MASSIVE UPDATE Medicare Advantage Disruptions Are Coming - How To Prepare

[@MedicareSchool]

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[@grandmasoffgridliving]

Number 9. The pharmaceutical companies charge 60% more for drugs than anywhere else in the world. We are the cash cows

[@user-TM59]

It's a conspiracy to make prescription drugs not only for huge profits but to make it unaffordable for Americans to purchase without their medicine their/ our health declines of course then we pass away. Corruption frm government plays a role in it goes hand and hand with pharmaceutical companies. Bottom line to cut the American population it's costing the government too much money.,, 💯

[@kwilliams2239]

Double edged sword. If we didn't pay the additional, many of the drugs wouldn't exist. Think of it as the rest of the world freeloading on us (just as they do for defense). If you look at the price of even things like text books, around the world, we pay far more. Publishers charge much less in other countries. In many cases not much more than the marginal cost of printing the book. A little money is better than no money. Back to drugs. Some countries (Canada) even threaten (or do) ignore intellectual property. If the drug company doesn't sell a drug for what the country wants to pay, they don't, and manufacture it themselves. Again, some money is better than no money. All of this means that we pay more than the rest of the world, for a LOT of things.

[@gc1172]

that is the lawyers share thru all the class action suits not allowed in other countries. Long ago it was stated in the the US that 60% of the charges is due to Liability Cost which doesn't have to be paid in other countries where lawsuit is by and individual and is heavily under government torte control so no one gets these huge awards and who knows how many are fraud in this country where most like half or more are. But the government representatives, heavily liberals, are given millions for sure in campaign fund and like speaking engagement like a half million to one person to speak like has been done and reported. How do Congress members like AOC come in a bar maid be worth over two million already.

[@GramGramGenX-ln5sc]

Mooooooo

[@rm19660]

Many of the countries are socialist or communist and pay less than what it costs to make the medicine. There has to be one capitalist sucker in the world to pick up the cost for everybody else! 😮😮😮

[@laurie6332]

This is what we get for going to corporate medicine. Hospitals owned by corporations are no longer in the business of helping and healing, they are in business of money making. 6 hospitals in the Boston area just shut their doors because they were not profitable enough. Where do all those patients go? Corporations don't care, they just shut them down. It's horrible what is happening in our country. And who are they going to get extra money from? The senior citizens, who can afford it the least. Corporations do not respect the elder populations like many other countries do. Corporate medicine happened so slowly most people don't even realize it happened. If you are in the hospital, you will never see your own Dr the way you used to when Drs made rounds twice a day. Nope, you see "hospitalists"...Doctors who are being paid by big corporations. Drs don't go into private practice any more. They work for big medical companies because they have to. To be in private practice nowadays is almost impossible due to the demand for paperwork put on private office Drs. They end up burning out, closing, and go work for the corporations. All the money needed is being tacked on to Medicare recipients. No doubt about it. Insurance companies are making billions of dollars, corporations are making billions of dollars and we are paying for it.

[@user-TM59]

😮,😭

[@garywood9119]

@@laurie6332 Apartment buildings in our area are being bought out by big companies who then raise the rents by $500-$600/month hurting the lower income people.

[@caddothegreat]

And most Americans are unhealthy. My wife and I are 75+. We recall when the hospitals were non-profit and ran by the nuns. Our first child. There was no health insurance. I paid $150 to the doctor for visits and delivery. Paid $150 to the hospital.

[@KB-ke3fi]

No it's owned by government.

[@Jane-x6n]

Because of trump

[@GramGramGenX-ln5sc]

When you retire, maintaining your health becomes your new job... Including dealing with the insurance companies and medical facilities.

[@BeAHappyCamper2Day]

Some ingredients in our food is banned in other states. The more I look into the carnivore and lion diet , the more I think that they are right. I need to get rid of chronic pain and not for weight loss

[@patburton837]

Why don’t we have the coverage that Congress gets. Americans pay too much money for health coverage.

[@douglaswilkinson5700]

Everyone is equal but some people are more equal than others.

[@philipchurch7036]

Congress has no special plan anymore. They are on the market like most others. CHeck your facts!

[@albertgrant1017]

​@@douglaswilkinson5700 you and 837 Well stated !

[@billdobbs6651]

Because they are special. They are the main reason that Medicare has problems.

[@teresamcgrath5376]

Because we don't vote for politicians that have integrity & the public interests in mind

[@riceburner4747]

Thank you for your honesty. WHAT A PIA!!! Older people dont NEED all the complications. Life is supposed to be easier when we're older.

[@threeftr3349]

Primary Insurance Amount (PIA) is a crucial factor in determining the amount Social Security benefits a person is eligible to receive. It is calculated based on a person's Average Indexed Monthly Earnings (AIME) which is based on your 35 highest-earning working years, and dividing them by the total numbers of months in each year (420) It is important that you get an account online, and reviewing your work history to correct any mistakes prior to collecting Social Security. Make a copy of your work history for your records. Couples should have copies of both.

[@NatureScapesStudio]

It’s been just the opposite of good since we retired.

[@riceburner4747]

@@threeftr3349 I MEANT Pain In the Arse (PIA). 😂🤣

[@threeftr3349]

@@riceburner4747 🤣

[@2012-JAF]

TRULY a Pain-In-Ass, but WHO claimed "Life is supposed to get easier when we're older"? Capitalism is the single problem responsible for the confusion in the medical industry. Medicine needs to be socialized for the greater good.

[@jacquelinedevlin6381]

What an outstanding presentation - clear, informative, concise - by such an engaging speaker. Thank you.

[@MedicareSchool]

Glad you enjoyed it!

[@threeftr3349]

Our parents and grandparents were the lucky ones, they truly had the promised best Medicare health plans. My mom never had a bill for anything. When she went to the hospital she was always there for at least a week. She one time spent 2 1/2 months at a rehab facility(not in a nursing home setting) that only had private rooms. The place looked like a hotel. She never received one bill.

[@MrHunt79]

That is a Medicare Supplement Plan F. A Medicare Supplement Plan G is still available, and works the same way as the Plan F, but with a $240 annual deductible (2024 - increases annually).

[@cindiparadise]

I have a Medicare plan that is a supplement… medicare is 80% the other is 20%…

[@tamb7587]

Your mom was most likely on Medicare with a supplement NOT AN advantage plan

[@anonemouse3768]

I just spent 12 days in the hospital. Partly for a TAVR procedure and I was one of the 30% that needed a pacemaker.. Zero cost to me including almost all my meds. 30 dollar copay for 2 CT Scans. 4 echo Scans at zero cost. A FitBit for it for at least 4 weeks. Zero cost. An at-home PT and nurse for 3 days at zero cost. Daily monitoring of my pacemaker through a cell connection at zero cost. And more. I have a non profit insurer and a non profit provider. I cannot complain. I only pay my medicare premium of $174. 15 years ago it was $147 / mo.

[@markbhoward]

'Never got a bill for anything'. Except a monthly bill for the supplement, Don't forget that part. And it's substantial.

[@AaronStephens-jl2pm]

I live in Forsyth Georgia and I absolutely love my Aetna Advantage plan. I did not lose one doctor or Specialist when I switched. I get an additional $5-6k in benefits annually so far. It may change but I love it now.

[@MarshaMarsha885]

My parents had Medicare and a supplemental. Been that way for decades. At it works. No advantage to advantage care. It’s not care it’s managed to suit them not you

[@user-TM59]

It's a disadvantage plan😥😭😭

[@kwilliams2239]

Saying anything about "Medicare Advantage" plans is saying nothing. Unlike supplemental plans, there are hundreds, if not thousands, of different Advantage plans. I have one, through a previous employer, that is in most ways _better_ than Supplemental Plan-G. The only negative is the slightly higher out-of-pocket maximum ($750 vs. $250, IIRC). Everything else is quite similar, but it also has the other Advantage perqs. It also saved me $5K per year over what I was paying for Plan-G + Part-D (two people). I say "saved", because I don't really know what the new drug plans are going to do. Someone's going to pay for the drug plan "improvements". It's not going to be the insurance companies, and not likely the drug companies either. Look for the formularies to be severely restricted and premiums skyrocket. There ain't no such thing as a free lunch.

[@carolapostolos8929]

Exactly!

[@lindahammond7759]

Congress gave our Medicare money to private insurance companies because they want the multi millions and bankrupt our Medicare in 5 years. Google these advantage Medicare and see their profits and how little they do for you when are not healthy in a serious health problem You need read the reviews about there coverage when those person become unhealthy. *

[@BobbyCole-nu7tq]

You have to be poor to get a advantage plan

[@bobwilliamson5993]

America can do better. Nationalize health insurance, do something or suffer the result. The system is failing.

[@gingerscott460]

As a good agent we should offer both MA and Supp to clients . Not everyone can afford the rising costs of a Med Supp . Original Medicare by itself is certainly not a wise option . The clients I serve have been extremely happy with their Medicare advantage plans. Every carrier is different. It’s never a one size fits all situation.

[@ericbond5276]

You are a good person. Every situation is diff. People become unhealthy.

[@4378200]

Exactly...my Med Advantage works well for me. I am healthy however. They side step the additional cost of the supplement premium. People also think k there is perfect plan. We all.are going to pay one way or another. Upfront with a supplement, or the 20% and limits of traditional Medicare. I initially enrolled into a supplement starting at $139 then realized I had to pay the traditional Medicare premium because you are being educated as you go and I've been in the insurance industry. So for the last 4 years that $139 went to me. I am lucky enough to be of good health. I stand on the 'maximum out of pocket' worst case scenario. If it were so bad I believe we would have heard more. There is no perfect plan. Not saying that there are no horror stories but it seems a lot of folks are happy with Med Adv. I'll take my chances.

[@johnstone7697]

What I don't get is why anyone would ever want to re-engage with a health insurance company after having dealt with them for so many years prior. They are greedy businesses that gamble with your money and do their best to give you the minimum return on your payments. That's their business model. Not much different than a Las Vegas Casino. Amazing that half of retired America has been bamboozled by these theives. After my experiences with health insurance companies, it was a no brainer for me to go with a highly regulated supplemental policy, which I'll keep till I'm dead. I know exactly what I'm getting and never have to worry about them screwing me over.

[@YT-User1013]

Wait, there are many commenters here that say their supplemental plan costs keep going up AND the cost for all the supplementals can put you at possibly $400+ a month (Part B + prescription + dental + vision + hearing + gap), so there goes your “highly regulated”.

[@threeftr3349]

@@YT-User1013 Exactly! Right now, we rather continue to work, just to get decent group employer's health plans, where you have options for your deductibles. There are thousands upon thousands that work, just to provide better healthcare plans for their families.

[@arnkriegbaum]

@@threeftr3349 i am new to this channel and a lot of people here are saying “just work forever”

[@ME-pt3bt]

Straight Medicare is too expensive, that's why we are on advantage plans!

[@carmenanico2786]

I heard that with these plans if you happen to get sicker, the sicker you get they are called "trash" whatever that means I disagree with these plans their more about making money

[@ambrosiamarvin5712]

No, my biggest problem is lying. My doctor gets a pre authorization and gives me a copy of of the form an the pre authorization form he submitted. Then l am told your doctor was so lazy he did not bother to submit a pre authorization. My response is always, "l have the pre authorization number. Do you want me to give it to you ?"

[@Amanda-rv8to]

Not everyone has the choice to not use an advantage plan

[@meet-jamie]

Changes to Medicare Advantage plans really feel like a double-edged sword-there’s potential for improvement, but the confusion and disruption for seniors can’t be ignored. Great job explaining what to expect and how to prepare. I’m curious about how are others feeling about these changes? Do you think the benefits will outweigh the challenges, or are you more concerned about the confusion ahead?

[@latinsilla]

Hi, we also have the option to call ship which is,state health insurance assistance program. The 800 number is on the back of your Medicare and you book . It is unbiased information

[@lightbox617]

I'm with Clover. Non of my specialists are "in network." They have left. It does not affect my cost and sometimes allows my providers to be more responsive. My copas change from month to month and the changes are complety opaque. CVS and Caremark are under government and Congressional scrutiny. I am seeking a professional to assist me in finding a new carrier in October

[@janehaefner9438]

I just moved to a new city, I started looking for a new GP. Finally found one who was taking new patients-but she doesn’t take Medicare. My question is this: Why am I mandated to have Medicare but the doctor is not required to take Medicare? I have A&B and a healthy supplemental plan. 🤷‍♀️

[@MedicareSchool]

Providers ultimately make the decision if they wish to accept Medicare or not. For those that opt out usually due to avoid the hassle of receiving payment from Medicare and/or the carriers.

[@carolhoyer643]

I don’t think we are mandated to have anything we choose not to

[@janehaefner9438]

@@carolhoyer643 well you can say no to Medicare but you will be fined

[@kc8aro66]

This is all BULLSHIT..I have been on an BCBS MI advantage plan and have never been denied and had excellent care everywhere I went. I’m not switching as the other stuff is way too expensive.

[@leatharay3565]

So far me either.

[@Jane-x6n]

I pay no premium no deductible I have cancer and it pays for my 15'0000 dollars for my cancer each month

[@MrHunt79]

@@Jane-x6n Mr "This is BS" is going to be surprised to find he has a 20% coinsurance until he hits the out-of-pocket maximum averaging $4000 to $8000 if he gets cancer. And won't be able to go to the Mayo Clinic because they got tired of fighting denied claims and will only take Medicare Supplement now.

[@Am5634]

i have MA plan in st louis its great. i have $7000 in dental benefits. it paid for my tooth implant .

[@user-TM59]

😄🤔 now I'm wondering are these positive comments regarding Advantage plan insurance coming from advantage plan agents 😄, if their not then their the few lucky ones that experience greatly with advantage plans, hopefully they don't get hit with a major illness then they will see Dis advantage plan insurance company true colors,😬, I'm team Medicare A and B.

[@MarbleForkBand]

What I hear you saying is that we'll pay more and/or get less so the CEO's of these companies can still get their bonus checks.🤔

[@ms.rlsteele351]

And that is exactly what is happening.

[@carolapostolos8929]

And retire with HUGE benefits that the average person will never receive.

[@lindawright2557]

We tried an Advantage plan several years ago. Big mistake! Costs were higher and more problems with denials. Got rid of it as soon as we were able

[@DistortedRainbowsArt]

I absolutely love your videos and appreciate all of your expertise. You truly are one of the best🙏🏻thank you for taking the time to help educate us all.

[@wendyramirez3350]

Cut out the middlemen! We don't need uninvolved people giving us authorization to have procedures done. And the wait times are out of control! It should go back to being doctor-patient with all needed paperwork done by the doctor's office. The costs would all go down...

[@colemant6845]

As Usual... Interesting and the MOST informative Medicare changes help. Thanks!

[@MedicareSchool]

It is our pleasure!

[@richardcallahan9646]

Great info, thank you so much for your service of explaining it in a very good way.

[@MedicareSchool]

Pleased that we can be so helpful!

[@d.r.martin6301]

It is ironic and sad that while many younger Americans can get covered under Obamacare/ACA with preexisting conditions, older Americans on Advantage with preexisting conditions cannot get the supplemental insurance if they wish to go to original Medicare. That is truly messed up! There needs to be a federal equivalent to the ACA for Advantage users who need medigap insurance.

[@Roslyn111]

It's because you can either have a Medicare Supplement or a Medicare Advantage plan. You can't combine both.

[@someguy95376]

Advantage plans are cheaper - Supplemental is more expensive. You can't assume that you'll pay the cheaper plan for years until you need the more comprehensive plan and expect to just jump in without a medical screening.

[@threeftr3349]

@@someguy95376 And that is why supplemental plans are the most expensive in states that don't allow medical underwriting. They forced supplemental plans to jack up the rates for everyone, because they are forced by the state to take unhealthy people. (take on more risk) The consequence is more people will be forced to move over to advantage plans..

[@d.r.martin6301]

@@Roslyn111 Yes, I get that. I did say "if they wish to go to original Medicare" from Advantage.

[@d.r.martin6301]

@@someguy95376 My point is: why does ACA allow preexisting conditions, and medigap insurance for original Medicare does not? They are both government funded insurance systems. It's not consistent or fair.

[@TakeTheRide]

Thankfully for the Medicare School team, I went with a supplemental plan. Thank you for all your help. ❤

[@user-TM59]

@@TakeTheRide Thank God you fortunate to afford a supplemental plan, some people can't afford it.

[@billdobbs6651]

@@user-TM59 My guess is they will become more and more unaffordable.

[@user-TM59]

@@billdobbs6651 Right

[@user-TM59]

@@billdobbs6651 Right

[@MedicareSchool]

It's great to hear that we can help! If you ever have questions just give us a call!

[@nettie3485]

Yes it is.

[@Deba7777]

Very, very helpful & understandable explanations of this mess! Thank you so much!

[@MedicareSchool]

Glad it was helpful!

[@john-r5j]

i love medicare advantage plans

[@ericbond5276]

I'm leaning that way. I'm on tier 1 and generic drugs. I hope I don't get slugged when I have something serious. I talk to oldsters and one has a HMO plan and luvs it and she took advantage of it because she has health issues.

[@4378200]

Me too...

[@brendaleahy5474]

Finding more doctors and hospitals dropping my advantage plan, going to look for a supplement plan next year!

[@MedicareSchool]

If you need any help with that search we are happy to help, you can contact our office at 1-800-864-8890.

[@wendywhite2642]

Yet another reason I am so glad to have gotten back on original Medicare. Don’t have to change Insurers every year and the supplemental policy stays the same.

[@katydudeus9278]

My husband wanted to go with Advantage and I told him NO WAY !!

[@user-TM59]

😄 right. Thank goodness you can afford a supplemental plan and stand alone plans.

[@judywho2249]

@@user-TM59 I've had no problems with my advantage plan.

[@user-TM59]

​@@judywho2249You one out of millions. Lucky you. People have died from delayed and denial of care frm Dis advantage plan insurance company.

[@anonemouse3768]

Depends on the plan. I am very satisfied with my advantage plan. Zero out of pocket for an angioplasty, TAVR procedure, and pacemaker. One ambulance ride from the ER to the Cardiac facility all at zero out of pocket. It helps to have a non profit HMO and insurance plan.

[@jrae6608]

Glad you did not go with advantage plan. Good for you, hope husband continues to listen

[@smidgen_13]

This video is one I'm going to share with family & friends about "what's up with insurance for 2025". I'm a retired medical insurance biller and I've watched several videos by different people explaining it. Thank you.

[@MedicareSchool]

Glad that we can help!

[@wk7060]

Needed more CMS accountability for years, good.

[@janar734]

Ive been hearing that big changes were coming. Thanks for explaining it so clearly! I have an MA plan...looks like I'll need to do some research

[@PhilipElsenbaumer]

I have a MA plan through the Teansters and have never been happier with my coverage.

[@MedicareSchool]

Great to hear!

[@twilde3754]

Thanks again for this information. Each time I listen to your video information, I know I will call you as soon as I know I'm going on Medicare (I'm still working). Question: how long does it take to be approved for a Medicare Supplemental Plan?

[@8aNda1d]

I didn't call him (just now found his videos) but when I made my call they were ready to sign me up and get coverage going by the 1st of the month. I haven't decided which plan to get yet. And I want to wait to find out what the changes are to part D. That may determine which plan I can afford

[@MedicareSchool]

So glad t hear that we can help. If you're new to Medicare and 65 or had employer coverage, you can usually get a supplement right away. But if you're changing your supplement plan, it could take a few days.

[@BrittMFH]

Very interesting to hear the reasons advantage plans are flailing.

[@markbhoward]

The advantage plans are not flailing. They're gaining market share every year and now exceed 50% of Medicare recipients. And that figure will continue to grow.

[@0annonymous]

Depending on the type of change will depend on if you want it, because some people will fight back against it. If they know there’s going to be a big enough disruption. If what they’re using is something they absolutely need to stay in place.

[@janiswenger3350]

My local hospital is going to quit contracting with most Medicare advantage plans

[@lawordersvufan8050]

Thank you for this information, never had this mess with my parents years ago ,I'm the generation of baby boomers who t caught up in this health insurance crisis omg but I will stick with original Medicare 😊

[@MedicareSchool]

Happy to help!

[@Luv-evedear]

I can’t wait to start checking out new companies. I have Humana Gold and it truly sucks. Bare bones and very few doctors. I used to have CarePlus in FL and it was great until they were thrown out of the Memorial Healthcare system. So now I have to go hunting for the most goodies from another Medicare company. I look for the benefit card amount, first. That is my food money.

[@ericbond5276]

Not sure if FL is a benefit friendly state. I submit home owners insurance bill, property taxes bills and condo fee copy of check to my county office to try and increase my SNAP allowance. It worked.

[@0annonymous]

I told a friend of mine about this, and she don’t believe it unless she actually sees it, and I don’t blame her Don’t believe it unless you see it

[@rs4425]

Thanks for trying to explain this dilemma. If you're on MA and in generally good health, not sure why you'd want to start paying for both a Medigap Supplement AND a Part D supplement. ? My Medicare Plan N supplement will increase 12.8% next year. My Part D drug supplement has almost doubled. My agent says it will continue to increase. What a mess.

[@user-TM59]

😭😭😭😭😭😭😭😭 us seniors are doomed!! The government way of cutting population. We can't afford healthcare premiums nor medical bills, the care we do receive sometimes not the best care. So us seniors just kick the bucket sooner, so with that been said it saves the government money that's another senior the government don't have to send a social security check to anymore nor pay a portion of the senior healthcare bill anymore. It's a conspiracy folks!! Every year it's a new virus emerges kills off alot of seniors. Getting the population down nationwide. Wake up people think about it. Our government is corrupted, can't be trusted.

[@leonardquirino2320]

Because good health today is not guaranteed for tomorrow

[@lindahidalgo1804]

The insurance people have a bigger incentive always to steer people into Advantage plans because they themselves make a much bigger commission!

[@valerieb8006]

Thanks! I'm saving this video to refer back to if needed.

[@MedicareSchool]

Glad it was helpful!

[@user-TM59]

Welp let me do my math,🤔 In 2025,, Estimation, Part B 185.00, plan D drug plan premium definitely going to increase with our 2,000 yrly cap , minimum probably be 65.00 month, dentist 55.00 month , supplemental plan N 120.00 month, vision 20.00 month, increases yrly.

[@feedtherich11]

Sounds good until you need them . Then watch what happens.

[@nolamoss1437]

WANT A Mess.

[@leatharay3565]

I had a ct scan found a 4 cm cyst under my thyroid had me in immediately and approved

[@bobwilliamson5993]

My daughter in law, My wife and I lost Rob,aged 43, 3 kids two adopted, April 24, 2024. The system not only made him wait for a CT SCAN but didn't have a room for him. He went to the ER and was sent home less than 15 hours later he was on life support. Complications to a knee injury that needed surgery ASAP. Long covid and non diagnosed small tumor in his thyroid - result was massive blood clots. I'm plenty pissed just as everyone else is. This guy should not have died.

[@ChrisSadowski-pp1np]

Don't do advantage. If you can't afford plan G (which is not a good value) or N (My suggestion for someone who wants comprehensive coverage) do HDG. With a $2,800 limit , it would take over $13,000 in part B expenses to hit that limit in a year. Basically a catastrophic event.

[@todddunn945]

The best plan depends on your health and your financial situation. For example, I have a chronic condition and go to the doctor a lot. Because of that the copays associated with an N plan would cost considerably more than the difference in premiums between N and G. Also if I went to a high deductible G plan I would have to pay the full deductible every year which is much more than the premium difference. Because of that a G plan works for me.

[@sheryllegg845]

@@todddunn945Thanks for the information…very helpful

[@ChrisSadowski-pp1np]

@@todddunn945 G is best for people who have chronic conditions. The premium at age 85 will be really expensive though.

[@ChrisSadowski-pp1np]

​@@todddunn945There's about a $30 difference between the two plans, but plan G has higher percent rate increases than plan N which will add up over time. Something to consider.

[@user-nm1rv2bh7k]

Advantage is great until you get really sick…

[@kwilliams2239]

"Always" and "Never" should never be used in a sentence. It's always wrong.

[@anonemouse3768]

Wrong. An angioplasty, TAVR procedure, and pacemaker for zero out of pocket. If you have the money then avoid any savings. EDIT: autocorrect messed up the last sentence. I have no idea how it got there. Minor adjustment to the costs: I paid $40 for psrkig for 9 days in downtown Los Angeles.

[@ericbond5276]

I'm going with Adv plan. Spent over an hour with agent from AARP united healthcare. Their drug plan $39 + $545 deductible. That means I got to pay that figure for my 4 generic tier 1 drugs, then they will pay the rest. Insurance industry needs a major overhaul along with politicians.

[@Elsie5500]

If I had an Advantage Plan and I wanted to switch to A, B, D, and G, would I be able to get G since I've not had it in the last two years?

[@BrittMFH]

If you qualify medically. You need to go through underwriting.

[@KB-ke3fi]

Pretty soon we're gonna have to cover the whole alphabet.

[@MedicareSchool]

You would likely have to go through medical underwriting to get onto that plan, if you've been on the advantage plan for some time. With the annual enrollment period coming that is the time to make plan changes. If you have any questions call our office at 1-800-864-8890.

[@chuckfullerton1667]

What do the advantage plan providers get in compensation for each client? The government must pay them something

[@smileytow1925]

From what I hear, the government pays the advantage plan 1000 a month for you. ( and you still have to pay the 174 dollars a month for part A

[@woolftwo]

@@smileytow1925 - Most don't pay for Part A, it's $174.70 for Part B.

[@user-TM59]

​@@smileytow1925 No monthly premium for part A , only part B in 2025 be 185.00 month.

[@loiscashner6567]

They get our paid in SS benefit money, wake up

[@user-hp8wt4hb9e]

Advantage Plan is another word for HMO which means you have to go through hoops to see specialists.

[@ms.rlsteele351]

There are specialists on the plan.

[@lubamordkovich4077]

Do not spread bs because we have MA PPO and see specialists when we need

[@CryptoSurfer]

@@lubamordkovich4077you may not have to go through hoops to see a specialist, but your specialist will have to go through hoops in order to treat you.

[@chettyspall]

Need to talk about the Biden reduction act which is caused all these problems

[@mls-jp9nb]

I’ve had no problems getting specialists with 3 different MA plans. I’ve never been denied a thing.

[@KB-ke3fi]

This is why if you just need a cavity filled at the dentist, they push deep cleaning and a root canal and a crown you don't need...about $1,200

[@Reed-2big]

If that $1200 is total, not copay that’s a deal for a crown and root canal!

[@debbieb5673]

@@Reed-2bigthat can’t be right , just a crown cost 1400

[@Reed-2big]

@@debbieb5673 Isn’t that what I basically said? It’s a deal if it’s both at $1200.

[@KB-ke3fi]

@@Reed-2big My copay was $880. It was a simple front tooth crack...they did a root canal I didn't ask for for a live tooth, so it was over $2,000 for nothing and the damned thing fell apart.

[@Reed-2big]

@@KB-ke3fi That p’s near where my co-pay will be too. I think mine is in the $600s but it’s been a while. The crown came off 2 days ago! The enamel was coming off which is when I was given an estimate. It’s been a while since I’ve done a root canal but I think mine was higher. The last major work was an implant where it had failed. It was under a guarantee so no cost for it, at least for the second one! There are several things that dental insurance doesn’t cover for an implant which always has a new crown.

[@marymastromauro8164]

Im glad i was able to afford regular medicare, never trusted the advantage plans

[@anonemouse3768]

Regular Medicare would have cost me 20% instead of the zero out of pocket for me. I did have a $30 copay for 2 CT scans.

[@Colt-ii4qn]

Don’t have a few bad years in a row. You’ll see the cost of the disadvantage plan 🥹

[@anonemouse3768]

@@Colt-ii4qn there is nothing in my contract with my advantage plan that would make your statement true. You are spreading false information.

[@karlabritfeld7104]

Don't we have enough problems in this country without more dire warnings going out??!!!

[@AdvocateWriter]

Thank you, I suffered a cuncussioin that advanced to a TBI over a year ago. I was continually denied referral to specialist when time was of the essence. It was a nightmare particularly at a time of cognitive difficulty and worst yet the injury was due to my headrest randomly deploying from a manufacturer defect they claim doesn't injure anyone despite common sense. Now I'm considering just going straight medicare this October, it feels like Corrupt corporations injuring the disabled are utilizing it as a form or Corporate Welfare too..

[@billwiley7216]

I have no issue getting referrals to the specialist it is getting the specialist to set up an appointment (if they even call you back at all) that is multiple months out from the current time. Never had these issues when I was working and on regular insurance but now on insurance associated with medicare it is a big problem it seems.

[@Reed-2big]

@@billwiley7216 Yep, neurology is 7 or more months out!

[@billwiley7216]

@@Reed-2big Of course no one would ever admit to it. But I wonder because of the reduced payout amounts of both medicare or medicaid if these specialists do not limit the percentage of their appointment slots for the lower payout patients to maybe 20-25% of their total open appointment slot availability to keep the office income level higher?

[@Reed-2big]

@@billwiley7216 I remember when doctors only took a certain percentage of Medicare patients before they were listed as taking no more patients. Many did say no more Medicare patients. With all the groups that have formed I’m not sure that’s completely true any more. Of course, knee doctors have many clients but replacements can get you mostly Medicare patients.

[@Reed-2big]

@@billwiley7216 I should have added that HMOs can also use similar pricing to Medicare.

[@garywood9119]

Note that going back to original Medicare plus a gap plan plus a drug, eye, dental plan will really cost us big money every month.

[@threeftr3349]

If you take an advantage plan, it is recommended to get a cancer indemnity plan. When you are diagnosed with cancer you want quick approval, and the best possible treatment plan. Up-to-date modern medical testing to determine your correct staging for your particular cancer is very important to determine your best treatment plan. Advantage plans will often use less expensive, less effective testing that is primarily outdated. You will not even be aware of the what is the most modern comprehensive testing for your cancer is because the doctor will not mentioned it to you, due to your advantage plan. This is where you need to educate yourself. You don't want to pinch dollars, you need to pick the top rated oncologists/facilities that are experts in the procedures, treatments of your treatment plan. This may require you to have more than one oncologist/facility/specialized doctor. Is your advantage plan going to pay for it? For example, if you had prostate cancer, an outpatient procedure called brachytherapy from the top oncologist in the country that does hundreds of these procedures a year can cost around 25K. Radiation treatment of 5 weeks can cost over 30K. Will your advantage plan cover this? Also a hospital indemnity plan to cover the ever increasing co-insurances you will be responsible for.

[@NatureScapesStudio]

Yes it costs some more but if you have a good advisor and choose carefully some of those things will be in you supplemental plan. It will only cost you if you have get unhealthy. The bait and switch of the advantage plans are starting to harm people thru denial of care.

[@user-TM59]

​@@threeftr3349, I agree 👍🏾💯

[@bmcb9422]

And of you and up in hospital take a look at Deductibles on Advantage plans. And copays.

[@user-TM59]

@@garywood9119 Right! Smh minimum 395.00 a month.

[@georgemead6608]

What happens when an "Advantage" plan withdraws from a market? What if you don't choose a different plan? What if there isn't one?

[@user-TM59]

@@georgemead6608 Be pretty much screwed

[@ms.rlsteele351]

There are options when your insurance has been discontinued.

[@MedicareSchool]

If a plan is being dropped you will have the option of selecting a new plan. If a plan isn't selected it just means that you are the second payer after Medicare A and B pays. So you are responsible for the remaining 20%. If you have any questions we are happy to help, you can give us a call at 1-800-864-8890.

[@threeftr3349]

@@MedicareSchool As you said once, it's an unlimited 20% responsibility. You have no control of it.

[@cachi-7878]

Thank you! Always informative!

[@MedicareSchool]

Glad it was helpful!

[@margaretames6522]

United Healthcare changed its policy about physical therapy as of 9/1. I had knee replacement surgery on 8/1 and had already started physical therapy but UHC is holding up payments. How can they change a policy in the middle of the year?

[@lisat9802]

Thank you so much for this important information today. I will be holding my breath when I get my ANOC this year.

[@MedicareSchool]

Glad it was helpful! If you have any questions, just give us a call 1-800-864-8890.

[@lolalucky6373]

This is torture for citizens why the hell this system is hell for us the Congress have plenty time to focus only in the that 😮😮

[@riceburner4747]

The Congress (Republican) wanted to give us choices and the power. WHAT A CROCK! I say "single payer" for ALL. The young on it, paying into it, and same for ALL. CHEAPER TOO!

[@KB-ke3fi]

@@riceburner4747 Don't blame the Republicans for this shit Obamacare nightmare that started in 2009. Now nobody can fix this nightmare.

[@craigbathurst1185]

Single payer is nothing but Socialism. Just like they have in Canada

[@trig33kgirl]

How can you love capitalism in the context of healthcare? It's anti ethical.

[@trig33kgirl]

@@roadking9680 1. Canada doesn't want an older American. 2. It took me over a year to get scheduled for a surgery I need here in the US, so we also have delays in getting care. (And I have excellent employer provided insurance now)

[@kimberlybegonia2869]

Our hospital system has advantage plan for Medicare and you just have to use their doctors in the list. Let’s see if it continues after the mad rush for so many people moving to Florida 😮💜

[@alanCalhoun2]

My Opinion, A Non Profit Medicare Advantage Plans are the Best Plans.

[@47retta]

So does this only apply to advantage plans?

[@MedicareSchool]

Yes, since supplement plans are not tied to a network they are portable all through the US.

[@vgwinva5669]

Question: ‘I heard’ if I have advantage and I want to change to a traditional plan, that I would have to go through ‘medical underwriting’ - my health is good, suggestions ?

[@user-TM59]

If you have good health it's a chance the underwriter would approve you for a supplemental plan, they will ask you about 25-30 health questions even few health questions of your parents health history, any meds you taken, denial if AFib, rematoid arthritis, diabetes, high blood pressure, etc they real picky, Good luck.

[@MedicareSchool]

That is correct, the only states that don't require this is CT, MA, ME and NY

[@ericbond5276]

@@user-TM59 Maybe tell the underwriters the parents are deceased but healthy at one time.

[@DRSTEVEPODCAST]

Great information!

[@MedicareSchool]

Glad it was helpful!

[@rm19660]

I think the main reasons for the changes is the $2,000 cap when medicine co-payment. All the other things happen all the other years up until now anyway. But the call shifting is going to get pretty bad. If you have a great plan and you've had really, really great benefits. Make sure that you look at your what's changing page that they send you. It's not going to be as much BS as what you think it is. This man is doing you a great service in letting you know what's happening!

[@ericbond5276]

Make sure your drs. and specialist are in the plan you are enrolling in.

[@stevenrein3118]

are you employing agents in Ga.?

[@kdlange6052]

What about kaiser it seems its a unique advantage plan

[@MedicareSchool]

They have their own system of plans, you will have to contact them directly. We are not aware of Kaiser, and if any changes are coming.

[@thomasmorris2245]

Thank You Marvin

[@MedicareSchool]

Happy we can help!

[@richardnwilson]

As a broker how are you paid? Do you get higher commissions selling Medicare Advantage?

[@Reed-2big]

My understanding is yes they get more for selling you an advantage plan. A good agent makes up for the lower benefit by giving good advice and service.

[@threeftr3349]

@@Reed-2big I also heard they also get a renewal commission every year you stay on Advantage plan. Sales commissions for Advantage plans have increased for the ninth year in a row. this was reported by Ritter insurance marketing. Example: For CA and NJ, initial MA commissions increased from $750/member/year to $762/member/year, a 1.6% increase YOY. Renewal commissions increased from $375/member/year to $381/member/year, a 1.6% increase

[@Reed-2big]

@@threeftr3349 And if you have to change advantage plans because they cancelled your previous plan, I assume that’s still a renewal? Have you seen the commissions for the medigap plans?

[@MedicareSchool]

All brokers are paid by the various carriers they work with if a policy has been set up. One thing about Medicare School is we are paid the same for both advantage plans and supplements. If you have any questions you can always call our office we're happy to answer your concerns! 1-800-864-8890.

[@richardnwilson]

@@threeftr3349 thank you for that information. I wonder if you might know what the typical commission is on a Medicare supplemental plan for comparison?

[@ericbond5276]

Lastly, If you jump from a Adv. plan to a Supplemental or Gap, you will need a drug plan. Correct me if I am wrong. I'm learning this before I turn 65 in Dec. I got my card several weeks ago.

[@MedicareSchool]

You are correct! A drug plan will also need to be set up.

[@markcalston5495]

Can I change from Advantage in Cali to Supplement if I have type 2 diabetes but healthy?

[@cccar67]

I did two years ago. I’m not in Cali but it will work for you if you’re in the same situation as me. I had blue cross advantage for several years. So they had to sign me up for their supplemental plan because I had been a customer for over two years. I didn’t need a physical or qualify. IF… I went with a different company I would have needed to be underwritten and qualify. Best of luck to you. Find a good rep to help you through the transition. It should work for you.

[@MedicareSchool]

There could be a possibility, every carrier is different with their underwriting. We can asses your options and review underwriting rules for carriers. Give us a call at 1-800-864-8890. We'd be happy to help!

[@ericbond5276]

I'll be 65 in Dec. Looking for a Gap + D as well as Adv. I live in a city that has a respectable hosp. UPMC.

[@MedicareSchool]

We would love to assist with reviewing plan options with you. We do want to note that you can't have both Plan G and an advantage plan. You can only have one or the others. Give us a call at your convenience 1-800-864-8890.

[@user-rw311]

I'm 51 years old on SSDI since 2002. If I live in Florida am I eligible for a Medicare supplement plan or do I need to wait until I'm 65 years old

[@MedicareSchool]

You likely wouldn't be eligible for a supplement until you are 65. Most states don't offer supplements under the age of 65, and if they are offered they are at a much higher price that's just not sustainable. Once you reach 65, you'll be able to enroll into a supplement with no medical underwriting.

[@STEVE-lk2ft]

Is another choice plan A and B without a supplemental plan without any underwriting? You made it sound like you need a supplemental plan if you go back to original Medicare.

[@nancy3853]

Please do Drug Plans part D

[@MedicareSchool]

Once we receive more definitive updates we will!

[@nancy3853]

@@MedicareSchool Thanks

[@jalqassar]

Strànge, I never got an ANOC. Its late in the season. Ive been with them for years. They shouldve notified me by now.

[@MaryBethMcCoy]

No, the ANOC is usually sent out in September, so you should wait a few weeks to see if you receive it. If you haven’t received it by the end of the month, call your company.

[@MrHunt79]

@@MaryBethMcCoy ANOC letters are coming out this month. They are required for both Medicare Advantage and Medicare Part D, but not Medicare Supplement. If you don't receive one by October 1st, call your carrier. They may have the wrong address on file.

[@MaryBethMcCoy]

@@MrHunt79 Yes, I know. I am the person who responded to the question asked by the original poster.

[@pjfreeman4789]

If you have never received an ANOC in the mail, you may receive it electronically. You may have to go to your account on line to read it.

[@DebbieBennett-p5v]

The company pulling out...IS that CIGNA???

[@BrittMFH]

Humana is also cutting back.

[@KB-ke3fi]

It probably is....I'm having LOTS of problems with that company and I have to change it AGAIN.

[@ericbond5276]

The movie Saw VI hit the nail on the head.

[@ericbond5276]

I'm glad you understand my train of thought (that didn't leave the station).

[@malinhead322]

Don't even think about signing up for a Medicare Advantage Plan - go with original Medicare and choose a supplemental plan.

[@jameskimejr9062]

I had a supplement for 2 years for 95 per month then they jumped it to 205 per month. Goodbye. Got advantage plans with no monthly pay ment, or copay. Saved over 2500 bucks per year and will stay where I'm at.

[@mikespangler98]

Medigap is $270 a month in this rural county, and no vision or dental coverage.

[@KB-ke3fi]

@@mikespangler98 Dental is a joke...they don't cover anything except this deep cleaning scam

[@bettyshosh1702]

My jump to $313per month. I will need to change to MA. Plan.

[@leonidlukashevsky6487]

Thank you! I will stay

[@Eaglesmere]

Thanks for the info Mr . Salesman !

[@jalqassar]

Approximately what is the priemium for that supplemental plant with medicare? $300 a month, less or more?

[@user-TM59]

. Depends what state you in, also if you get G or N plan. G usually is more expensive than N. Both are great. Premiums increase yrly.

[@MedicareSchool]

It could be less, it all varies based on where you live. We would be happy to review those with you! You can call our office at 1-800-864-8890.

[@BobbyCole-nu7tq]

Its the same. Theres always been the ageing. Ceo of cvs. Made 12 million last year.

[@TheBuddy1939]

Thank you very much

[@ericbond5276]

Thx re. learning about ANOC. I'll know about the initial plan when I enroll in Dec. I'll keep an eye out for my letter in later part of 2025.

[@rattlesnake63]

Does that include United HealthCare

[@sheryllegg845]

No reply about United Health care?

[@stephenkern5784]

They cover people over 65. What do they expect?

[@skydancerforever]

I don't start medicare until May 2025. I need insurance from Jan 1st to May. Do i use the health care act like i have been using the last 2 years? will it automatically stop in May when my medicare kicks in? What about my wife. She would be on my plan thru the health care act. What happens to her when i go to medicare in May???

[@Hibernia2324]

I let my private insurer know that I would be enrolled in Medicare on 9/1. They d/c'd my policy on 8/31. My spouse is still on the private insurance and the insurer actually tried telling him the premium wouldn't change. He called the state insurance commission and set up a 3-way phone call with them and the insurer. His premium was reduced.

[@MedicareSchool]

You will want to cancel the plan when you start Medicare. Have the last day of coverage be set for the day before your new Medicare starts. For your wife you will want to sign her up for her own marketplace plan until she is of Medicare age and can then transition as well!

[@skydancerforever]

​@@MedicareSchool Are you saying to sign my wife up on the health care act on her own policy starting for the new year or at the time I sign up for Medicare in May?

[@wendywhite2642]

I think capitalism should be subject to the priorities of the people as a democracy, that governs business and everything else. If the government represents us all as its first priority, then business must produce the best result for humans as the first requirement. They can make Reasonable money off the result. We the public do not need to be dominated by the few people with lots of money.

[@v2kguy]

They put me on Medicare. I have a deductible $240. I applied for help from human services.

[@callicordova4066]

Medicare Disadvantage.

[@user-TM59]

Right ,😀🤨