BREAKING: 4 Medicare Changes Finally Being DEMANDED By Congress!

[@MedicareSchool]

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[@rednekokie]

The idea that a private insurance company - whose sole reason for existence is to make profit for its shareholders - could adequately provide medical services and regulate medical treatment is absolute folly. And the fact that, for years, they have used former celebrities to hawk their goods on just about every television channel only makes the problem worse for people who need those services, and do not realize they are being scammed. If anything needs to be curtailed by the government, it is these entities. Actually, I would prefer that medicare alone, without any private insurance, would provide all medical service payments - and tax the entire populace to cover it -- same as in Europe or anywhere else that national medicine exists.

[@VoiceTotheEndsOfTheEarth]

yes, as long as the doctors and hospital staff are not government employees, like the NHS in the UK. That would lead to rationing and you would end up with the same problem as MA. Then private hospitals would spring up that the rich can only afford and you''ll have a Medicaid type system for everyone else where the patients get substandard care. The real problem here is the insurance companies as the middleman. They provide no real value and cost the doctors offices to hire so much staff just to keep on top of all the private insurer's requirements.

[@michaelmccafferty7341]

Excellent video. My friend’s husband was just notified that he needs a cancer drug that will cost $4000 a week. Not sustainable. Kaiser Advantage Plan.

[@cookie6325]

Perhaps they should discontinue MA plans and revert all to TM. Some of us did not understand what we were getting into at age 65 and did not know there was a difference in the MA plans and TM. Once we knew the differences the Supplement plans would not take us because we had preexisting conditions. Many were fooled.

[@BeckRD1]

I sure hope they’re able to get these changes made.

[@joegarrett7580]

A 'temporary' solution would be to allow anyone in a Medicare Advantage Plan the option to change to a Medicare Supplement plan WITHOUT having to go through medical underwriting...

[@BrittMFH]

Supp plans are already high. If companies let in anyone, most likely those wanting to change would be sickly, monthly costs would skyrocket.

[@MikeD_]

That is allowed in four states, I believe. One is NY where I live. Our rates on the supplemental plans are 50% or more higher than in many other states, so there is a trade off.

[@karenkoe7096]

@@BrittMFH Actually according to this video, MA plan patients end up costing the government more than Traditional Medicare patients cost. Also, a lot of what is payed by Medicare into the MA plans is going into the pockets of the insurance companies that administer them...that would be eliminated.

[@BlessedBeMyDay]

So you want someone else thats already been smart with their choices and paying higher prices with medigap plans to start paying for those those that went cheap medicare advantage now say, i made a mistake., now cover me no matter how sick I am .

[@doraquintano1421]

I hate Medicare’s system. I have AFIB and didn’t want to pay a big premium since I couldn’t afford it. My agent never mentioned the supplement or that I wouldn’t be able to have a better plan than an advantage program. I hate my coverage. The constant waiting for referrals, the minimal care done by my primary care(Conviva) in Fl. I got covid in Colombia and was able to get insurance there for $20 a month. They covered my 7 day hospitalization and all meds, MRI two heart scans and Inter vinous anti biotics, a doctor follow up visit at home and a lung therapist for a week. In a third world country. I paid into Medicare all my life. I’m 69 years old. I have very large arms since I’m over weight and Conviva doesn’t have a blood pressure cuff large enough to take my blood pressure. I’ve Ben going there for over two years. They haven’t resolved anything. I have arthritic knees and can’t hardly walk. They barely check my heart and that is it. Pushing meds for everything and their own doctors and testing sites😱

[@Losttoanyreason]

I'm so grateful I did my research( you being one of my sources) and didn't get taken in by a MA plan when I entered the maze that is SS and medicare I'm still bombarded constantly as I'm sure most of us on medicare are with claims to save me money and give me back money by signing up for a MA. I've always hated healthcare plans that require a network and pre-authorization from my working days and never chose them even though the other choice was a little more.

[@integratedservices5432]

People choose MA because they CAN'T Afford The supplement plans + A&B&D

[@collinsfriend1]

We recently had a patient on United Healthcare that had his cancer treatment delayed by them for months. They FINALLH approved it when it would no longer be useful and he died soon after. I don't know one medical person that would take a MA plan. and yes there is an algorithm- one is called Interqual and it is very very limited in what it considers hospital worthy. Patients can be prostrate, confused very very ill but if their WBC's or temp isn't high enough- or they have a serious infection but it's not in their eye or over a prosthesis---- it is denied. HORRIBLE. Even if the person NEEDS IV antibiotics. I am required to learn the algorithm and supposed to let the Dr's know what they are- hate it and I spend more time looking for a way around them, Algorithms SHOULD BE ILLEGAL TO JUDGE PATIENTS CARE. They are flawed and limited for insurance companies benefit. Who owns Interqual? McKesson a company that has software and medical supplies.

[@judys1340]

Thank you for speaking up!

[@AmaTXLori]

It will be interesting to see if anything good comes out of this. I work in healthcare and have seen how detrimental “Advantage” Care has been so devastating to so many. The insurance companies make us fill out a form every week to show how our patients/clients are doing with treatment but disregard what we say. They use AI to determine if a person qualifies for continued treatment. It is so disheartening.

[@Lou_Cyphre]

I have traditional medicare and every time I see my doctor I get asked to sign a CMS form. The receptionist said it only means I see this doctor regularly. Not true. It is very similar to MA in that there is managed care with my doctor getting a monthly check whether I am ill or not. Wasting my hard earned medicare benefits by paying for healthcare I am not even using! I am on traditional medicare, this is a CMS "equity" program which appears to be Direct Contracting reworked for a Democrat administration

[@judys1340]

Do you sign it? I've never heard of this and am doing a search on it, of corse Google won't tell you the truth.

[@Lou_Cyphre]

@@judys1340it is called ACO REACH. Both lying parties like it so watch out and NO, I refuse each time. this is so wrong. they have no right to waste my social security and medicare then claim these programs are bankrupt

[@Lou_Cyphre]

@@judys1340it is called ACO REACH. It is giving monthly checks to Catholic Health and my doctor in my region. it distributes my medicare benefits based on demographics with more money flowing to "underserved communities" and subcultures. both lying political parties are for it. it puts an organization between me and my doctor, like MA

[@Lou_Cyphre]

@@judys1340ACO REACH and absolutely NO! I refuse to sign

[@Lou_Cyphre]

@@judys1340 both lying political parties are for ACO REACH, it benefits their donors immensely. it appears to be Trump's Direct Contracting money grab reworked for a "woke" government. Big business wants control of our healthcare decisions

[@leonaowen9234]

Some people can't afford medicare so I'm grateful to have United Health Care.

[@dmulvany]

United Health Care appeared to be riskiest MA plan to join as they had had the highest rate of turning down pre-authorization requests. If you've been on it less than a year, you still have options. (Many hospitals won't work with MA plans.) Talk with a SHIP counselor about your options. Low income people may be able to qualify for assistance from their state.

[@anniesshenanigans3815]

There may be a few places where these plans do what they were designed to do, but for the most part they are not. The money goes into the insurance companies pockets and the patients do not get the care they need. Profits over people.. that is the bottom line.

[@brucemoose926]

I think that curbing payments to MA would result in further delays and denials to patients who need care as insurers defend their profit margin.

[@bethesda1146]

Interesting as always, very complicated, ultimate reform would abolish need for medigap or advantage. Why can supplement plans deny someone, in most states, with a pre existing health problem to switch from advantage, are they just as bad as advantage carriers to deny someone access to health care, no there trying to make profit as well, otherwise supplement premiums go out the roof, surely would not want that to happen!

[@debgalvez4383]

Mahalo, Martin for making sure we are aware of the pitfalls and your team for giving me the important facts re: MA when I was determining btwn my MC and MA choices.

[@DebbieB2023]

I wish I could have stayed on my insurance I had prior to turning 65. Since being on Medicare, I can't save any money. The agent wanted to put me on MA right off the bat, without even telling me anything about it, other than 'it's free!" and I'd get dental, etc. Sounds great but I asked "Will it cover my $5,000 monthly or every 6 week eye injections"? His face dropped (because apparently they get a little extra for everyone they enroll in MA). He said no and I'd have to get a Plan G, which I did. The insurance company I got was to charge a certain amount, but yet my bill was always $40 higher, oops, they didn't get their letters sent out in time...This year they doubled their premiums so I'm on another insurance company plan. Meanwhile, I have friends all on MA going on vacations, constantly talking about how good it is and why aren't I on it? Because MA wouldn't cover my injections or other things, if I got really sick or cancer, etc. I work one full time job which I pretty much work 7 days a week, and a part time job. I'll be working until I die I guess. Thankfully, I like my jobs...but right now I'm working so much just to pay insurance (and just had blood work done and same blood work I had done last year and was covered, this year I have to pay almost $300).

[@MedicareSchool]

Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com

[@charlottedavidson9194]

Thank you for this video!

[@Joshua_Cares]

Rep. Jayapal is a problem solver who comes up with practical solutions. It is a shame that they did not listen to her when she stressed the need for diplomacy with Russia to resolve the Ukraine crisis peacefully. Now hundreds of thousands are dead, and our tax money wasted. Hope they listen to her now to make Medicare more efficient.

[@JanetVaughn-cm3et]

A comprehensive explanation of what has been going on for decades. The "enforcement " of rules already in place is key. Everything you covered would reduce Medicare advantage plans to make huge profits, & in turn probly reduce Medicare part B premiums. Better care, less roadblocks by plans that try to deny or delay care needed, & better ,more efficient care to people who need it & pay for it. It's a no-brainer, but unless it's enforced it probably won't get any better in my lifetime as these things take FOREVER to take place. Hopefully people who will longer than I probly will might get the benefit they deserve in the future. It's like congress, they take WAY too long to pass bills & then put them into effect to help the people.

[@ckstaff]

That is what will still be a problem with MA IMO. Who is going to enforce or monitor these Big insurance companies? Somehow I don't think these big companies will care much what the government says and neither will the politicians getting money from them.

[@JanetVaughn-cm3et]

@ckstaff , yes that's the problem. All talk & threats to take action, but NOTHING ever comes of it. They know the problem but to act will endanger their political agenda & in many cases their re elections to congress , the senate & etc. So nothing will change. Insurance companies will continue to rule their way regardless of rules set in place that say otherwise. The government is of no help to us, as usual.🤨

[@wk7060]

I hear numerous complaints about MA plans, I have been on one, the same one for 8 years and have been very happy, with no prior authorization problems and the network of doctors for my plan has been good. They (MA) plans must not ALL be bad.

[@MrDjinxbass]

If you don't mind, what state, and what company?

[@Rodeo32145]

Dentist drop delta dental, patients are forced to pay what dentist charge. Dental dental is nonprofit but executives make millions as retirees pay $80 or more for cleaning and bite wing X-rays. Was paid in full in the past.

[@TrulyJefferson]

Very informative. Thank you!

[@MedicareSchool]

Glad it was helpful!

[@ohiopat]

If they can get this done, and it helps with the waste and fraud, then it should help to keep the Medicare Part B premiums from going up as fast.

[@artaptic]

Thank you for all your informative videos, Marvin! Your employee Josh helped me today with everything to return to Original Medicare. ** I suggested to him for you to make a video on on the "exclusion & how to" not sign up for Medicare when you're in a foreign country turning 65. That was my case. I signed up anyway to not be penalized. However, it didn't seem fair. I've been continuously out of the US for 4 years.

[@MedicareSchool]

Great to hear!

[@karenwhite1541]

I think people that are healthy on no meds and take control of their own healthcare are at a disadvantage no matter what plan one takes. Medicare +a supplement would have costs 1200 per month on a 65 yo male with no medical issues, no meds, and a family history of no health problems-while a MA plan costs only 172.00 - I think lifestyle and prior health should be incorporated into the costs

[@stevem1081]

I am almost at the age to have to deal with this mess, I hope the mess is cleaned up soon.

[@Hbd2002]

Just make Medicare advantage plans illegal. Also add hearing vision and dental to our regular Medicare. If we need more in our older age, not less.

[@rslitman]

I've posted on your channel before that I have a Medicare Advantage plan and am very satisfied with it. It is run by our local Blue Cross/Blue Shield organization, and is administered a lot like the health plan I had at my last job before retirement, which was also through a BC/BS plan. As I've said before, I live near a state boundary, and that last job was across the state line, with that state's BC/BS plan. My Medicare Advantage plan is a lot like that plan but without the out-of-state filing hassles. That said, you weren't around when I began Medicare, and no one told me that if I went with an Advantage plan, I would need underwriting if I wanted to go to a MedSupp plan. Would I still have gone the Advantage route? Probably! Yes, my plan, which is a PPO, has a network. How many of the several medical professionals I see are NOT in the network? ZERO! In this area, not being in the BC/BS network costs doctors and facilities a lot of potential patients. How many times have I needed a referral with this plan since I joined it mid-2017? ZERO! How many times have I reached maximum out-of-pocket and then had to start over the next year? ZERO! Is my monthly premium $0? No. It started out around $160, then a few years later suddenly fell to about $51, and this year it is $25.60. Do I get grocery deliveries? Only for 4 weeks out of each year, and I decided it wasn't worth it. Do I get dental and vision coverage? I could, but my long-established dentist and optician are out-of-network. Do I get gym memberships? Yes, and I love this. Ditto for $125 in OTC products a quarter.

[@ckstaff]

So you are saying you have not yet reached your out of pocket and have not been sick yet to find out?

[@bigd3104]

​@@ckstaffExactly. MA is fine for healthy people. But if/when your health declines later in life, then, not so much.

[@rslitman]

@@tator2345 Usually 3 times a week, but I've just been recommended by my personal trainer (not covered by MA plan) to increase this.

[@rslitman]

@@ckstaff One year in February, I suffered a serious injury, not an auto accident, where I could have gotten 1st or 3rd party benefits depending on fault, and not a situation in which I could have sued someone. I had lots of treatments over the next 6 months, but my out-of-pocket cost total was low. Yes, I had copays for doctors, hospital, rehab facility, physical therapy, etc., but it never got as high as my annual out-of-pocket limit, even when combined with my other medical conditions.

[@rslitman]

I realized after I posted that a few injuries/conditions I have required authorizations for physical therapy by my Medical Advantage plan. But other tests I've had have not.

[@kkay2270]

The government needs to get rid of advantage plans. Advantage plans are definitely putting people at a disadvantage. Insurance companies of any kind take advantage of people and are a ripoff.

[@tubtimhosking3696]

Thank you for keeping us up to date on Medicare's!

[@MedicareSchool]

Our pleasure!

[@Alpha_Mare]

Thank you for telling us about this. I only found out about the intentional attempt to destroy Medicare using this predatory scheme from Thom Hartmann here on y.t. He has taught me so much.

[@RandyChilds-q2d]

Why can’t Americans get free health care like the majority of The civilized countries in the world, they take care of their citizens,could it be that our representatives are to busy taking money from insurance companies and big farms!

[@eracer1111]

Many reasons.

[@judys1340]

Ya, talk to someone in those countries. It's no better and often worse.

[@VoiceTotheEndsOfTheEarth]

I don't know why Marvin loves this comment. It simply is not true that other countries have free healthcare. Doctors do not work for free, hospital staff does not work for free. The citizens of these countries pay much higher taxes for the "free" coverage. I actually compared what they pay in Germany with their tax rate for coverage with what we pay and it turns out ours is slightly cheaper with our Medicare tax and the premiums employers charge or Medicare Advantage costs. Plus, the waiting times in Canada and the UK are much longer for less urgent care because the government rations care. There is a very sad KZbin channel of a 24 year old in Canada who was having seizures needing to see a neurologist in Canada and an MRI. It took like 6 months and then when she moved back to Ireland to be close to family, she couldn't even get her MRI from the Canadian radiologist because they "owned" it. Turned out she has brain cancer, which took a year before they could operate on her. So there's no such thing as a free lunch. But I will say, the US system is such a mess in terms of coordinating care and the patchwork of insurance plans. That's what needs to be cleaned up. And of course, the misleading advertising needs to be stopped and the elimination of programs that end up costing more than the Medicare program while producing substandard care.

[@greyholcombjr.9623]

I would get a reverse mortgage on my home to afford my Plan N Medigap premiums if I had to.

[@billyrayband]

I think this true, but does not explain how the insurance companies force the government into increasing their payments to the insurance companies, or how much that is. I have heard the government sends about $800/mo from the trust fund as a premium to the insurance company for each person on a MA plan. What is the amount, and how has it changed the last few years?

[@michaelmccafferty7341]

I heard it was a $1000 a month.

[@paulawhitehead7321]

Why Medicaid/Medicare patients are automatically Medicare Advantage?

[@MedicareSchool]

Medicaid/Medicare patients are not automatically enrolled in Medicare Advantage plans. However, some individuals who qualify for both Medicaid and Medicare (known as dual-eligible beneficiaries) may have the option to enroll in a Medicare Advantage Special Needs Plan (SNP), which is specifically designed to meet their unique healthcare needs. Enrollment in a Medicare Advantage plan, including SNPs, is voluntary, and individuals have the choice to opt-in or opt-out based on their preferences and healthcare needs.

[@thaithaknot]

Marvin's videos are always helpful.

[@MedicareSchool]

Glad to hear that!

[@normawingo5116]

I learn so much watching your videos and I’m very grateful for you. Thank you.

[@shelleybush8871]

MA is a joke and I hate it due to authorizations I need help now

[@MedicareSchool]

Contact our office we would love to assist you, 1-80-864-8890

[@johnmclaughlin7406]

Great job!

[@sueharris6616]

Thank you, thank you, thank you my friend. You always bring light to these necessary Medicare news.

[@MedicareSchool]

We are glad we can provide everyone with more information!

[@anonymouspost9144]

We need to demand Congress start balancing the budget and putting american taxpayers medical needs first and stop giving our taxes to illegals and others.

[@DM-px9ip]

Your tax dollars are not going to illegals. In 2017 trump and the Republican congress gave 3 trillion of your tax dollars to the rich and corporations. Thank Trump and the Republican congress for the unbalanced budget. If the republicans gain control in 2024, they will cut Social Security and Medicare to give another tax cut to the rich.

[@jeanelegarrett3273]

I’m stuck in an advantage plan I call it disadvantage ! I no longer have real health care ! O

[@MikeD_]

Great video, although also not surprising. We know the insurance companies are using MA to increase profits, and they're doing so at the expense of customer care. It's fair to be annoyed, but I'm more annoyed at our government for allowing this to happen and for such a long period of time. Will they fix it now? Color me dubious.

[@johnsb1550]

Thank you.

[@freedomliberty895]

I tried Medicare Advantage ,it is not for the people who are elderly on a fixed income. And it's up to the insurance company to decide if any procedure will be done. And then at that, you have to pay 300 hundred or more out of pocket before they will do whatever procedure you need done.

[@almoemason]

WOW Marvin! Great and super informative Video. I wonder what would happen if they just got rid of Advantage plans and just went with tow or three supplement plans. Your thoughts.

[@jamesmcdonald6047]

Thank You 🙏🏻 😊😊😊

[@Maltojo]

My MA plan is fantastic! I did do my homework though. Traditional Medicare only is not a good idea. You need a supplemental plan to cover that 20% co-pay. The supplemental insurance company is out to make a profit, too. I could not afford those high premiums in my area. And those premiums go up every year, also. And they make it so hard to qualify after being on MA. YES! if TM could include dental, drugs and vision, that would be great!!!

[@JeanneWright-we8dn]

I know 1 person who couldn’t get what her doctor wanted. Two others really like Sparrow PHP, they do not travel out of network.

[@madelyngriffith-haynie9495]

YES!! Reforms are desperately needed across the board. Penalties for non-compliance are key, however. Stiff ones.

[@wk7060]

This sounds like a good positive move for Medicare Advantage policyholders.

[@lindabunce5133]

Maybe we need a Part B premium based on the program you're in. So TM premiums for Part B might be different than that of participants in MA programs.

[@stepheninge2173]

Good grief! My AETNA Medicare Advantage plan is terrific!

[@-Frost--]

This guy is a clown and should be reported to CMS for steering which is illegal

[@MikeD_]

@@-Frost-- You have it backwards. Agents get paid more for enrolling customers in MA plans. That's traditionally what happens. Many agents hype MA's. They get paid a higher premium when the customer initially signs on to an MA plan, and I believe they also get paid more over the life of the contract. Getting something for "free" up front, which is often what happens when you sign up for MA, should be the first warning. Nothing is free. One thing not mentioned. The government needs to punish agents and their firms who push customers into MA with deceptive claims, and by not fully explaining the tradeoffs. That should be one of the items on that list the government should look to fix.

[@-Frost--]

@@MikeD_ that's true nothing is free, but I don't have it backwards. As far as commission goes I don't take that into account at all. The cost of a Medigap plan could actually be much higher over the life of a person when you take into consideration rate increases and separate drug coverage, dental, vision etc...which an agent that sells you a Medigap plan can also make commissions on as well. Not to mention that they can continue to make commissions on switching to another Medigap and PDP every year when rates increase. It's not so cut and dry as you make it seem. It also depends on the time of year the person purchases the advantage plan. For example if your plan is effective in let's say October, the agent only receives commission for October, November and December that year. If they retain the client and they keep the advantage plan, then yes of course they will receive the renewal commission. With a Medigap plan you receive the full commission not matter what time of year the enrollment is, so your comment is partly correct. Plus what about the constant yearly (at least) rate increases people experience with Medigap plans. I'm not saying either one is better than the other but both have their pros and cons and should be compared and contrasted fairly.

[@Direct.injection212]

MA plans require Authorizations and referrals. That will cost you some and money. Get MediGap instead.

[@barreloffun10]

@@-Frost--Sure Frost, report Stephen Inge to the government for posting a comment about how he likes his plan. Go ahead, call CMS and let them know. 😅😅😅😅. Ever hear of the First Amendment? 😂😂

[@JamesDIYGarage]

Amen to that!

[@rauljimenez8132]

So rates/charges are going up.

[@audie-jerrykobes1704]

state of Wisconsin dont offer a G plan have to take some thing need to be done

[@barreloffun10]

Wisconsin and two other states have a waiver to opt out of the standardized medigap plans. You pick the medigap benefits you want a la carte, instead. So you can certainly get a medigap plan in Wisconsin with exactly the same coverage as a Plan G (paying for all the Part A and Part B cost sharing except the Part B annual deductible), it just won’t be called “Plan G.”

[@LA70S]

Put everyone on straight Medicare and eliminate Advantage Medicare plans. There should ne no premium for Part B and supplement insurance programs premiums should be tightly controlled.

[@barreloffun10]

Sure, we can totally afford to have no Part B premium. It’s not like the national debt is at unprecedented, ruinous levels or anything.

[@joedwillyx3d]

Left unsaid, the MA corruption is mostly in Red states that have preserved to ability of Insurance companies to rule.

[@VoiceTotheEndsOfTheEarth]

Proof?