Massive Medicare Advantage Changes - MAPD
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- čas přidán 7. 05. 2024
- Big changes coming to Medicare Advantage. How will they affect you?
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We should read books on music, the sciences or art. We should go to museums and learn new things. We should not have to study the fine print of health insurance. The system is daunting.
That makes sense
Medicare suplement cost expensive,how people can afford to pay for
Original Medicare plus a Plan G supplement cost $470+ in my area. That's the $170 Medicare payment everyone makes, the supplement plan G is $275/month. Then add on a plan D supplement. I agree original Medicare plus the supplement is the best, but not everyone can afford $470/month. That's why people not choose, but are FORCED to take Medicare Advantage.
Plan G would not make sense in your area. Likely GHD. Out of pocket would still be less.
Plan G high deductible cost $200 and up. I can't afford that either. The only one that MIGHT be barely affordable is a plan N.
@@vincentspano8879 GHD is less than Plan N. Less than $100
@@vincentspano8879 I'm on Plan N. If you are not always at the doctor's office, Plan is is usually the best way to go. Or as mentioned ... checkout the HD Plan G. There is an annual deductible with the HD plan, but that deductible ONLY applies to the 20% that Medicare does not cover.
@@vincentspano8879that sounds odd to me. I'm not someone in this business nor have I even priced my own area yet since I'm not on Medicare yet, but just logically it seems the GHD would cost much less than the G and less than an N plan. Who (what company) quoted you $200 on GHD?
Really, you don't understand why some choose the Advantage Plan? Many choose it for the buy down premium option who cannot afford anything else.
Would choose a GHD plan to stay with original Medicare if cost were an issue
@@MedicareonVideoYou have to have the money for the extremely high deductible which is only going to get higher.
Also, almost all of my older friends who have been on Medicare Advantage for years didn’t even realize what they have or why. When I explained the difference between Medicare Advantage and Traditional Medicare with supplement they were shocked and angry although to be honest I’m not sure how many could afford a supplement and part D drug plan.
Medicare Advantage plans can have a max out-of-pocket this year of $8,000+. Wouldn't be surprised if a lot of companies who don't have their MOOP that high start to creep up there. The typical high deductible premium is around $50, with the deductible now sitting at $2,800, but still giving you all of the freedom of Original Medicare.
If I were a betting person, my bet would be millions cannot afford it.
Medigap plans are only “expensive” to people who have no illness and are not practicing prevention. If or when we are faced with a serious illness or develop a chronic medical condition, the real value of a medigap plan with original Medicare becomes very clear. If my insurance company fights to not pay for my medical care, then I just wouldn’t be able to afford to be sick. I don’t have a lot of money, but I prioritize my health and have chosen Medicare with a plan N. It’s affordable because I want to remain healthy…and alive.
If I have a $1300 a month income living in S Fl how can I afford a supplement policy and a part D?
Laurel, my agent for Medicare On Video, was very helpful in getting me to a carrier that would accept my medical underwriting to switch from a Plan G to a Plan N.
What kind of supplemental coverage do you need? If you’re currently on an advantage plan what steps do you take to get off it? What is the advantage to just being on Medicare? Do you always qualify for supplemental coverage? What companies have supplemental coverage? I have advantage and I have had zero issues with it all my stuff has been covered including MRI and CT without any problems.
Amen!
The most popular supplement plans are Plan G and Plan N. Most state require underwriting to leave a Medicare Advantage to join a supplement, which is an assessment of your health history. Most major insurance companies offer supplement plans in most states.
Husband's retirement offers a BCBS MAPD plan in retirement. $1200 MOOP. It is a traveling MA plan...good anywhere that accepts Medicare in the US. Drug plan is great. There are very few extras...just Silver Sneakers. 50,000 employees are on the plan over several states...he was an iron ore miner. When people talk of MA, they never seem to address GROUP retiree plans...why??? Tell me what you think here, PLEASE.
Hi Michele, how's your day going with you?
I know alot of seniors that would have loved to stay on orginal medicare but cant afford it .
What do you think of EGWPs for state government employees? For $195 a month, Florida has a plan that is nationwide in scope and has a max out of pocket of $500.
Hi Gail, how's your day going with you?
Correct me if you disagree:
If one can afford a Medicare Supplement (Medigap), then one would most likely choose a Medigap plan. Accessibility alone makes it a no-brainer. However, Medicare Supplements are subject to rate changes. If one can no longer afford their Medigap plan and tries to switch Medigap plans then medical underwriting occurs. The sicker one is the more expensive and difficult it is to enroll in a new Medigap plan. The older one gets the likelihood of chronic sickness increases. So there is risk in Medigap plans too.
I can give you two reasons; $345.00 and $25.00 per month for media gap and drug coverage, besides $174.40 for Medicare. That’s $544.40 per month.
$345 for a Medigap is higher than average. Typically in states with costly Plan G, I recommend looking at high deductible options.
Yeah get HDG. It can cost $70 per month versus zero for Medicare advantage but maximum out-of-pocket cost is $2,800 versus $5,500 versus $8,500 typically for an advantage plan. I should say disadvantage plan because you can have procedures denied, your plans change every year, and you want to go to Mayo clinic. You can forget about that.
95 percent is it all comes down to is money
I'm so sick of hearing about how Social Security is going to be insolvent in a few years! I've been hearing that same story every year for at least the last 40 years!
True. Hopefully will always be funded.
Lies. damned lies & statistics.
Great video! Your videos are always worth the time! Thanks!!
Thanks!
I echo some of the other comments here. When you say you can’t understand how someone would choose to go on Medicare Advantage plan, you are illustrating your lack of understanding of how people struggle with money these days. They are lured by the zero premium and highly promoted perks. And they are often told that it’s the same as Medicare A and B while the CMS does not regulate the plans as closely as it should to assure the insurance companies actually provide the required services.
MAPDs might be more stringently regulated than MediGap plans are, in part because of Fraud, Waste and Abuse that could occur from providers that want to overbill the government for excess and unneeded services.
you and Julia have been wonderfully helpful, thanks...
This will cut into the CEO bonuses.
It’s all about cost, Keith. I can’t afford to stay on original Medicare.
Why do I choose Medicare Advantage?? Because this cool CZcams Channel, Medicare on Video, says that if you are on SSDI and under 67 that it's better than traditional Medicare because of the cost not being horrendous. Do you think I should listen to that guy? He seems pretty trustworthy.
I think so!
I know seniors on advantage care denied treatment because referrals so sad .
Hi Lori, how's your day going with you?
Humana is awful i have had trouble with them from day one i would like to talk to Bruce myself he dont have the balls to talk to me they lie and tell you anything to get you off the phone i just want a few minutes with old Bruce !!!
Why choose Advantage? Because of eye and dental coverage, which some of us really need. The problem is, they've been gradually screwing us over, a little more every year, so I knew this point was coming. Are there any supplements that cover eye and dental? I'm relatively low income, so I'm limited.
There are Supplements in some markets (usually called "plus" plans), that include a dental and vision discount plan, and sometimes even a fitness benefit, at extra cost over the standard Supplement. But again, the dental/vision isn't really insurance, just discounts at participating providers.
Traditional supplement plans do not cover routine vision and hearing, but there are some lower cost plan options, or also discount dental plans that can cut down costs.
I can assure you, the dental benefits of most MA plans is quite basic ... only covering limited procedures. MA or original Medicare, most people need an additional dental plan. I pay $50/mo for mine.
About to turn 65 and want a Medicare supplement N plan but can't find a doctor in Salem, OR that is taking new Medicare patients. I will probably have to stay with Kaiser Permanente's Medicare Advantage as I don't see that I have a choice.
Again, Medicare only pays 80% of the bill! So if you can't afford to pay 20%, what good is it!?
supplements cover the 20 % - usually less than $100 / month
@@MedicareonVideo Less than $100 monthly is going to be G-HD, or maybe a Plan N if the enrollee is below age 68-70. No way you would find a plan G for under $100, at least in my ZIP Code.
@@MedicareonVideo I got off Medicare not knowing this and went to advantage under Wellcare, it sucked and after 6 yrs was finally frustrated enough to get off and go to medical G plan which I pay a little over $300 a month for including Wellcare part D! Is this better than Medicare with a $100 supplemental? And which supplemental!? Plus I was shocked my ellcare part D went down from $12 a month to I think $3 or $6 I'm not sure off the top of my head and imagine I don't have as good of coverage with that either!
If you get on medicare advantage you will pay 20% also except for what they cover at 109% because they are preventative. advantage plans have a max out of pocket for your copays as a stop loss where medicare alone does not.
Now Supplement plan HD G runs the same where you pay 20% of everything except preventative and it also has a max out of pocket then becomes when that max is hit the G supplement covering everything.
The HD G max out of pocket is lower than medicare advantage max out of pockets and there are no prior authorization or networks to stay in.
So if you cannot afford a supplement G or N then this HD G is the much better way to go than a medicare advantage plan from everything I've studied so far
You are the best 👍
Thank you!
Sounds like Medicare would be solvent if they quit paying all these private insurance companies. People can have the choice Medicare
Or private, if they want private they can pay the $1200 per month that the government is currantly paying
yes - makes little sense to pay more than what it cost to stay on original
The government is paying Advantage plans a fixed amount ($1000-$1200 or whatever per month) so they can assume risk instead of the government. Advantage enrollees still have to pay their Part B premium. But Part A payroll taxes and Part B premiums only cover part of Medicare payouts. The government makes up the rest. So government funds are either subsidizing claims on original Medicare, or are subsidizing private Advantage plans. The issue is it costing more to subsidize Advantage, when all is said and done.
That would be fine with me, as long as they refund my monthly part B premiums of $174.90.
@@miguelberrios19 Why would they do that? The govt pays your Part B premium to the MA insurers, to take over your health care!
Be nice if all citizens could get everything “free”
Can I get your newest video please
My newest video should be at the top of my homepage. The current newest one is called "The Real Cost of Medicare."
😊
I have Humana. Should I just go back to Medicare I just need a lead way some way to help me. I am in New Jersey and so worried about you mine are leaving me with nothing
I can't even use my over the counter card at the stores that they say you can use. You have to order through their pharmacy. So that's a lie right there. I'm really afraid
Thank you so much yes you are really helping me I appreciate you so much thank you
Here's the reason I moved from Medicare Parts A/B to Medicare Advantage: My wife's HMO (UC Blue & Gold, part of HealthNet), which I use, told me I HAD to move to Medicare Advantage or they would drop me. Does it matter very much if my wife and I are double-covered? (I have Kaiser Permanente, but need to use my wife's HMO.)
So you are stuck in a network because that network threatened to dump you? I would run from that thing. Don't threaten to dump me. There are many other doctors and hospitals etc taking Medicare and the supplement plan you want over your advantage plan threatening to dump you. I would personally laugh at them after they say that to me.
Why is that your wife's plan? Is she working and it is a work plan that you are also on or you are both on medicare and wife chose first and she is now stuck in this plan for health reasons? If so you don't need to stay in same plan
Ps, kaiser is a advantage plan. It is a closed network plan if used as an employer plan. So if you have kaiser why do you need wife's plan why can't you separate plans? Very confusing
Sounds a little complicated- you have A, B, and Medicare Advantage and an employer plan?
@@MedicareonVideo I currently have A/B, but I have already submitted paperwork to my wife's University of California office to change it to Advantage. I fought this, but they said either change to Advantage or we will drop you.
Easy to cut cost. Stop giving away the free money debit cards
How soon can citizens get everything free?
Friends don’t let friends Medicare Advantage.
That is a great motto!
I was on Medicare advantage for 6 years with Wellcare and IT SUCKED!!!!!
Familiar story
I agree. I'm with a different MA plan, and have been for two years and love it.
@@miguelberrios19 Some Advantage plans are better than others, and Advantage plans in general work better in some geographic areas than they do in others.
@@miguelberrios19 I was with Wellcare for 6 yrs, it was terrible, all of the downside he discussed and more! Couldn't do it anymore and the copays!! I was hospitalized so many times and every time it was a $1500 copay just to the hospital $300 a day for the first 5 days! I pay $300 a month for my medigap G plan and it's sooo much better! Every Dr visit was $50 too!
I started with supplement plan, couldn’t afford it so I switched to Advantage plan !
This is a terrible video. 15 minutes of basically saying nothing. It is all a bunch of maybes but no facts. It was a waste of time to watch.
The stock prices dropping is factual information.
And guess who manages all the MediGap plans he seems to be extolling the virtues of? The same MAPD companies he's trashing.
Better listen people. This is all true. Wait till you may need skilled care extended. Or a surgery.
A lot of people don't realize the pitfalls until something happens medically and the plans start to deny things.