2024 Medicare Costs UPDATES | Advantage vs Supplement Battle 🥊
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- čas přidán 30. 06. 2024
- The 2024 Medicare costs are out, it's important to be aware of the Advantage vs Supplement battle. In this video, we'll discuss the pros and cons of each plan's costs, and help you decide which is the right fit for you.
This is a big year for Medicare. The cost of healthcare is going to rise drastically, and it's important that you are as prepared as possible. In this video, we'll discuss the Advantage vs Supplement plan battle, and help you make the best decision for your health and wallet!
CMS Announcement:
www.cms.gov/newsroom/fact-she...
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Erik@TheRetirementNerds.com
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This video is NOT sponsored.
The Retirement Nerds is the no-cost educational platform and serves to offer information around Medicare, Social Security, Financial Planning, and Estate Planning.
⏰ TIME CODES ⏰
0:00 Introduction
0:12 Assumptions
1:32 Original Medicare Costs
3:15 Monthly Premium Comparison
4:13 Drug Premium Comparison
4:57 Dental Premium Comparison
5:23 Vision Premium Comparison
5:41 Total Fixed Costs Comparison
6:55 Deductibles Comparison
7:22 Copay/Coinsurance Comparison
7:45 Excess Charges Comparison
8:10 Out of Pocket Max Comparison
9:03 Total Variable Costs Comparison
9:23 Drug, Dental, Vision Variable Costs
10:44 Final Comparison
12:28 Wrapping Up
=============================
#medicare #medicareadvantage #medicaresupplement #medicareexplained #medicare2024
Federal Disclaimer:
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
The basic difference not discussed here is that Advantage plans can refuse paying for medical procedures by denying approval for treatments where traditional Medicare you do not need prior approvals. This is a BIG difference. There is not an advantage for Advantage plans. Additionally when making these decisions most people are 65 and maybe not having anything wrong at the time of the decision but what does the future hold? Decision made at 65 may not work at age 75 or 80.
Hi Glen, thanks for watching. Not sure how far you made it in the video, but we address your comment directly in that this is a cost comparison only. We have lots of videos that go deep into what you're talking about. Thank you for sharing your thoughts!
That is not true. You will need prior approval for some procedures no matter who it is.
@@the_original_skytigerreally ? Medicare requires prior approval? Haven’t experienced that yet.
@@Theretirementnerdswhen the recommendation is to talk to an insurance agent, it’s like asking Trump what is truth.
traditional Medicare can refuse paying for medical procedures by denying approval for treatments too. for the same reason
My husband is on an advantage plan and has had 3 very expensive hospital stays in the last 5 years where he almost died twice. BCBS covered everything with the exception of a very low deductible. We have never had a referral denied either.
Thank you so much for sharing your and your husband's experience!
Can i ask what state / Town you are in ?
@@flexjay87 Illinois, Cook County
This video, and others like it, illustrate that there are no good options for the average person. The health care system in this country is terrible.
I liked the video. Easy to follow the details. I chose OM when I turned 65 while my wife was still on Tricare (Military) for a year. I like OM because I can go to most doctors and do not need referrals. I'm in good health for a 66 year old. When my wife turned 65 in Jan 2023, we stayed with OM with Tricare for Life (military, zero cost). Glad we did because she was diagnosed with cancer in late April 2023. So far OM and Tricare 4 Life have paid out over $230,000 and we're not done yet. Military drug costs are covered by Express Scripts with some co-pays. Averaging $52 a month. We have vision and dental via Federal retiree progams. Total costs (include co-pays and new glasses and a filling) for Drugs/Vision/Dental was $1,870. If I include OM (for 2) the grand total is $5,828. My message to others is YOU NEVER KNOW WHEN YOU'RE GOING TO HAVE A BAD YEAR!
Thank you for watching and thank you for sharing your experience! I hope your wife's treatments are going well.
@@Theretirementnerds So far so good! Two more chemo treatments to go. Update: Total paid by OM & T4L is $242,000!
I’m going to choose the plan that will best serve me if I find myself in an extreme medical situation because that is when my choice will matter most.
You'll want a Medicare supplement plan then. Doctors and hospitals from every network accept it. Medicare advantage plans you're restricted to whatever smaller network the "advantage" insurance company represents
Then your going to want supplemental plan G which covers 100% of everything.
I just signed up for my company subsidized medical, dental, and vision today. It went up $25 from last year. I am not complaining. After next year I will only have 10 months until all of this kicks in. So far I will be going with the Supplement G plan, plus D, vision and dental.
Sounds like a great plan :)
We have a video coming soon that goes into the differences outside of just costs - similar to the one we put out last year, but much more detailed and with 2024 numbers :)
Appreciate your support!
Huge difference in disadvantage plans coverage. Experience from myself and brother in law. Both have bone on bone in left knee medial lobe. My supplement plan allows me to choose full knee replacement or partial. I prefer full because I won't both sides to be the same, not normal on lateral side and titanium on medial. Brother in law has same problem, but advantage plan. He goes to doctor and his plan covers knee injections and therapy first despite the fact that he has bone on bone condition. When that does not work, he may be approved for a partial replacement. All of this costs me zero dollars, zero delays, zero hassle. As usual, you get what you pay for.
My mom had a full knee replacement. Original Medicare + Supplement. Never had injections Very painful post-operative recovery, and then a very unpleasant experience in a rehab facility, which would never be mistaken for Club Med.
My take is if you really need the full knee replacement, so be it. But if injections might work, I would definitely want to try that first, after watching what my mom went through.
Like Pre-authorization for procedures with Advantage plans. For example, you may want the best doctor in your state, but that doctor may not be part of your network. To get that Doctor, you would have to go out of network. So, you accept a surgeon that is in your network and that doctor says you need a new hip. The Advantage plan review says no you don't and will only cover the charges associated with a "rod" to address the problem. This can happen... In most cases the very best physicians in their fields are not providers associated with Advantage plans.
From my research, you are correct. There are statics out there about breaking your hip and how long a person lives after this, especially involving the extreme pain associated with this
The best doctor would be performing a minimally invasive total hip replacement. The mini-posterior approach to hip replacement surgery involves dividing the muscle by separating - not cutting - muscle fibers at the side or the back of the hip. This method insures that muscle function is preserved. Excellent long-term results and minimizing risk of injury or complication in the short term or long term.
I wonder if Advantage cover this.
I only know of one person with Advantage, not sure what hip surgery he had, certainly not the best one, to this day a year later he has a bad pronounced limp on that leg.
Compared to my husband-a cycler (not on Medicare), who had the best care was back on a bicycle in 4 weeks.
It boils down to the quality of care. The quality of care, and the faster you receive that quality of care, can make all the difference in your longevity..
I did read one comment on additional perks being offered with Advantage plans - they continue to grow each year. In 2024 I’ll receive $360/yr for OTC products, $1,200/yr for fitness expenses including hiking and running gear, dance lessons, private gym membership fees (if not participating with Silver Sneakers) etc, $2,500 annual hearing aid support and more. These are real costs savings that need to be included in a personal cost-based decision along with the ones presented in this video.
Which Advantage plan do you have?
Yup! They do increase those benefits each year. But how do they pay for that? By increasing the number of denials for claims every year. It's data you can look up
"Advantage" plans *make money* by denying your treatments and care. Supplement plans are required to pay any bills approved by Medicare. Who do you think is going to take better care of you?
Unless you get cancer. A supplement will vastly pay for more.
@@rayzerot Your generalization is not true. And what makes you think the government (Original Medicare) is going to take better care of you??
BS. All insurance plans will pay exactly what the policy says they will pay@@rayzerot
VERY nice summary. I think the bottom line is if you don't take drugs and you are in good health, few doctor visits, MA is the way to go. I get $60/mo reduction in my Part B premium and I get $50/qtr for OTC drugs. Add in the dental and the vision benefits, I'm rockin it. Plus I have a large HSA balance that gives me a cushion against a bad year. I think if I got in a bind, I'd move to a state with guaranteed issue for a supplemental plan and then move back to my original state. So complicated. GOOD LUCK TO ALL!!!! EDIT: 10/18 I really appreciate your even tone in delivering this information. Some on YT sound like carnival barkers, breathlessly describing the carnival sideshows THAT THEY MUST SEE!!!!
Your tone, plus the well thought out and organized summary of the numbers is VERY HELPFUL. It's not 100% of all the facts, but it gives us a structure to think about our situation and how it compares to other options. Thank you for your attention to detail and your calm presentation style,
Thank you for watching and sharing your experience!
Didn’t mention the possibility of having expensive treatment denied altogether with an Advantage plan. That drives up the risk quite a bit…
Could mean denied or prolonged for a long period of time not good.
Thank you for watching! Not sure how far you made it into the video, but we address the fact that this video is dollars and cents only. We have lots of other videos that go over what you're describing, including a new one coming out soon! Keep an eye out for that one :) Thank you again for watching.
"Advantage" plans make money but denying claims. Supplement plans must pay any care or treatments approved by Medicare. I don't get how people don't see through the advantage plans as the scam
There are many levels of the denial process. If you research this you would be terrified. There are reports of people fighting the denial process for up to 2 years.
Where I live, if cost were the deciding factor, advantage plans save you a lot of money, even if you reach the maximum out of pocket. He didn’t factor in over the counter benefits that in my are are $40 per month. There are give back plans in my area that give $165 a month, almost wiping out the part b premium.
If fixed costs are the determining factor, absolutely.
This video goes into more detail that just the fixed costs if that's helpful:
czcams.com/video/eOP76hMPiDs/video.html
GREAT INFORMATION!!! I am so happy to know an Insurance Broker who specializes in Medicare Plans in my area of NJ. I'll be 65 this December and will start my decision making in late September as to what to choose. I've dealt with Medicare Advantage plans the last couple of years as POA for my father and it was easy decisions for him. However, it won't be so easy for me, as I'm in another State, I have different health issues, and I have to research which of my doctors are in whatever network I go with.
Many or most people, I have to believe, are picking the Advantage Plan on one condition, finances. This is the cold, hard reality, not the perks and fixed monthly premium.
I have an advantage plan. Zero deductible, zero premium. I had cataract surgery in both eyes this year. My total copay was $40.
That is awesome! Thank you for sharing your experience!
My Medicare premium is $675 per month. My supplemental G plan is $138 per month. I think this is reasonable for the care I get.
This is an excellent and timely comparison of the basic costs of the two diverging paths (Advantage and Original+Supplement.)
Thank you so much Nancy!!
The retirement nerds are some of the most informative uploads on retiree healthcare. 👍👍
Thank you 🙏 😊
A couple of issues. Vision coverage only covers glasses and contacts. Vision treatments for cataracts, glaucoma etc are covered by medicare. Medicare advantage plans can also restrict or not authorize coverage. So with medAdvantage plans you may not be able to get the care or medications your doctor recommends.
Wife and I are both 77 and have had some health problems over the years but not once did medicare advantage ever refuse payment or changed surgical procedures. I have had cataracts fixed in both eyes and laser surgery and a glaucoma valve placement in one eye. My wife has had cataracts in both eyes, We both have gotten a couple of pair of glasses. No problems ever.
I am currently on an Advantage plan, which costs zero monthly. I do have co pays on drugs but are very low ($10 for Xarelto for 90 days). There is vision $200 per year and $1500 dental (but doesn’t cover dentures) so that part is worthless. I am other than overweight in good health, so as long as that continues I should be fine even though an Advantage plan is more restrictive the regular Medicare.
One bit of advice IF your talking to someone about health plans, be sure to ask IS THIS AN ADVANTAGE PLAN you are promoting ??? Learned this the hard way.
Excellent comment and advice. Thank you!
Lots of misinformation about Advantage plans out there. Usually from people trying to sell you their services, like this guy. I have had UHC Advantage plans for years. They have a large network, and have never denied me anything, including my cancer treatment.
Very misleading. At my age $5800 in premiums for supplement. Out pocket Advantage $4700. On Advantage for 14 yrs Avg $4000 premium puts $64,000 in mySavings Account vs Insurance. PPO can go to any doctor who takes medicine. Plus more people on Advantage than Medicare.
What part was misleading?
That's a big point many of these types of videos skip, even though this guy is the fairest of them all. I tell people that if you are currently sickly, Educate and Supplement may be best, if you don't have any serious illness, Advantage could be better "over time". To many look at just one year. If you are concerned, put a monthly payment into a savings account (as though you were making a supplement payment) and you should have the money you need over time. Don't forget to increase that contribution each year like your supplement plan increases
That’s a great point Texan. Another thing to consider if you’re worried about gaps or out of pocket costs associated with your advantage plan would be getting a guaranteed issue senior stand alone supplement policy for accidents, cancer, heart attack and stroke or even hospital indemnity. Depending on the state you’re in there are very affordable policies that rates don’t increase for yearly. So you can get signed up for a cancer policy and get locked in at the rate you signed up with
Agree w/Glen Davis the CMS standards were established years ago and the advantage plans do not necessarily embrace them as they were proscribed at a time when our country cared about their countrymen. This equates to a more generous time in rehab or efficient and vast services without having to do a dance when you don’t have the energy to shake your leg. Moreover your treatment isn’t put into the insurance bucket (everyone gets the same) rather your doctor treats your condition as it is seen in his/her eyes. Freedom to go to the hospital or facility of your or your doctors decision and stay within the medical guidelines of CMS not the Advantage Plan Company
Thanks, 90 Days From Retirement, for your excellent content; I always look forward to seeing you pop up in my notifications!
Sure do appreciate you so much! We have a few videos we're working on with all the 2024 updates :)
Hope you are well!
@@Theretirementnerds I look forward to seeing more of your long-form content, and I see a 90-Day From Retirement podcast in your future. 🎯
OUTSTANDING, CLEAR explanation. Another great video. Thanks😊
Appreciate you Janet!
I am a SHIP volunteer and I cannot express how relieved I am that my presentation as a volunteer match what this fellow is saying. I do prefer hid description of ‘maximum risk’ when describing the MOOP.
Thank you for the work you do and for sharing your thoughts!
Thank you so much for this excellent video! Exactly what I was looking for!
So glad it helped!
We have a new on coming out this week that goes over a 20-year look rather than just one year. Should be pretty interesting 🙂
I live in CT. No questions asked to switch plans. This also works for MA, NY and ME. All other states are toast. IF I GET REAL SICK, I just switch to supplemental. Now I just need to look for an advantage plan with the lowest MOOP and I am all set.
Solid strategy! The supplement plans in those states have some of the highest costs because of that, but it's nice to know you have the option! Thank you for sharing!
Good video. I have watched some of your other videos and you may have covered what I am about to mention. The main thing is the quality of care if you need it. Medicare with a supplement offers much better quality of care than any Medicare Advantage plan. The reason is that regular Medicare has a nationwide network, including providers such as Mayo Clinic and MD Anderson. Mayo Clinic recently announced that they will not take Medicare Advantage in the future. There are also no pre-approval delays and care denials with regular Medicare. As to dental, while I was on employee dental insurance, I had implants. They only paid 10%. That is the quality of most dental insurance.
Medicare doesn't actually have a network in the insurance company sense of that term. They simply allow all doctors and hospitals to accept it and between 98 and 99 percent of all doctors in the country do.
Medicare Advantage cost more in the long run,even if you have no premium,and have all the
Out of pocket costs take away from the money you "save" For 2024 you can get a drug plan for $0.50.
This will depend a lot on health. We made a video about it looking at a 20-year-period here: czcams.com/video/DgpS_RlA4gk/video.html
I see all the comments about advantage plans denying coverage and requiring prior authorization but what some people don’t know is that there are PFFS (private fee for service) plans that work very similar to original Medicare in the fact they do not have an established network you need to use and they also do not require prior authorizations or referrals. So if that’s the major thing holding you back from switching look to see if you have a pffs available in your area. You also have 12 months to switch back to your supplement plan after getting an advantage plan if it doesn’t meet your standards.
Great video, very concise. Thank you!
Thank you Ralph!!
Best presentation I’ve seen. Helped a lot. Thanks! 13:04
Thank you so much!!
Extremely good comparison video. First video I've seen that include drug, vision and dental Great Job! .⭐
Thank you so much! We have one coming out this week that'll look at a 20 year span rather than just one year 😉
Should be pretty interesting
Excellent presentation, thank you 👍💯❤️
Thank you so much!!
Thanks for the video. This is the easiest to understand video on Medicare I have seen.
Thank you for saying this! Means a lot!
Excellent presentation of critical information. Well done!
Thank you so much Tina!
My HR department told me to take a supplemental plan and NOT an advantage plan.
If you can afford the supplement, it's amazing! We have a video coming out next week that'll shed some light on that. Thank you for watching!
This is a fantastic video. It's clear and easy to understand your explanations. Thank you for providing this information.
You are very welcome! Thank you for watching!
I just read through the Sharp Medical Advantage PDF for 2024.
The MOOP is $2,900. I had to read carefully near the end to find that 'out-of-network services' are not covered outside the San Diego county, CA network.
I like my HDG plan ($34) for the incentive to stay healthy and I can travel anywhere in the USA without worrying about medical costs above the MOOP.
HDG is a great option for many people. Thank you for sharing! And yes, always read through the details of plans...
What is HDG plan?
@@hotwheel6663 here you go 🙂
czcams.com/video/Gw5mg3H8CWg/video.html
Read the fine print when it comes to MOOP, some advantage plans do not count MOOP paid to out of network services separate, because it will not go towards your total that you have to pay, they only count what you pay in network.
I extremely like the video, man. Very helpful and informative. Thank you very much. It is presented so well too. Great, positive work.
Thank you so much! So glad it was helpful, and appreciate you taking the time to leave this comment!
Thank you for the Medicare information, great information 👍 thank you Eddie
Appreciate your support Eddie! We have a few videos coming out that'll go over the 2024 changes :)
@90DaysFromRetirement thank you, I'll be watching for the video
Thank you! Your channel is fabulous.
Thank you so much!!
Some hospital systems in Southern California will not be accepting Medicare Advantage HMO plans in 2024.
Great point, thank you for sharing
The Medicare advantage PPO plans are accepted in more locations in general vs the HMO plans.
Supplement plans are not controlled by insurance companies the doctor is the boss of treatment.
Advantage is controlled by non medical provider.
I will pay up front and have less stress.
Thank you for your honesty because to me if Medicare gives you freebies with a zero dollar co-pay-they want something in return like if you have a catastrophic incident like cardiac or kidney and need dialysis say, my fear is you will be paying a larger catastrophic co-pay.
Thank you for watching Kathy!
Advantage plans has a maximum out of pocket to ensure that your concern doesn’t happen.
So very helpful! Thank you so much!
So glad! Thank you!
You know I love the whiteboard!
I just had this convo with a 68 y.o. client who is still working & on employer's PPO (re-enrollment is 10/30-11/8). Anyway, plan G runs around $220/mo in these parts. Plus PDP (not "mandatory", but late enrollment fee applies), dental, vision, gym membership (most MAPD plans include this) and OTC allowance, it changes the numbers quite a bit if you consider "in network MOOP" is $4700.
Use an agent.
100% agree!
There are some areas that have less than $1,000 MOOPs... crazy.
Thank you for sharing!
And if you had any morals you would be adequately advising your clients to the extreme limits to network accessibility to providers on any MA plan.
@@Davek111 Some advantage plans have more robust networks than others. PPO plans provide more flexibility and choices than HMOs.
@@Davek111 Actually, I advised him to stay on his employer's plan, maybe get Medicare B as a secondary payor as he had a recent health issue. And, where I am, the MA network is VERY strong.
@@Davek111 You must have been brainwashed by the anti-advantage plan videos.
Love your channel
Thank you so much! 😊❤️
Yours has got to be the most (only?) balanced Medicare-centric CZcams channel out there. Two topics I don't think I've ever seen addressed anywhere are:
1) How much Medigap insurance premiums tend to rise as one ages, and
2) Whether or not one must go through underwriting if they wish to switch from one Medigap policy to another
Really appreciate you saying that!
We can kind of help with #1 in video form:
czcams.com/video/xpof_szxKBc/video.html
The tricky part is insurance companies don't publish the rate increases, so it's near impossible to get real numbers. Also, it is highly variable by state/company.
In regards to #2 - this video addresses the switch from Advantage to Supplement and vice versa, but a lot of the principles address the switch from one supplement to another:
czcams.com/video/djuGeI829M4/video.html
Sounds like we need to make a video on this :)
But, to answer question #2 here:
"It depends" is the real answer. Some states, you can switch whenever you want (rare). Other states, you can switch during certain times of the year (also rare). Most states, to switch from one plan to another with a different company, you'll be asked medical questions.
Insurance companies can decide not to ask questions if you switch from like plan to like plan, or down. For example, G to G, or G to N.
We like the idea of making a video around this, so stay tuned :)
Thank you!
Wow! A considered and detailed reply to my post within a few minutes! Thank you!
@@EmptyP here to help! Thank you for watching and for the video ideas!
My experience in Virginia, working with some kind of broker who probably approached me online 1:13 during open season was that he said, oh, we can get you a cheaper medigap supplemental plan than the one you've had for 5 years or so, but then had to do medical underwriting questions and two companies wouldn't offer me a policy, cancer in 2017. Afib in 2019, etc. didnt work for the insurance companies offering the other medical plans. The only way was to move, I think out of state, but maybe just out of my zip code, then i could apply for a different supplemental plan with no medical underwriting.
Med Sups premiums do rise with age and also somewhat depend on the company's claim experience over time. That's a longer discussion than I can make here. If they get too high for you, each year at this time you can join an Advantage plan and cancel your supplement. Generally, if you are medically healthy enough to pass another company's underwriting and your claims frequency isn't really too frequent, switching can be done and, in many cases can save you lots of premium. Check about every 3rd year. Premium isn't always the only consideration, but substantial premium savings is usually a good thing. As a Medicare specialist and licensed with over 30 different plans nationwide, I had access to well over 60 different supplement plan premiums. If a Plan G, for example, was only $150 mo. and you are currently paying $205 monthly for a Plan G, then, by switching, you could save $660 for exactly the same plan with no change in doctors or other medical facilities. One company's Plan G is exactly like another company's Plan G. Some health conditions preclude the ability to even think about switching. But when you enter into Medicare initially, there is no health underwriting (in most all cases) and once you have a Med Sup, they are guaranteed renewable and they can not cancel you, unless you don't pay your premium. If you move from one state to another you can keep your plan. With MA plans, when you move from one state to another you get choices you don't normally have with the MA plans from year to year, but you have to change your plan as MA plans are geographically specific, though many times a similar plan may be offered by the same carrier. Medicare is not simple and, as almost always, there are exceptions, so many and in varying situations, which is good reason to have a good agent who wants to share with you your options so you can make the choice that best fits your preferences and needs. Find someone you can trust. And be sure to check you drug plan EVERY YEAR. I have saved clients as much as $17,000 in one year just by switching to a better suitable drug plan. And if you have a MAPD (Medicare Advantage Prescription Drug plan), be sure to check how the drug costs work for you in the upcoming season's plan. Med Sup plans do not change each year (deductible may go up) but the MA, MAPD, and PDP plans change every year.
After a bad health year, you may never be able to get off of a plan C. Also, I found very few of my main doctors that would even accept my plan C. I am going back to GAP Insurance this year while I still can.
Sounds like a good plan! Thank you for sharing!
Thank you for the explanation. I was glad I signed up for supplemental plan. I hardly have any out of pocket cost. In terms of Plan D, drugs depends on the insurance company’s formulary. For example, Humana only covers Novolog, not Humalog insulin. So if you want to use Lilly’s brand, you are out of luck. So you ended up paying cash for insulin anyway. It’s good thing it’s only $35 per syringe, which is totally affordable.
Excellent points and thank you so much for watching and sharing your experience!
New to your channel. It’s very informative and presented well - thank you! I’ve heard a lot about the ordeal of prior authorizations with Advantage plans as far as how they sometimes can be difficult or time consuming to obtain. Is that a common occurrence?
We have a video that addresses that specifically and we'll be releasing that hopefully in the next week.
The short answer is, based on the most recent data we have available to us, about 6% of prior authorizations are denied. Of the denials, 82% are overturned wither fully or partially.
So, people will draw different conclusions from that. We get a lot of comments that say Advantage plans deny everything. The data doesn't back that up.
Hope that helps! Keep an eye out for our complete Advantage vs Supplement guide video in the next week or so 🙂
@@Theretirementnerds Hopefully you reference and interact with this governmental study in your video: oig.hhs.gov/oei/reports/OEI-09-18-00260.asp
This is an excellent analysis.... and as you mention, it is only focussed on $$$'s.
I still have 5 yrs before I need to select, yet I already know that the freedom of going to a ANY provider that accepts Medicare, and anywhere in the country, is enough for me to go with traditional medicare and supplemental. The absolute most horrific risk with MA is limits to provider access.... and zero access to providers outside the immediate area where you live (except for ER services) is enough for me to never go MA.
Thank you so much! We have a major deep-dive video into the things outside the dollars coming soon :)
Appreciate you!
@@Theretirementnerds Let me know if you'd like to have any reviewing. I just jumped into early retirement after 35 yrs in the industry, leading strategy for regional and national carriers.
Not entirely true. Some Advantage plans provide coverage for non-urgent/emergency care away from home. Check plan documents before signing up, if going with Advantage and might have occasion to seek non-urgent/emergency care away from home.
The go anywhere you want concept is overrated. The MA networks are about the same as supplement plans. Travelling across the country for care is not necessary and stressful.
@@SuRFerretti This is total BS. Your MA clients might be receiving a very very very small dental benefit, but they are limited to an extremely small provider network.... unless it is ER care. I hope you're not lying to your clients!
I found your video fascinating. Basically an Advantage Plan
Is like an elephant: ponderous, bulky yet aware of its surroundings (insurance hazards) with a herd mentality. A solitary rhino represents the Supplemental Plan…straight ahead, no nonsense and powerful yet without vision adequate enough to foresee the future hazards (insurance landscape). To add to the analogy, there are always jackals waiting in the wings to sense a weakness and bring one down. - How is this integration of your challenge to use a rhino and elephant? 😊
If there was an award show for best animal to Medicare analogy... you'd run the table. Well done.
Excellent presentation
Thank you!!
Much more to consider over and above straight $. I believe you have another video/s covering this.
Correct! Costs aren't everything. This video is the most recent where we dive into more than costs:
czcams.com/video/eOP76hMPiDs/video.html
The Advantage plans offered by my retirement (PERA - NMRHA) have no drug coverage deductibles, and much lower MOOP. Though the monthly premiums vary from $0 to over $100 depending on which insurance carrier.
Thank you for sharing this!
I understand insurance brokers get a larger commission from selling Advantage Plans.
Hi Alan, we cover that here:
czcams.com/video/eOP76hMPiDs/video.html
And here:
czcams.com/video/5Tl0Ut1tTEs/video.html
Hope that helps!
Medicare Disadvantage plan
It all depends on how many medical services you have during the year.
Very well done. This is how I figured things out for me. I made the right decision for me.
So glad you are happy with your decision. Thank you for watching!
I went with traditional Medicare
The reason most retirees go with the advantage plans,,, is because the average social security payment is 1800 to 1900 a month,,, subtract the $175.00 ,, that leaves a retire
With 1750 a month to live on ,,,
This is definitely a reality. Thank you for sharing!
Excellent
Thank you so much!!
This is exactly why the US needs single payer health insurance.
I assumed about $500/month for medical insurance, so $435 seems fine. An extra $3000/year seems a small price to pay for the flexibility of regular medicare/supplement, etc. I have an HSA for deductibles, so I think I will be o.k. I still have several years until I qualify for Medicare, and your video was helpful to help me figure out my best options.
Thank you so much for watching!
Thank you😊😊😊😊
Thank you for watching!
Have watched many of your videos which are best out there. I understand there was a study on advantage plan denials. Any information from reports/studies or your experience as a broker on the rate of denials for joint (hip, knee) replacements or necessary cancer treatments? It is difficult to sort out the antidotal stories (where the details are generally lacking) from real hard evidence on when denials led to irreversible harmful events.
Appreciate you!
We have this video that dug deep into the data we do have available: czcams.com/video/sA9EzoiHjEM/video.html
It surprised us. We agree, anecdotal evidence makes it hard, which is why the KFF is valuable. It is just ALL claims.
Look up Vivek Garipalli of Clover Health. See how much he is paid and where the money comes from.
Super helpful. My Medicare agent does this part time and I am always having to be the one to reach out to her each year to review any possible changes. Any recommendations of agents in Phoenix?
We arent in the business of stealing from other agents. At the same time, your agent should be there for you.
We have someone here licensed there (lives in Utah). Also, know someone in Mesa.
That doesn't necessarily mean we'll move you, but happy to take a look.
Erik@90daysfromretirement.com is my email. Let's connect there.
Which plan is recommended for a full tim rver who is always on the road and going through different states, which, i imagine would make mean regular out-of-network costs. I'm new to rhis and its SO confusing!
The answer - with most things Medicare - is "it depends."
Supplement plans don't have a network, so your plan spans states and is easy to use in that regard. They cost more per month, but their coverage is great.
Advantage plans cost less and have a network. There are a few nationwide PPO Advantage plans that have nationwide networks, but you'll want to meet with an agent familiar with your area to go through those options.
Hope that helps! I'm jealous of the RV-life!
You completely missed the initial cost. Supplement vs advantage. That is paid no matter what. Love your videos, but do agents get a better commission on supplement or advantage plans?
Hi Alex, not fully following the missing the initial cost part. Could you explain?
In general, Advantage plans have higher 1st year commissions that Supplement plans. Advantage plan commissions are regulated and set by the government. Supplement plan commissions are set by the insurance companies.
Depending on where you are and which insurance companies you work with, they can be close, especially factoring in Supplement plus a drug plan plus dental, but if we're strictly looking at the Advantage plan itself vs the Supplement plan in that first year, yes, Advantage plans have higher commissions.
We go over that a bit more in this video:
czcams.com/video/eOP76hMPiDs/video.html
Two questions - 1) Your Part B IRMAA chart - is the premium in the far right column inclusive of BOTH the regular Part B premium AND the IRMAA surcharge? 2) Isn't there also an IRMAA surcharge levied on Part D plans as well based on income?
Great questions!
1) our figure is inclusive of the base premium PLUS the surcharge.
2) yes, there is a surcharge for Part D as well. They are here: www.cms.gov/newsroom/fact-sheets/2024-medicare-parts-b-premiums-and-deductibles?mod=ANLink
Thank you!
Great video …am applying for Medicare and plan to get supplemental plan G ,dental and vision , any recommendation for an agent near me here in Fontana Ca ?
Thank you for watching!
Would you be willing to shoot me an email to erik@90daysfromretirement.com and I can give you a couple options?
in this video, I would like to ask, in the equation you made, you did not include the
$2100 part B cost to the supplement plan? Or did I miss it?
It's there 🙂 at the bottom where it says total includes the Part B premium
I heard that the maximum number of days of hospitalization is quite different. Is that true?
Lets just say that Gap prescription just ate me up this year, I am going to go to Mexico or Canada for prescriptions these drug companies are making a huge profit!
Even if its averages, real world numbers as an example, should be quite helpful to most people i would think.
We sure hope so too! Thank you for watching!
how about the office visit co pays on MA would that add to the out of pocket expenses
Hi Randy, thank you for watching. Those are all included in this video. They go to the out of pocket max. Once someone hits the out of pocket max, they don't have those office visit copays for the rest of that year. Hope that helps!
My husband is in the NYCDC Carpenters NYC union and they offer a United Healthcare Medicare Advantage plan but until you actually join the plan by sending in the copy of his Medicare card we don't really know which doctors will be available to him. My husband called the union to ask him for a list of doctors but they weren't helpful over the phone. He's an early retiree, retired at 55 and had Empire BCBS for most of his retirement which was good (they switched last year to Independence Administrators BCBS, it's been okay, he can still use his same doctors). He's worried about going onto the UHC Medicare Advantage plan. One of his doctors already told him they don't take that MA plan (his dermatologist who is in NYC).
Not sharing the provider directory or having a provider search is worrisome.
@@Theretirementnerds I told my husband that he should consider opting out and getting a supplement plan bc I’m concerned that the MA plan won’t have the providers he wants in the future. Once he goes on MA it’s hard to switch to a supplement plan and he’ll be stuck with MA plans forever.
@@jdenino6022 an agent in your area should be able to help. They may even be familiar with the employer plan your husband is on. Comparing that plan with what you could find in the market could be beneficial.
We have an agent partner in New York if you want me to introduce you. erik@90daysfromretirement.com is my email.
@@Theretirementnerds We live in NJ though. We do use both NY and NJ doctors on his current BCBS plan. Unfortunately NJ doesn't have guaranteed issue and NY does, we should have stayed in NY.
What about if you spend part of the year in a state that doesn’t fully or not at all fund Advantage. Also, how difficult is it to find a doctor in that state?
Hi George, the state isn't involved in the funding of Advantage. If you spend time in multiple places and are considering an Advantage plan, when you move, you have a special election period where you can change to an Advantage plan that has coverage in the zip code in which you live. This is assuming you spend say, 6 months in Florida and 6 months in Ohio (as an example).
There are some Advantage plans that have nationwide networks, that could be another option.
If you are spending more frequent, but shorter amounts of time elsewhere, all Advantage plans must cover emergency care as in-network, so you do have emergency coverage, but if you are looking for routine visits or non-emergency treatments, you'd want to make sure you have a plan that has the providers you want as in-network.
Hope that helps!
My company that paid for my prescription put me on advantage
plan but I still have a plan F do they work together ?
They do not. Something isn't quite right there. You're not allowed to have an Advantage plan and a supplement plan at the same time. It's not that you'll be penalized, it's just that one of them should cancel.
I just dont know what to do. I do NOT go to doctors unless I feel I am dying. I do not take meds except an occasional asthma in haler. However, I previously had cancer 6 years ago so I fear if i dont make the right decision then I could be majorly screwed in the future. But how the heck do I afford the premiums and out of pocket expenses with Medicare original AND the rapidly rising insane rent prices?
We know the decision can seem overwhelming. That's why we and other agents and resources are here. The good news is you do have people that can help.
Do you have detailed information on what would a person get covered under a Supplement plan versus an Advantage plan, such as max amounts covered under each plan for, i.e. what would be the max amout for optometry visit, lenes, frames, extractions, root canal, crowns, dental hygienist , fillings etc...
Yes, this is exactly what an agent can do for you. If you have an agent, he or she can pull all of this up and compare with you. If you don't have an agent, we're happy to help. Erik@90daysfromretirement.com is my email. Just need to know your name and zip code.
The video explains that there is a $3300 dollar out of pocket max for part d prescription drugs. The 2024 official Medicare handbook I just received in the mail says it’s an $8000 max. What am I not understanding?
This video will help:
czcams.com/video/KLUZJMY5QYw/video.html
Interesting. Makes me sad though. I don’t know how I’ll afford any of it. Too much money for Medicaid, but barely enough to live on.
Where can I find a good agent?
Answered this on the other video you watched :)
We're happy to help if you trust us to do so (erik@90daysfromretirement.com) Just include which state you live in.
If not, there are several channels here on CZcams that do a good job. A google search for an independent agent who specializes in Medicare will pull up agencies near you. Just make sure they represent both advantage and supplement plans from several different insurance companies.
Do you disclose the fact that agents receive higher compensation selling advantage plans?
Hi Kevin!
We do!
Here: czcams.com/video/eOP76hMPiDs/video.html
And here: czcams.com/video/5Tl0Ut1tTEs/video.html
We actually mention it in several of our videos on the channel, but those two are the most recent where we mention it again.
Hope that helps!
Do you broker both supplemental ad advantage? I’m only 62 but keeping my eye out for a broker that can offer both in CA, who is impartial.
Hi Ralph, we do. Us and all our partners are independent (represent several different insurance companies) and offer supplemental, advantage, and Part D plans.
We know you have lots of options, so we are honored if you keep us in mind when the time comes :)
for Kaiser Advantage Plus supplement plan they no longer cover eyewear and exams, the fitness program, hearing aids, and home delivered meals following discharge from the hospital for congestive heart failure. They are wittlling away at the free benefits that were so attractive when they first came out with the Advantage policy.
So is that Kaiser plan a Supplement or an Advantage plan? If it is an Advantage plan and they have stripped out all those extra benefits they used to have, it may be time to shop for a different Advantage plan that still offers those extras, if they are important to you. Kaiser does not offer policies in my State.
So try a different plan.
Email your senators and ask them to co-sponsor H.R.4968 - GOLD CARD Act of 2023. This bill, if passed, will eliminate the ability of Advantage plans to require prior authorization.
Do know anything about co pay protection insurance, that someone on Advantage should get.
Hi Josephine, we have a video about cancer and hospital indemnity policies:
czcams.com/video/cgo5luXwDqI/video.html
Is this what you're referring to?
I live in NY, which frankly has many limitations in general! That said, I believe NYers can switch between Plan N and G, as well as MA plans and Supplement plans, with no restrictions. Is that true? If so, is there any reason I should not start out on an MA plan and only switch to a Supplement Plan is things go sideways?
Beware! You cannot switch to a Supplement Plan once you sign up to Medicare "Advantage" without serious underwriting and medical tests. You'll get denied or pay out the arse if you're sick
You can only get into a medigap plan without underwriting when you first get Medicare
Hi Mike, you are right. New York is an exception in that they have guaranteed issue year round for Supplement plans!
This depends on the state. New York is a year-round guaranteed issue. Mike is fortunate to live in New York for that reason. The bad part about New York supplement plans is that they are some of the most expensive in the country.
Has the 2024 deductible for the High Deductible Plan G been provided yet? Thanks for your great videos.
It has!
$2,800 for 2024
We have several videos that'll include High Deductible Plan G coming :)
Thank you for watching!
Great. I'll be looking for them.@@Theretirementnerds
I thought Plan N was the high deductible plan. How is HDG different?
@@headlibrarian1996 there is a Plan G and a High Deductible Plan G. Regular Plan G has the Part B deductible of $240. The High Deductible Plan G has a $2,800 deductible. Different plans :)
My husband is about a year away from retirement. He will be 65 and I will be 62. I stopped working due to depression. But have enough time in. My question is should I file at 62 because I'm not working or collecting anything yet. Should I try for mine or half of my his? Can I change as time goes on? I was advised to collect now because I haven't been working. I never filed disability I just stopped working. What are our options.
Hi Linda, this sounds like a Social Security question rather than Medicare. I'm not sure if you've seen this video yet, but it is a deep dive discussion into your options with Social Security:
czcams.com/video/KXFqGra9qHI/video.html
We'd always recommend meeting with someone on this because there are a lot of factors going into this decision, many of which you probably don't want to share in a CZcams comment (income, investments, health, etc). We're happy to go over that with you, or if you already have a financial advisor that knows SS well, you shpuld use them.
The compelling factor for me to get a supplement plan: _____CANCER_____
I wouldn’t want my oncologist to miss me, and I don’t want some insurance functionary deciding how my oncologist treats me
Thank you for this easy-to-understand video
Of course! Thank you for spending some time with us 😊
So basically you need to save all your money your entire life so at the end you can turn it all over to doctors and insurance companies.
Unlike an Ostrich, I pulled my head out of the sand and found this vid. I'll be looking at $400+ a month in premiums. Yikes.
You may be interested in this one that goes over the costs over 20 years:
czcams.com/video/DgpS_RlA4gk/video.html
Eric, in many of your other videos, you seem to prefer traditional Medicare with a supplement over Medicare advantage. In one of your videos you mentioned that occasionally, depending on a person’s ZIP Code, there might be MOOPS so low and attractive that we must give them consideration. I live in Las Vegas and I just saw a plan with a Moop of $700. I don’t take any medication‘s and many of the doctors that I know are in the network. There is also a flex MasterCard given with $2000 to be spent on vision, dental, And some other things. I am ready to sign up for part B and give this plan a try for the coming year. What do you think?
Hi Mark! Thanks for reaching out.
As agents, we're quite restricted in sharing plan-specific information without proper licenses and disclosures. So, in regards to that particular plan, I'd need to connect you with a partner of mine licensed in Vegas. She'll be able to speak to that plan with more detail than I can over CZcams comments 🙂
My email is erik@90daysfromretirement.com, or you can email her directly as well:
jodie@90daysfromretirement.com
Or email both of us because I'd still like to hear from you 🙂
@@Theretirementnerds Thank you for responding back so quickly. I know this is an extremely busy time of year for you. Just the fact that you responded back so quickly tells me that you really do care about your clients. When I receive my part B card, I will send an email to both you and Jodie to discuss different plans. Your business just may be the broker I need to take care of me. Thanks again.🙏
@@marksirota3153 we're happy to help in any way we can 🙂 look forward to your message!
They don't have any smaller options for people who make say $12,000 in Social Security. My 90-something year old grandmother's SS was $8000 per year. She passed away but, in truth, I took care of her and other relatives and my yearly salary was closer to $24,000 most of my life. I hate it when categories start $100,000 and less when I know so many people who have made closer to $15,000.
Those with low incomes and on Medicaid can get extra help and/or a reduced part B premium.
@@Theretirementnerds Thank you. That makes me feel better.
I guess everyone on both sides of the "war" between Medigap and Advantage would hate everything about it, but would it be possible to do an imaginary cost comparison spanning 30 years, for an "average" person? Premium increases for Medigap would need to be guesswork (albeit as educated as possible), as would the specific illnesses and the number of good years vs. bad for the imaginary subject. Nobody knows the future, but such a comparison could help to illustrate the overall impact to retirement savings over time. I know how much I have saved for retirement, and although Plans G and N have some wonderfully attractive features, I'm worried about the ever-increasing premiums for Medigap. Not counting the Part B premiums (let's say $70K over 30 years, taken from SS), Plan G could easily eat $100K or even closer to $200K (or more?) of my retirement savings over 30 years. If I had twice as much saved for retirement, Plan G (or N) would be a no-brainer for me, but alas, I do not.
Saw this comment on another video of ours. We're on it!
Made this for you :) Even mention you. Would love to hear your thoughts.
czcams.com/video/DgpS_RlA4gk/video.html