matter of balancing in life), and need to improve my daily rest (sleeping only around 6 hours but not solid). Take care, liked your advice.
I love your honesty. I saw a guy in Wisconsin he tried so hard to push Advantage. He gets bigger commission i heard to give me a crap plan. Advantage is bad if you have to go to rehab.
I turned 65 a year too late for Plan F, but I am so happy with Plan G. My premium is over $200 though. That is what it seems to run in my state and zip code. At the time I switched to Medicare, I was midway through treatment for breast cancer. Once I qualified for medicare, it was so much easier. Got nothing but grief from my previous insurance.
Glad it worked out
Plan G . A simple decision after futzing about with a HMO plan with an illness that required some extended care. It's hard to prequalify stuff and the extra el cheapo testing that diminishes care made me miserable for no reason.
One thing to mention is the
Importance of a good insurance agent who will answer questions about your care. I had to have three IV injections a day to fight a nasty bacterial infection that settled in my spine that required spinal surgery and skilled care over a seven week period. Medicare tried to get me to go home for the injections after three weeks, do I called my agent and he asked what the drugs were that I was to have injected. He advised me to stay at the skilled facility simply because the drug copay would be more in I took the drugs at home than paying a percentage of twenty percent of room and board for an overstay.
It now looks like the overstay will not cost anything as messing about with a PIC line requires a RN to inject the medicine and I could not self inject it as Medicare wanted. Even with the professional staff there were all kinds of issues over doing the process to a medical cleanliness standard that was much worse at the tier one hospital than the skilled care facility. I learned a lot about overworked and overwhelmed nurses making mistakes in that seven weeks.
Some nurses were like Florence nightingale and others like Nurse Ratchet
I’m 66 and chose the Plan G and love it. It is actually a better plan than when I had work insurance. I don’t like surprises if something major happens health wise. I don’t like having to get referrals. I don’t like having to worry about doctors being in network. I would never go with an Advantage plan.
Good choice 👍🏼
How fortunate you are to be able to afford G (also known as the "pay up front" option) ... and it's increases every year! Thank God that another option exists for those that cannot and need to be able to pay only "as they go."
Everyone can’t afford the supplement. Be grateful you can.
The more of you who stay with regular Medicare, the better our Advantage plans get. So please stay with the old Medicare plan. You all let the government provide us with these full comprehensive medical plans. You all let these Healthcare plans make lots of money.
@@GAderly-fn5ly hopefully you don’t get really sick, because that advantage plan won’t cover much. Anytime something is advertised for months you have to wonder, if it is so good why so much advertising. Good luck with that advantage plan.
My wife had a stroke in 2022. One of the medications alone, TPA, carried a charge of $42,000. On Plan G we were responsible for only about 500 for the total hospital stay. Plan G is the way to go....we would never change to another.
Amen
How did you pay for the medication? That is what I'm not understanding with this video. Medication's are a fortune for me.
I have been on Medicare plan G for a little over a year. I pay 230 per month including B, G, and D. I have had numerous Dr’s visits, a knee replacement, and many PT appointments for rehab. I only had to pay the Medicare Part B deductible for everything except prescriptions. I kept asking the Doctors what my co pay was. It was NOTHING! Prescription is not great for my expensive glaucoma meds but still much better than when I was working. Love Plan G.
Aren't there drug plans too that go with Medigap?
@@analuquinones5781 With Plan G, you need to choose a drug plan (Plan D) through a Medicare broker - like the person who did this video. If you don't take too many prescription medications, the monthly cost should be around $50 ( level 1).
@@analuquinones5781 Not anymore.
@@analuquinones5781 You have to take out separate coverage to get drug coverage when you have a Medicare Supplement plan. Part D plans cover prescriptions drugs. Taking out a Medicare Supplement plan now no longer includes drug coverage.
@@analuquinones5781 Medigap does not cover prescription drugs. You must buy a separate Part D prescription drug insurance plan.
My girlfriend is a case manager at a rehab hospital. When she attempts to place a patient in a nursing home or assisted living center all of the so called wonderful medicare advantage insurance programs are refusing to pay !!! Florida blue / blue cross is the worst! So beware!!! Yes medicare advantage sounds wonderful until they have to pay for prolonged care. Thats when you face the death squad that denies your claim !!!
I have aetna medicare advantage... because of this i am seriously considering a change at end of this year to G or N plan !
Sounds like a plan. That’s why we are here.
You are in Medicare Advantage for over one year? You will be subject to medical underwriting screening before being accepted into any Medigap plan. Watch out because Medicare Part B will allow you to switch, but if the Medigap underwriters deny you, then you are now on Part B without Medigap which means that you are on the hook to pay the 20% since Part B only pays 80%, and that 20% has no ceiling. Hope that during your time in Medicare Advantage you were not treated for any chronic disease or condition that requires drugs to manage (such as high cholesterol, diabetes, or heart condition) because those are the things that Medigap underwriters will use to block you from obtaining a Medigap policy. At that point, you are stuck in Medicare Advantage for the rest of your life.
Again I had no idea I had to be screened for Medigap. What do you do if you have like many of us by this age pre-existing conditions. I've been on disability for many years. My company sent me a letter of termination in January. I have been on Medicare this entire time. Now I need supplemental insurance and I am just lost with all of this. I paid approximately 210 a month Premium for my Blue Cross and Blue Shield. Deductible 1500. Various co-pays for medicine and then I also paid all the Medicare part premiums and deductibles.
I will never support the privatization of health care. We see where that has gotten us.🤬
We haven't had truly private health care since the 60's. What's "gotten us" is the government sticking its snout into everything and making EVERYTHING grotesquely expensive.
It IS privatized already. The GOP is simply focused on getting rid of medicare. Vote accordingly.
@@sw6118 As I said in the second sentence, "We see where that has gotten us." But, I guess I should rephrased that and said that I am against privatization of healthcare --as well as a whole host of other sectors which have been privatized!
It is the sole reason we have the worst healthcare in the West. It's criminal. Healthcare, like housing, is a human right.
Is there anything left of our lives which these grifting sociopaths haven't commodified?
@@sw6118 ALL OF CONGRESS. Not just GOP.
@@V_Hayden7 What?
Wow, I actually got Brian when I called. :)
I thought I would go to plan N or G, because my plan F is so expensive.
After discussing the pros and cons of plans N & G without my asking, Brian pointed out that since I was in a new zip code my plan F was only $20 more a month then plan G. So I wound up staying with plan F.
I could hardly believe that he would go to so much trouble to make sure I got the best plan with the best price.
Thank you, Brian
I find it curious that Plan G Supplemental can cost more than Original Medicare Part A and B.
Medicare Part A and B cover 80% of the bill, and Plan G the remaining 20%.
I'm paying more for the plan that covers less...
Only in America...
You have been paying for traditional Medicare all your working life in your payroll taxes they remove from every paycheck. They also remove money that they put into your social security account.
The Supplement plan is a private company, in business to make money. Medicare is a service of the government, and like a lot of things the government does, it loses money! 😂
@@kbail9806
I have 2 rare cancers and belong to support groups. Those with Advantage Plans consistently lack access to centers with the expertise they need. No way would I choose an Advantage Plan.
It is beyond confusing. I can only afford Part A.. and make payment plans for all else and I've had cancer , radiation. I pay the Part A premium and I can't afford Medicare to take more of my check for Part G. All the financial folks hospital etc look at my $$ income abs say oh darn you make $125 too much for Medicaid. So if your lucky n worked since you were 13 yrs old and stayed working close to retirement age. You will barely survive on social security because you are considered rich and this number game has followed me through to finding affordable housing. Rental $$ go up , food n I know that a trip to a state that will assist me to heaven is in the cards when I'm closer to the end. There's no gray area. They are handing , medical , housing to immigrants who want out of their countries. Being an American that worked hard , and that's blue collar hard. You will see little help if your over the $$$ amount. I've considered my car, a cheap van and one day there may be no choice. I've been watching these videos here n other channels. What a racket. ,, and these brokers must get paid off the brow of our sweat n decisions but by whom ? I'm so frustrated and it's dam frightening. I get it and I can't say thank you for explaining this unfair Hella expensive medical system that's all for us at the end. This isnt an issue of people who didn't work hard enough. This is the working class who had the rug pulled out when production jobs left the country. This is back in the 1970s and moving forward. Just speaking my truth.
@@SuntoSet77
An Advantage plan is probably your only option if you can’t afford an N or G plan. You won’t have as many choices as far as where to go to get your cancer treatment but that’s better than not being able to afford your supplement at all.
As someone who travels both within and outside the USA, I would NEVER take an Advantage plan. It would not cover me outside of my region.
The day I turned 65 in August a few months ago I got calls tons of them non stop from morning until night 7 days a week from pushy sales people trying to get me to switch to a horrible Medicaid advantage plan, I would block their phone numbers but they would just call from a different number, but 2 weeks ago I couldn't take it anymore and got my number changed, but they wore me down and talked me in to getting the medicare advantage plan! BIGGEST MISTAKE OF MY LIFE! I found out I was better off with my regular Medicare n medicaid because the Medicare advantage plan turned out to be a scam! They would NOT pay for any of the medical or dental I needed! They would not pay for an MRI or xrays I needed, they would not pay for dental xrays or the oral surgeon I need so badly! They wont pay for a lot of things! Research advantage plans and the state of New York they discovered the medicare advantage plans are shoddy! Thank God I found out before it was too late and I was stuck with the worthless medicare advantage program the rest of my life! I hurried up and called Medicare and told them I made a big mistake and I just want to go back to being on regular Medicare. So starting January 1st 2023 I will be back on regular Medicare but until then I'm stuck on the advantage plan, but at least I will be back on regular Medicare in January, but if I had waited much longer I would not have been able to switch back. But the Medicare advantage plans are horrible and they're not going to cover you like the lies and promises they try to fill your head with, so don't fall for it, stay on your regular Medicare...one day in the future your life may depend on it because in a health crisis the medicare advantage plans will NOT pay for the medical help you may need whereas regular Medicare will....
Same here… I travel abroad ..so will stay with my Plan F
If you travel, no problem. Most of the major carriers allow you to see anyone in their network nationwide on an in-network basis. Not just emergency. You are also covered for emergency care worldwide.
Advantage plans that are PPO will cover you
@@brocklanders6969
Yes. But look who is in their network. I have a rare form of cancer. It was caught early. I’m expected to live. I’ve researched who the top specialists are and I found out most of them don’t take any Advantage plans. People in my cancer support group are constantly having care denied and it’s heartbreaking.
The problem with Advantage plans is that they are run by for profit companies. They get a fee from Medicare for every member and their profit is the difference between what Medicare gives them minus what they spend for your care.
After I’ve paid (or had deducted from my monthly SS benefit) for B, D and G or N, there isn’t much left from my SS benefits to live on.
Check on med aid
Look into local Govt agencies to see if and what you are eligible for assistance for your living expenses.
We work all our lives and pay into the system. We should have much better options. America do better😢
My wife and I both have plan G and after a revision surgery for my left knee and my wife dealing with Breast Cancer this past year we would not change a thing, excellent coverage at an affordable price.
What if your income is only $12,000 a year, which is true for a lot of senior women. We are in trouble. Nothing to look forward but bankruptcy. Would like to move to Canada but of course at this point I can’t the for profit health care system is killing us, and so much is thrown at us.
medicaid
@@sustainablelife1st Don't qualify by about 20 dollars in income......Don't move to Canada. worse.
You may be able to qualify for Medicaid as your supplemental plan. It depends on your state.
Go to Mexico, enter illegally back to California, and you live.
@@bobsum1745
She would qualify for a free Medicaid supplemental plan in my state. Or she can also get a zero dollar Advantage Plan.
Having been denied needed care on an Advantage plan from a well-known provider, I learned the hard way the dark side of going cheap. I was fortunate to be able to switch back to original Medicare with a Medigap G policy. Never again will I allow a for-profit insurance company be the decision maker for my health care.
This man is phenomenal. He goes way past the last mile to make sure you are set up with the best plan for you. In my life, I have experienced very few people like him and I am 75 years old.
Really?
Are you a shill?
Thank you for your input I need it I will be turning 65 this year. Thanks ❤
@@christineparker3805 In the beginning of this video he mentioned that if you go with the Advantage plan you will be screened if you try to switch to original Medicare (after 12 months BTW). That is something I have been considering as an incentive to go with Original Medicare and Medigap ( Supplemental) and a Plan D for around $12 a month.
If I never get sick, the Advantage plan is very enticing but if something does happen I am screwed. Then I think to myself, that is why I need insurance to start with. I pay more for my auto insurance. That is when common sense takes over. Get rid of one of my autos.
Aren’t this premiums based on your zip code ?
Here in BFE Montana, I pay $130 a month for Plan G. I am very happy with it and don't expect any issues.
What company is giving that plan price ? I started last year at $115 in SoCal on G but after a year will go up at $150 dollars with Anthem.
@@mimi1o8 Montana Health Co op. This is for coverage nationwide.
I love my plan N! 3 years ago I went from an F for $182 a month to plan N for $82. In 3 years my premium has only gone up $7 to $89 now.
Great to hear it. Nothing like saving money and being happy with your coverage!
Dental benefits aren't that great on Advantage. Barely covers anything. I have 2-3 patients on it. Don't get sucked in with a carrot in front of you that says "Dental Benefits". Been a dentist for 30+ years. I know dental benefits TOO well.
Dental benefits under Advantage plans cover only routine cleanings but are not comprehensive dental insurance. No coverage for things like x-rays, root canals, fillings, crowns, bridges or implants. Probably no coverage for periodontal treatment such as "deep cleaning".
Many of them include comprehensive in the dental allowance actually. You just need to know which companies
The problem with medigap plans in FL is that they are extremely expensive, well over $300/month, plus you have to pay your Medicare premium, so sometimes over $500/month just in premiums.
That’s where Plan N or the FHD, GHD come into play for many!!
Call into some of the agents on You Tube who can look over costs for Medigap plans with you to see if they can get adequate coverage at lower cost. Watch some of their videos to decide which of these agencies you would like to work with.
Blue Cross Plan G , age 66 , non smoker South Florida is $ 312 month . But worth it . 😍💙
My husband has plan G and has a life threatening illness. We have been able to get the best care for him without any approvals and are able to go anywhere not have to stay within our medical group.
Unfortunately, the only time you see how great the plan is when a loved one gets sick. Praying for your husband and family 🙏
As a 49 yr insurance veteran…you are really good, open and thorough. Well done faithful servant. Dave
Thanks you sir
The title of this video almost made me assume that the presenter was going to be against Medigap Plan G. I enjoyed the info and am glad I watched.
The difference in monthly premium between Plans N and G in my area equated to $660 annually. With a $20 copay requirement with Plan N that equates to 33 doctors visits a year. Additionally, after having a bad accident that required 3 different hospital stays and numerous follow up doctor visits I was pleasantly surprised at how few of those visits required any copay at all. So I’m sticking with Plan N. I’m in PA so no excess charges allowed here anyway.
Plan N can also have co-pays for surgeries done in the hospital as well as out patient services done in the physician's office. I have a friend with plan N having chemotherapy done in the physician's office of $250 per treatment.
@@DickNasty480 I believe this is because drugs fall under the individual’s Part D Drug plan.
I’m helping older friend Thru this& plan N has lots of copays, pays virtually 0 while Plan B coveted most & was discounted. Beware modifiers “GA” on ABN many greedy Medicare providers add even after refusing any test that can POSSIBLY be not fully covered by Medicare- those sane refused tests will be run unbeknownst to patient- NO discount, & get shock when Summary Notice arrives. Appeals - will not win as long as deceptive ABN exists on file 1 to 5 yrs. Same here Ben if one signs a new one REFUSING all non covered Medicare. My friend has 4 insurance policies & still paid over $1k OOP; she wasn’t even that sick but it was her 1st time experiencing significant illness.
Then, why were you so surprised?
Here in California exorbitant excess charges are the rule.
All my life I've had insurance restrictions through my employers health plans. Even original Medicare & Supplemental plans can have restrictions. I currently pay $120 a month thru my employers health plan. When I start Medicare, I'll have to pay $170 a month for required Part B. A supplement would cost another $150 for similar coverage to what I now have. $320 a month for health insurance over 65? That's a sad shame in America and too much for me to pay! The best hospital & Dr's in my area are In Network with most Advantage Plans. Proper planning is key.
If you are on an employer's qualifying health plan, you DO NOT HAVE TO ENROLL IN MEDICARE when you age in. You can elect to remain in your employer's plan (if they permit it) as long as you care to and enroll in Medicare at such point that you are no longer enrolled in another qualified plan. And be subject to no Part A or D premium penalties when you do.
Medicare is a rip off.
@@chuckschillingvideosEXCEPTION- If you are on an employee's qualifying health plan and turn 65 and there are fewer than 20 employees, you are required to sign up for Medicare! Look it up.
Get educated on the Medicare Cobra Trap. If you are eligible for Medicare Cobra will refuse to pay more that 15% app and deny the claim Get educated no one warns of this
My wife and I switched from the F supplement to N with a different carrier several years ago. This resulted in much lower premium. The $20 copay is an issue if you go the a doctor many times a year. Excess charges really are not a problem as Medicare discourage doctors from doing this and as you mentioned some states do no allow the practice. As a result very few doctors do it.
Switching supplements does involve passing medical underwriting insurance companies use to screen out the most expensive customers. That being said both my wife and I have chronic medical problems and did not have a problem passing. But switching supplements may be impossible later in life so it is good to think of them as a lifetime choice.
Thank you for being honest with us older folks. My wife and I both have plan F. We’re both happy as can be. The plan F offered us future financial Peace of mind in the area any future medical care and bills.
Problem now with those supplement plans will be that they will be raising premiums faster every year now that they ever did before.
They will cite inflation and other things to raise it up just to make more profit and many people will eventually get priced out of traditional Medicare supplements unless there are changes in law not allowing large raises of premiums
Advantage plans will be raising the out of pocket expenses faster than the grease hits the skittle… in my opinion
Thank you for your honesty. I’m in a plan G and I think I just made the right decision 👍
I’m 82 and for the first time I am now going with Plan G that starts in January. However, I was on a Blue Cross Advantage plan since I was 65. Luckily, it worked for me because I’ve been fortunate and healthy. Yes, I paid some co-pays to see a doctor, had a couple minimal surgeries on both feet. Most things I needed was covered and never hurt our budget. The biggest mistake I made was never getting a part D for RX coverage. So far, I’m still on one very inexpensive common drug, even at 82. But if, for my peace of mind, I want to buy a Part D, the penalty is about $68.00 per month! I’m still deciding on that one…
My cost for plan G will be $199.00 per month because I qualified to stay with Blue Cross without underwriting. Again, fortunate even though I don’t have any major illnesses. I didn’t want to go through the underwriting.
I still have family and friends telling me I’m crazy for paying these premiums when I could stay with an advantage plan.
Thank you for your video and the great information. At 82, I feel much better about the switch and will enjoy the total confidence of no financial surprises.
Thanks for sharing your story!
Didn’t your Advantage plan include a drug plan? You shouldn’t be penalized if it did. Of course you may be in a state that’s different on this. Are you going to have to go through medical underwriting to get a Supplement?
My advantage was without part D RX plan.
@@keilana6 You have an opportunity every year during open enrollment to shop for a plan, if you’re getting yours on the open market and not through an employer. Those on the open market have been very low cost. I understand the affordability of a supplement. Hope everything works out well for you…
@@cccar67 Most of the ones I’ve seen included one. Of course there seems to always be an exception across the nation somewhere on everything. That doesn’t surprise me…
I was on an advantage plan for less that 6 months. It was a nightmare. Never again and I will advise anyone who asks me. I needed PT during that time. Between the hosp and ins company, they screwed up the referral. Both blaming the other. I was to have PT 3 times a wk. which found out the I had a 35.00 copay each visit. 105.00 a wk. They would not see me unless I pd that before I went in. That adds up fast when you are on a fixed income. I just gave up on care until I could get back on regular Medicare.
Name one person in the entire usa who is not on a fixed income.
@@DrSchor You are right about that!
I just turned 65 and am switching from my husband's Advantage plan to plan N. He has CareFirst BC. We have to choose an in-plan doctor, hospital, urgent care, lab, and even facility to ensure we have the lowest out of pocket costs to us. The small co-pay was nothing. However, having to pay 100% of all excess charges was a constant worry. I was in the hospital and one nightshift doctor came in for 2 minutes to ask how I was and charged me $697! I had to pay all of it because he wasn't a plan doctor, even though we were in a plan hospital. I will no longer have to worry about emergencies or getting sick.
@@jasonscott6174 0ll
Isn't there the "surprise law" in your state? My understanding is that eliminates that. My sister went through that when she was in the ER for a heart condition and she fought it and they wrote it off. They tried to charge her $1000.00 for a 10 minute consultation when they admitted her to the ER and she had no say so what doctor came in.
@@shannonk.6528 Modifiers GA supersede Medicare federal laws enacted to protect seniors from surprise bills & excess charges. Anesthesiologists are not covered under any plan, being “ specialists “ which is nonsensical- the surgeon & staff are not specialists, but one giving bene any anesthesia IS & can charge large fees
@@shannonk.6528 I have gotten my son and my husband out of these charges by explaining there was no doctor in network in the hospital. And yes, they have finally passed a law against doing this to people.
@@shannonk.6528I think you’re referring to Balance Billing laws but hospitals fight them. What was described above is the the ER Physicians are NOT in the network even if the hospital is Network. Found out with commercial insurance. 15 years ago. Ambulance drove 7 miles and charged 2,000. ER physician was not in Network but the hospital was Network. Fortunately, my commercial insurance did not reprice these high charges as “emergency” and my portion was 20%. If these charges were outside of emergency, they would Re-price and I would be responsible for balance.
Thanks for keeping it simple and straight to the point. You answered and verified everything that I have suspected about about the so called "Advantage" plans.
Appreciate it Harold
I have plan g. My premium jumped $20 per month starting in June. $185. Per month!
My husband went through cancer treatment for a year. Plan G was amazing! He lost the battle but we had no medical bills for a year of treatment. It's great for catastrophic cases. ...but expensive! I'm 72 and in good health thus far, but who knows what can happen down the road? Still contemplating.
Plan N will save you money 💰
My husband had cancer 3 times in 3 states, we are in the G Plan, never paid an extra cent.
We traveled for 6 years in a motorhome & he has an emergency gallbladder removal, not a cent paid out.
He passed away last August, was in & out of the Emergency room, ICU, & we had Hospice, not an extra dime paid out.
I'll take plan G over anything!!!
I'm sorry for your loss. Thank you for the information.
In NY Medicare Plan N is costing me $211.25 per month with AARP which has about the best price here. In February the rate will increase to $217.25. Between this cost and the cost of Part B I don't have enough money left over for a drug plan. I am disabled after 50 years in the American workforce, what is wrong with this country...
NY is expensive
There is a TON wrong with this country and you know it. Vote the politicians out, they created this mess!
The price has risen $6 in 2023
Steve, you can choose other plans. Straight medicare, 20/80 split. You wanted the best. You pay for it.
I believe NY has a law that allows you to get into plan G at anytime. People wait till their sick to get on thus driving the rates of plan G higher.
I am 85 and have been on plan G since day 1. the only thing have paid is the monthly preim. and the 1 time bill at the first of the year. Have 10 surg. and no telling many office visit, and about 4 weeks nurseing home Plan covered it all.
Thanks for this!
I have been on Plan F (which is no longer available) for six years. It has nothing MOOP/year. I love it, never take my check book/credit card to Dr. or Hospital.
My opinion is that McDisAdvantage is great as long as you have no claims. It’s like having no car insurance. I always have had car insurance. I would never change from it even though my premiums are slightly higher than plan G. But if the ever cut the F, I would go to G.
And as long as you have the income to pay for it,
I love my plan F too.
You are clueless!
I pay $65/month for Plan F high deductible here in Oregon. I think I am in the right plan.
I have had Advantage plan for 6 years. It is a PPO plan. All my doctors, specialists, hospitals are in network. It depends on where you live. Even if I hit the max out of pocket at some time I am way ahead in the saving of premiums I would have paid. Also if married you're paying out $5000 in yearly premiums if you include drug dental/vision coverage. We use the savings to buy long term care insurance.
This can be true for some advantage plans. I do have clients on advantage but yes… it all depends on your specific situation
That’s good. But what if you have to use your plan a few years in a row, as you get older? My accountant takes all my medical premiums off of my taxable income. So I actually get a discount on those dollars. I’m personally not worried about my health care cost today. It’s when I get in my later years that concerns me.
Nobody is going to tell me what MD I can go to…EVER!!!
GET ready to fork over HUGE BUCKS!!!
@@traybern I would disagree huge bucks difference and, in the long run, the return on premium well-worth it.
I just looked in my area and almost all physicians are enrolled with MA. Along with the major hospitals. Having said that I would still be reluctant to go with a MA plan as in many areas of the country lots of doctors and hospitals are dropping MA. Nothing is guaranteed going forward but I am more comfortable with G.
FYI, there are now G plans with the gym membership. I have one through United Healthcare. You just have to get an approval number by phone. Stick with G and buy your own glasses when you need them.
Yes I have silver sneakers with my AARP supplement plan and love it!
Very informative. I went with Plan G, myself, and what I like about it is the level of certainty. Not being an HMO, I can get service anywhere, and without referrals, even going so far as to cover 90% of foreign costs, so unlike advantage plans I don't feel grounded like a 5 year old. As to cost, I'm currently paying $920 per month for my wife's healthcare (she is 63). That is with a $9300 max out of pocket, an 80% coverage and $120 per doctor visit in an HMO, no vision, no dental, etc.. When she goes on Medicare, I will be paying $175 part B, $145 G, $13 Wellcare D, $35 DeltaCare dental, coming to a total of just under $400, 0 max out of pocket, 100% coverage, $0 per visit (except for that first visit at $230), no HMO, no referrals, universal worldwide (more or less). 100% peace of mind. Or, in other words, $520 per month cheaper than what she has now, not even counting the massive costs every time she goes to a doctor. I even took out a wellness insurance policy against that $9300 max out of pocket stuff.
I've been on Plan G since July 2023 (6 months). Premium = $125.43/Month. Deductible for 2024 is $240/Year. I love it. I don't have to worry about anything after my deductible is met. My Insurance provider is easy to get on the phone and a pleasure to work with if I ever have questions or need any help.
Sounds good to me
MANY OF US ARE LOW INCOME & CANNT Co Pay (. Middle Class are STRUGGLING too)!
I am all about the middle class. Thats 99% of my clients.
The employer I retired from reimburses me for all my Medicare/Supplemental insurance premiums each month. However, even if they didn't, I'd still stay with original Medicare and Plan G. I did a lot of research before I retired, to make sure I was making the best decision for myself. Note: Anything that is covered by original Medicare, is covered under the Medigap Plans. What is paid by each Supplemental Plan is determined by the plan you choose.
To put it simply, with Medicare Advantage, the insurance company has the ultimate control over your healthcare needs, not your doctor and certainly not you.
Also, with Advantage, (whether it's an HMO or PPO):
1. The network part of the plan can change yearly, so, your doctor may be in network this year and out of network next year. This means if you want to stay with your doctor, you pay the bill out of your own pocket, or change doctor's to one that is in network. (You'd want to check this every year, to make sure your doctor is still in network for the next year). Coverages can also change yearly.
2. Say your doctor recommends you see a specialist, need an MRI, or hip replacement, but Advantage doesn't agree and won't approve it. Then your only option is to pay out of pocket, or do without. Just about everything like this needs pre-approval when you have Advantage, and it must be in network.
3. Doctors receive less money for seeing Advantage insured patients, as opposed to Medigap patients and they make up for this by volume. So if you live rural, (smaller population) you may have to travel further to find a primary doctor that's in network.
4. All the "extra's" they like to tout on commercials for Advantage are geared toward people who are considered low income and not for someone who's SS income is above what the government has stated is poverty level. This is where you get the bait and switch, regarding premiums for Advantage when you call.
My 76 year old sister was just diagnosed with Parkinson's and asked her doctor who was the best specialist in our state. Within less than 2 weeks, she'd made an appointment, and was seeing that specialist. No network and no pre-approval needed. She has original Medicare and Plan G.
I was in the workforce 52 years, am in my early 70's, still in good health, but no one knows the future and I'm giving myself the gift of the best healthcare coverage I can get.
Fayanne- This is one great comment! Thanks for taking so much time to leave such a detailed synopsis.
Wow - that was really impressive.
Well stated. I am doing the same thing. Plus if you travel from state to state your covered and there is some coverage for foreign travel.
Thanks for your comment. I am going 65 soon and need to study this complicated health insurance decision but bottom line on my research is our health is fine now at 65 but we won't find out all these plan issue until we actually need it on serious situation. Thanks again.
Thank you for your video. I went with the Plan G because my company wasn't offering Plan N at a lower cost. And they offer gym costs. I'm just now turning 65 so we'll see how this goes.
I originally got on Medicare at 60 because of end stage renal disease. Was on dialysis for several years and finally got a transplant. I was on Plan F all of that time and paid very little OOP. I was hesitant to switch to Plan G because I didn't want an hassles in continuing my treatment. I pay roughly 171 per month which I don't mind doing as long as I continue getting treatment I need and it's fully covered.
Plan G or F is great for you. Hope your treatment is going well.
I wouldn't mind doing it if I had the money to pay it along with other life expenses. The system is not fair to all,
THANKS…..for taking such CRAPPY CARE of yourself!!!!
You’re LYING about the PREMIUM amounts!!!!!
@@traybern Who is lying about what premium amounts?
Everyone should realize these advantage plans receive funding by the govt and they turn a profit by denying you care via the prior authorization process, not by being more efficient at delivering care. In fact they make a ton of money off these plans which is why they push them so hard. As a physician I can tell you multiple times per week I receive denials from advantage plans. Sometimes I'm successful in changing that decision but a fair amount of the time I'm not. This never occurs with traditional medicare. Additionally, if you do need a test/procedure/imaging study/etc this can be done the next day. With the advantage plans the authorization process can take weeks delaying care and prolonging suffering. If you can afford a medicare supplement and Rx plan it is almost always a better decision. The only time an advantage plan is likely better is if the financial burden of a supplement plan is too large and you assume you will never be significantly sick. The sad reality of anyone pushing these advantage plans is that they are paid everytime they convince someone to sign up for one. This is probably true of the gentleman in this video as well. So I caution everyone, buyer beware.
Great points
Superior info, Brian Forzani! Thank you. What you said was better coverage is what I have.
Exactly.
I will be 65 in June 2024 and I met with a insurance agent today April 5th. I was set on original Medicare and I could tell she was softly pushing the Medicare Advantage. Luckily I did my homework beforehand but I still didn't like the sales pitch. Yes buyer beware. Thanks for the info.
Thank you Doctor
I had surgery this year and all the bills were paid by the end of the month with plan G. No questions asked. It paid out more the all my premiums for the year.
Yes, I'll be getting G. I don't want my doctor hesitating to treat me the best way because of my insurance coverage.
Premium changes by state - Florida is very high, $173 for AARP United Health. I have G and I'm getting resistance about them paying one of my tests. Three phone calls so far, PLUS I was at Quest to reiterate my insurance.
As a Senior I get a discount at the YMCA for low income. I need to go to the YMCA more often!! I’m on plan “G” and happy about it.
Go for it Kit!
I’m turning 65 in about five months. I’m starting to take a hard look at this. Thank you so much for these videos. I’m finding them very helpful.
This is great information. Wanted also to say, when it comes to Medicare excess charges, if you use a doctor who is a participating doctor in Medicare (meaning he accepts the Medicare rate for all services, also known as "accepting assignment"), there will be no excess charge. IF you choose to use a doctor who is NOT a participating provider, then you may be exposed to paying up to 15% more out of pocket for services rendered by that doctor, depending on the state in which you live. So the important thing to know when you choose a doctor is whether they are participating and "accept assignment." Of course, there are also a small number of doctors who are neither participating or non-participating. These doctors do not accept Medicare for any portion of their services and should be avoided unless you're independently wealthy and don't mind paying 100% out of pocket. Have a great day, folks.
There are two critical drawbacks of advantage plans. 1. The need to get pre-approvals for many procedures. 2. Must use an in-network doctor which limits your choice.
True
And MD's don't like Advantage plans. There is too much paperwork & pre-approvals for the office to do. Therefore, there are fewer md's to choose from.....With a regular supplemental plan, most md's accept the plans throughout the country but not as many accept Advantage.
Doctors come and go. They all should be qualified , mine have retired so stuck with new doctors , who's to say
False. With PPOs, you can go in out out of network. Pre-approvals are non issue. Never once have any of my clients been denied a procedure.
If you live in a rural area medicare advantage is very limited...
I just happened to see your video and decided to listen to what you had to say. I started Plan G this past year with my wife who just turned 65 in May and I am 67. I agree with your evaluation and cost breakdowns for Plans G and N, and the Advantage plans. I did not wish to be "networked" in an Advantage plan. My previous health plan was a Federal Health Benefit Plan that served me well but was also a network. I had some health issues this past year and my visits to doctors and the tests they had me do was all paid for with a Plan G. I believe, like you said, that I have the best plan for my cost and needs. It was nice to hear your recommendation that lines up with what my wife and I are enjoying in our senior years.
I appreciate the comment.
@@maryculbertson7349 Yes, it will increase each year, which it did this year. I like the coverage so far and am happy with my plan G.
My 91 year old Mother has plan F and since she was 65 i will be 65 in 2024 thank you for sharing your fabulous information video ❤ Plan G is for me because i want the very best ❤
A thought occurred to me.. as we age.. it is nice that with our plan.. F... from back in the day... I do not have to keep track of medical bills. As you age and have no children.. keeping track of co-pays, any excess charges etc... it will become more challenging
This was EXTREMELY helpful. I am just entering the Medicare arena and was completely lost
Glad it helped. Give us a call if you need individual help. 1-844-552-7426
Excellent presentation but a major DISADVANTAGE of the MAP is choice of doctors is limited to which doctor participates in the MAP. With Traditional Medicare, there no such worry anywhere in the country wherever medicare is accepted.
This is true
No notice, now I pay 166. Plus an additional 50.00a month now. My income is 765. So time to move on.
I am 76 and been on plan G since I turned 65. Its the best.
Keep it!
Nice review!
My wife has Plan G high deductible. $46 per month in FL, also her Part D is less than $10. Saving $1300 per year on premiums vs regular G, so net at risk is $1400 per year, but it’s not necessarily a “deductible “ since Medicare pays first. So for outpatient would need to spend $7000 to hit max. She is healthy, we were in healthcare. We know that most(not all) people will use minimal services most years, with an occasional high use year, especially when older. We are aware that the deductible goes up over time, so just playing the odds.
As to drug plans, we bought the cheapest available, as she is on only one generic. Can change in future yearly if needed.
Thanks Randolph. Glad you and your wife are saving a lot of money in premiums!
@@Susanshops FYI we are both retired physicians. My wife also has United American. You are talking about drugs that fall under Part B and not part D. These are typically injected or IV drugs. Hospital medications are usually covered by Part A. Medigap will cover Part B medications. Skilled rehab is covered under part B and Medigap up to 100 days per episode. You do have to qualify for “skilled”, however it is usually not that difficult, and it would be rare that a person would not get coverage for “rehab” if you have a supplement, unless you are just getting “custodial” care which is not covered by Part B or Medigap.
If you have Medigap most of the things you mention will be covered, and it is rare to have out of pocket expenses. If you have Advantage then often there are much higher costs with all the things mentioned.
I live in CT with a high deductible deductible plan ‘G’ through CIGNA. It’s $864.00 annually for each of us. The IRMAA is a killer so it made sense to buy the HD plan.
Thanks for this helpful information in this open enrollment period. A friend was very excited because her dentist called to tell her that if she switched to Advantage, her $3000 worth of dental work would be covered. I thought that was unusual that a dentist would be pitching Advantage. ?
Very unusual. Your friend could have just got a stand alone dental plan from the company of her choice.
For me I received $1600 back in benefits on plan G this year so far while paying $1800 so for $200 I am paying for unlimited top end coverage and zero risk to wealth .
Right on Don. That’s what it’s all about.
I am 55 and on SSDI and I pay nearly $400/ month for a plan G from TransAmerica. I have been told they can charge a whole lot more for disabled vs seniors for a Plan G. It’s worth it to me because I have a lot of medical issues requiring specialists, procedures, surgeries etc
You’re correct about this. I have been getting tons of calls from people who were taken off Medicaid and they are under 65… and want a plan G but don’t realize it’s 3 or 4 times the price as a person who is over 65. Good info to comment on.
At least Part D and vision insurance should be added to Part G and N to compare to advantage plan
When you talk of the premium, is that paying for this particular selection? PLUS we have to pay into Medicare $170/mo to have it ... meaning we are paying over $300 a month?! That is nuts.
Every plan should be customized to the clients needs. Most seniors are living on fixed income and it’s not easy with inflation at 40 year highs. If you have a very healthy senior the Medicare advantage plans will be all they need and you save them any extra expense of a monthly premium.
Very informative and good detail in this video. These Medicare gap plans or F.N, and G are an extra monthly expense to your client. It all depends on each seniors needs and budget. Some of these plans range in the 150-300 a month depending on your zip code. If your core policy has a max out of pocket of 5k for the year on a Medicare advantage , the Gap plans aren’t worth the money. Gap insurance is costing around 1800-3600 every year regardless if you need any healthcare. That’s an average of 50% of the max out of pocket every year. Terrible risk reward.
Again it all depends on each clients health and financial situation. No plan is the best. It’s what’s best for your client needs.
Thanks for the comment. Yes, of course the plans are always tailored to each individuals needs.
Exactly!! American politician created rip off health care billion dollar scam plans!!!!
In you plan G and N you did not add drugs plan (35x12), dental vision (40x12), hearing $, gym $, transportation to Dr $…..! It’s impossible that none of you clients wants Advantage plans! Statistics show that only 3 to 5 % of Adv plan patients hit the max of $7500.
Inflation happens every year, so yes, every year is at an all time high!
would like to hear how much coverage for dental /vision /hearing are these advantage plans paying per year ?
I pay for Plan G, and I like it a lot! It gives me peace of mind, as long as my doctors accept medicare assignment I am covered. No fuss no muss except for a small deductible every year. Who could ask for more? Going Advantage is like going back to the private medical insurance days with their high deductibles, and their billing games. No thanks.
Thanks for the comment. Good stuff 👍🏽
I think perhaps Plan F (what we've got) is the best. But it's not being offered anymore, which really sucks.
Question … yes I stayed to the end :-) …. why do I not see Blue Cross / Blue Shield ? …. here in Massachusetts the lower version G Plan is around $110 a month …
I worked in hospital administration. The most common misunderstanding was the difference between “inpatient” status in the hospital and “observation” status. Often families would try to demand “inpatient” because of the out of pocket costs. It’s not up to the hospital or the doctors. There are very specific Medicare rules that define which status is “appropriate” and have a huge difference in the “out of pocket cost “. Very few people understand and often think the hospital is price gouging them. Medicare is not lying- they just have tons of poorly understood rules.
But consumers are mislead when they're put in a hospital bed, in a hospital room, and think they are now inpatients, when in fact they're being billed at the more expensive "Observation" rate.
THE OLD PLAN F SHOULD BE BROUGHT BACK . ...
It was a great run
I am happy with my Advantage Plan since living metro city area which most docs and hospitals are in-network. I pays $0 premium, $5,600 MOOP, $0 PCP or primary doc visits, $25 specialist, $2,200 Dental Allowance, $600 gym membership & equipments allowance, $90/qrt OTC allowance, $90/qtr foods, gas, utilities Allowance, $250 Vision allowance, $250K foreign emergency, and Drug RX(Part D) included. If afford extra $300/mon for Medigap Plan G, Part D, Dental, then go for Medi Gap/ Supplemental. Have been w/ HMO/PPO last 40 yrs…
If you’re happy, that’s good.
Before I retired, I had United Health Care Point of Service. After retirement I chose plan G, also United Health Care. Very satisfied, although I do hope they offer dental and vision, for a higher cost of course. I have my plan through my retirement at 229.00 per month. I am 74 now and very glad I chose a good plan.
I just turned 65 though I've been on disability Medicare since 2000! Because of this I was able to get plan F. Though I may theoretically pay slightly more the peace of mind of having no copays, no deductible means a lot. The added benefit is the slightly higher monthly premium reduces my monthly income and can be offset with housing assistance and/or SNAP benefits.
Good plan
Best video ever. I have the g plan. My mom had the f plan when she was alive. Such fantastic plans. I tell people that I may drive a 24 year old car, but I have a Mercedes insurance plan. Lol!!
Thank you sir
We are on plan F and love it. We will never change. No doctor or hospital bills and my union pays the premiums. We are blessed. I am 75.
Hi Eastcoast, do you mind saying what union? My husband is IBEW but all they lined up are Advantage Plans which they will pay in full for 10 years, 5 if husband & I split the benefit. After how awful Advantage was for my dear mom who died last year, we don't want to go with Advantage--because in our mind--it ISN'T. So we're envious of your union retirement contract!
Again, politicians have sold us down the drain. Life USE to be good in this country. NOT any more!!! Your gonna get ripped off by the politician created unhealthy system!!!
The last 2xs I was in the hospita, 2018 +2021, it was $11,000 per day for the room alone.
Your numbers are incorrect for AZ. $15 copay. If you get Plan N and then you have to pay for part D so you need to add that amount into Plan N
I am happy with F.
I had been on an Advantage Plan for years - OMG! The paperwork was stressful to try to keep up with my extra share bills.
I now realize that because of the pre-approval hassels there were years of not being diagnosed with a rare gentic disorder. I needed spcialists who did not overlook the blatant signs on my blood work and docs who just thought I was complaining over nothing. I'm not blaming my primary docs at all. I simply needed a better plan that fit my needs overall.
Thanks for the comment Malika. Definitely helps people
I'm on Plan F and have been for a long time. It's getting more expensive because they don't sell it anymore and the pool is getting smaller as we begin dying. Plan G is the next best alternative and in my state, once a year I can change with no exam etc. I was in the hospital for almost a week, with lots of cardiac tests and was given meds while there and i never saw a bill. THAT is gold to me so until I simply can't afford F anymore, that's the plan for me.
Advantage providers make their money by denying/deferring service. It's best for healthy people who don't go to the doctor much, want catastrophic protection. Someone who actually needs something will hit a wall of delays, denials.
@@markfuller Also, if you ARE very healthy and end up with an Advantage plan and then discover you are ill, it will be almost impossible to switch to Medigap plans.
@@pamelawing5747 why would someone switch if s/he already unable to afford it from the very beginning of living by a fixed income like most seniors! And even worse when time goes by?
as a young working person, this is what im facing with work health plans. about 214/month for health, dental, vision premium. 3500 deductible, 8500 moop, 1500-2k dental max payout from insurance with 50-80% of cost covered by insurance. copay 50 dental, copay 45 doctor/90 specialist. I can't say whether I got it good with work insurance or bad. oh but let me toss this important bit of information out, my cobra would probably be 750-800 for health insurance. so maybe insurance for retirees is better/maybe not. I don't really know how one can tell
Thanks. Very Informative.
I have 8 months to prepare before starting Medicare. This explained a lot.
Glad it helped. Call me for more assistance at 1-844-552-7426. Free of charge.
I went with Plan N. So far I see my PCP once a year and have no prescriptions so I'm not concerned about a few co-pays. The difference in premium compared to a plan G was worth a couple co-pays per month so it made sense to me.
Thanks for the comment
You do have a drug plan right?
@@gregtarris9057of course.
We're on Plan N. My wife has CHAMPVA so she doesn't pay anything for her doctor visits or meds. I use mostly the VA so I don't pay anything out of pocket. Less than 2% of doctors charge excess charges, mostly psych visits.
The psych drs should be paying you.
My G plan from AARP United includes Silver Sneakers. I have about ten places within 5 miles of my house that would take me for free, not to mention my town's senior center, which costs me exactly $15 per year. The addition of Silver Sneakers to Advantage plans is very attractive to many, but this should definitely NOT be even a minor factor in picking an advantage plan because recreational outlets for seniors is finding its way into other plans or components or avenues, all readily available to seniors in particular. Shop that out, starting at AARP (also $15 per year) and your local senior center.
Your out of pocket cost analysis omitted Medicare Part B premium. The primary reason I went with Plan G instead of Advantage (2023-March. Age 68) is a lack of confidence that Advantage will cover all of what is suggested it will. BTW I pay $202.40 per month in WA. What dental are you quoting? My Delta Dental is $144.20/mo for my wife and me. My Rx plan is $0 and I chose to pay vision OoP.
Thank you, thank you, thank you. It's amazing how complicated this is, and you did a wonderful job of clearly presenting some options.
Glad it helped
Don't you have to add the monthly drug and dental vision to the total cost for the year? That's another $900.
You do have to add them but drug plans range from $5 up. Vision, dental and hearing is usually $40 and up. So yes it can get expensive.
I'm not sure dental and vision plans are worth it. Most of the ones I've found have annual limits that are typically about twice your premiums. So just save your premium and pay cash. Would love to see those benefits added to regular Medicare. Unfortunately, while we were only two votes shy of that happening in the Senate BEFORE today's election, I fear we will be further than that now.
Advantage plans are not free. You still must pay the Medicare premium.
Yes, but you should add the part A premiums you still have to pay, so your totals will more than double for total costs, You give only for the plans themselves, and then there is the additional charge for the part D which is the best deal for the consumer especially those who are on the lower tier of SSI benefits. Working poor get screwed blue by both the Govt. and ins. companies.
Pre authorizations and networks! I feel that advantage plans give you the extra perk to distract you from the sub-par health care. As a PT I would constantly see patients with bone-on-bone knees who had no business in therapy. Unfortunately, their advantage plan required them to get PT before they would authorize the surgery. Do you want your insurance provider to determine your care or do you want to your doctor to?