Medicare Advantage Plans Explained

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Medicare Advantage Plans Explained
Also see Medicare Advantage vs Medicare Supplement Plans • Medicare Advantage vs ...
Medicare Advantage Plans Explained What is Medicare Advantage?
If you’re researching Medicare and looking for a video to help you understand Medicare Advantage plans and if they are the right choice for you, this is the video you need to see. Stay tuned.
Hi, I’m Matthew Claassen with Medigap Seminars Insurance Agency. We are an independent insurance broker helping people with their Medicare and retirement needs from Hawaii to Virginia and Alaska down to the Florida Keys. We represent our client’s best interest, not that of an insurance company, and our services are free to you the consumer. All you need to do, is ask.
This video is different than other videos you may have seen on Medicare Advantage Plans. I am not going to simply describe a Medicare Advantage Plan. Rather, the intent of this video is to give you the information you need to decide for yourself if a Medicare Advantage plan is right for you.
Check out our video on Medicare supplement plans and insurance companies: • Medicare Supplement Pl...
Medicare Supplement Plan G • Medicare Supplement Pl...
Medicare Supplement Plan N • Medicare Supplement Pl...
If you want to limit you’re your financial risk, you can either purchase additional coverage via a Medicare supplement plan or replace your Original Medicare with a Privatized version of Medicare Part A and Part B managed by a private, for profit insurance company. That is a Medicare Advantage Plan.
Now, there are many different types of Medicare Advantage plans. But literally 98% of all Medicare Advantage plans are constructed as either an HMO or a PPO. In this video we will just be discussing HMOs and PPOs and not other types of Medicare Advantage plans.
To be clear, a Medicare Advantage Plan is not a Medicare supplement. It does not supplement your Original Medicare, it replaces it. You still must pay your Medicare Part B monthly premium to Medicare, but you are no longer using Original Medicare. You don’t use your red, white and blue Medicare card. The insurance company you choose for a Medicare Advantage plan will issue you their own insurance card for the plan you enrolled in.
As you may know Original Medicare has a lot of copays and deductibles. Each Medicare Advantage Plan has its own copays and deductibles and by law must be designed as an Actuarial Equivalent to Original Medicare. Actuarial Equivalent. It’s an interesting term. What exactly does it mean? It means that the average person on any Medicare Advantage plan must have roughly the same annual out-of-pocket expense as they would have if they had simply kept their Original Medicare Part A and Part B and NOT added a Medicare supplement.
Unlike a Medicare supplement, every Medicare Advantage plan is different. Each has different coverage, uses different doctors and hospitals and every Medicare Advantage plan can change its benefits and costs each calendar year. But, by law, they must remain an actuarial equivalent to Original Medicare.
However, as I mentioned earlier, Medicare Advantage plans have maximum limit on a policy holder’s annual financial risk, also called your maximum out-of-pocket expense.
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#MedicareAdvantagePlansExplained #MedicareAdvantage #MedigapSeminars #MedicareExplained #NewToMedicare #Medicare2022 #Medicaresupplements #MedicarePartC #Medicare

[@debrakettler6077]

Absolutely great KZbin video. My husband and I just spent an hour and a half with an insurance agent yesterday and all he wanted to talk about was an Aetna Medicare solutions plan at zero cost. I told my husband that there is something wrong with the situation ...if it’s too good to be true, it can’t be true. I have worked in skilled nursing home for the past 12 years in admissions and definitely have seen the outcomes to people having a Medicare replacement policy compared to traditional Medicare. My husband turns 65 this year and we have been trying to find the options for him. This video certainly gave me a better way to explain it to him. I knew that insurance agent yesterday was trying to add some money to his pocket. I’m sure he’s good at what he does, he had tons of awards all over his office. But as you stated, doing your homework is the best thing anyone can do. Thanks for your videos I will watch more.

[@donnakelley1202]

Thanks for helping me understand this. I have to admit I'm totally overwhelmed by all of the information out there. Your videos are clear and concise and I am grateful for the information you provided here. I need to watch all of your videos. Please keep them coming.

[@MedigapSeminars]

Thank you Donna. I will have more soon. In the meantime, I have licensed assistants here in the office that will be happy to help. 800-847-9680

[@nancydelathouwer9919]

I'm sure glad that I listened to you before my husband and I signed up for medicare. Our plan N supplement saved his life when he needed heart surgery. Mayo Clinic accepted it and we are so grateful. Thank you for the good advice. I had a feeling Advantage plans weren't a good idea, but they sound even worse than I imagined. How awful to have necessary care denied when it is most needed.

[@sheilakelly9116]

Absolutely excellent information. I worked with the Medicare and Medicare Advantage system as an RN for many years. I was aghast at the unscrupulous behavior of some HMOs particularly in the Southern CA area both in their lack of coverage as well as their marketing practices. I am glad that you are out there providing great clarity to these issues. Sheila, Retired RN

[@forgodsolovedyou]

I’ve never had one problem with my Advantage Plan. Sometimes the insurance company wanted a pre authorization. But I’ve never been turned down.

[@bbhihoney]

Yet. Key word missing.

[@Stongray67]

You will have problems 100%

[@rodolfositon8102]

@@Stongray67 n

[@ut561]

wow, what an eye opener about them denying health care. you are the 1st video that mentioned this, thanks so much. i'd give this 2 thumbs up if possible :)

[@atthrower01]

who is denying?--- medicare doesnt----- unless there is renal fail

[@leealexander3507]

All for profit health insurance makes their money by denying care when it's expensive and badly needed.

[@gauravipal9518]

@@atthrower01 The Medicare Advantage plan is a for profit plan that replaces Medicare. Medicare does not deny service but Medicare Advantage plans can and do deny service.

[@jerrygreene2154]

What a great explanation of Medicare Advantage plans. I am so tired of the commercials on this topic. They say what I want to hear instead of what I need to hear. Thanks so much for the information.

[@MedigapSeminars]

You are welcome. Some of those Medicare Advantage Plan commercials seem to push the boundary of honesty.

[@johngarnergarner6724]

Excellent stuff. I am a medicare agent in North Carolina and this mirrors exactly what I tell my customers. I've been doing this a long time and, as you can imagine, I've run into about everything you can think of. I remember a situation just a couple of years ago. I was working with a gentleman who was turning 65 and instead of buying a supplement from me he went with medicare advantage. He gets cancer ----and I think he was diagnosed at the end of September--- hits his out of pocket limits and then the clock re-sets in January. He calls me and I have to inform him that he can no longer get a supplement. The most difficult client I have is the person who says to me, " I don't get sick, I never get sick." Well, the answer is simple. You don't get sick until you get sick

[@MedigapSeminars]

Re: "The most difficult client I have is the person who says to me, " I don't get sick, I never get sick." Well, the answer is simple. You don't get sick until you get sick" EXACTLY This is why I tell people to get the insurance plan they will want to have when they are seriously sick or injured, not based on their health today. Thanks for your input John.

[@hcadambi1]

I have type 2 diabetes. Live in Madison Wisconsin. They are r3fusing to accept me for medigap since I am on insulin (long acting insulin). Then how can I get affordable medigap?. I like all the advantages of medigap but I feel out of luck unless you can provide remedial plan. Currently in 5 star Medicare Advantage plan which seem to coincide with your opinions in this context. I making every effort to keep A1c levels and stay healthy

[@johngarnergarner6724]

@@hcadambi1 Hello Harry, happy thanksgiving from the Tarheel state. Just read your comments. Couple of things: As I mentioned, I am in the medicare insurance business and have been for many years. I'm also about to turn 65 so I'm right therewith you. Typically, when someone buys a medicare supplement----and they are past their initial turning 65 period, they must qualify for the supplement through underwriting. I represent ten different insurance companies and they all ask pretty much the same health questions. For instance, if an applicant has diabetes and is taking more than 50 units of insulin a day, that typically would exclude them from purchasing a supplement. Other things would be breathing issues such as COPD, cancer, etc. Regarding medicare advantage, I'd say that if you go that route they are not all created equal. So go with the largest providers. Blue cross for example. They tend to have the largest and most extensive networks and in general you'll have less trouble getting the coverage you need. And while as an agent I clearly prefer the supplements, I certainly admit that you're paying more for them. Yet there are some nice things about the advantage plans beyond the premiums, like, for example dental coverage, small co-pays for Dr. visits. One of the things that I recommend for people on medicare advantage is that they consider a hospital indemnity policy. They tend to be inexpensive and would protect you from some of the high out of pocket costs from medicare advantage should you get sick. That's something you might ask your agent about

[@shelley2861955]

You have saved me hours of research and decision making trying to understand the medicare advantage plans. I have been overwhelmed with the amount of mail and calls and couldn't understand the FREE premiums. I have a friend in a doctors office who told me, stick with medicare and now I'm sure that is what I'm going to do.

[@Stratneck]

Wish I had all this information 2 months ago before I switched to an Medicare Advantage plan. I’m trying to get back to independent Medicare again !!!…I hope I can 🤞 !!! Thank You for this eye opening video 👏👏👏 !!!

[@MedigapSeminars]

You may be eligible for a trial right to get your supplement back as a Guarantee Issue. you can certainly use the Medicare Open enrollment (Jan 01- march 31) to get back to Original Medicare and apply for a supplement. Go here: medigapseminars.org/resources/ Check out the second Trial right listed on page 23 of the 2021 Guide To choosing a Medigap Policy".

[@tylertaylor9855]

I leaned more about advantage plans from this than 4 years of pharmacy school and 10 years of working in a pharmacy.

[@MedigapSeminars]

Thank you Tyler. I'll bet you'll like my Part D videos too! #Medigapseminars

[@mingziquan4799]

@@MedigapSeminars 1qqqqqq

[@emilystevens6335]

yes he is better than the other speakers

[@TK-cl1jm]

LOL, completely different industry.

[@gwingatetx]

I've watched several of Matt's videos and became very knowledgable very fast. I ended up doing a Plan N and Part D with a total out of pocket of $287/month including the Part B premium, plus the $198 annual deductible and $36 in annual drug cost. This was my last video to understand why I do NOT want an Advantage plan. I do not want my insurance company involved in what they will pay for and who I will go to any more!

[@denisd.budnik7803]

Great video on Medicare Advantage Plan... thank you Matthew. I fall into the poverty level, were the Advantage plan is really my only choice... I'm a Medi Medi. I'm a Multiple Sclerosis patient, at the time I was an undiagnosed MS patient and had Scan a HMO Advantage Plan. SCAN continually denied a referral to see a Neurologist, I was walking with a cane at the time. I can no longer walk, and have to use a powerchair. Had Scan allowed me to see a Neurologist, chances are I'd still be walking as I'd have scene treatment for my MS. I switched Advantage plans and was allowed to see a Neurologist who diagnosed me with MS. I'm now on Anthem Blue Cross an HMO Advantage plan. I cannot say enough good things about Anthem. They have never once denied a referral -- unlike SCAN, I call them "SCAM."

[@maydawson2843]

I have been on Medicare for 16 years I have learned more in the last hour than the 16 prior years. Thank you for these videos

[@maurylee5239]

Nice to find an honest broker. How refreshing to get an honest opinion. I wondered why I get so many mailings trying to get me to switch to an Advantage plan. Easy to see that if they can deny coverage at some clerk's whim, it really IS an ADVANTAGE to the insurance companies.

[@MedigapSeminars]

Bullseye!

[@yolandaharold2792]

Wow! This video is a MUST SEE for anyone who is confused about the Medicare advantage plans vs Medicare supplement. While I am not of Medicare age my parents(who are 83 soon to be 84 and 88 soon to be 89) are and will be moving from California where they had SCAN to northern Virginia to be near me so I have the responsibility of trying to help them figure out health care for them when they move here. It was driving me crazy trying to figure out Medicare advantage plans and you’re right insurance agents are definitely not pushing for supplement plans. I will definitely be checking out more of your videos, your website, and hopefully also be able to speak to someone. Thank you so much for this.

[@MedigapSeminars]

Thank you for your comments. We are here if you need us. 800-847-9680

[@barbaram5787]

Wow, I had already decided against an Advantage plan because of one of your prior videos I watched but this video reinforces that decision even more. I'll be sharing your videos and information.

[@steverosengren1492]

This guy/company is amazing. He and his videos guided me through the enrollment process last year. I made a great decision with his help! Matt, I’ll be calling you again in a year or so for help in getting my wife enrolled. Thanks for being you!

[@MedigapSeminars]

Thank you Steve!

[@debrafollmer6129]

Definitely worth the time to watch this video! With the benefit my husband has had with his supplemental insurance, watching this video scared me right out of the idea of considering a Medicare advantage policy! I’ve seen the “advantage” of choosing a supplemental insurance policy! Thank you for making it perfectly clear!

[@Remember_when]

The advantage plan sounds exactly like the insurance we have already through my husband's work. United Health Care PPO. Any time I need a procedure we have to get approval first. Never been denied so far and it's approved in a day or two. If we were to get the wrong advantage plan that might change.

[@auntielsllc5606]

Thank you for the information. I was so confused and overwhelmed. With the clarification you provide, I feel many people will benefit. Thank you!

[@MedigapSeminars]

you are very welcome.

[@alicehardy1668]

Thank you. Very well explained and easy to understand. I keep receiving 5-6 solicitations each day trying to sell me more insurance with premiums "sometimes as low as $0.00!". I may be old and disabled, but I still maintain a healthy skepticism when someone offers me "much better coverage, including dental and vision" for "sometimes as low as $0.00!" Thanks again!

[@chrissmith7078]

Thank you for a very clear video on the Medicare Advantage plans. I will stick with my supplementals now that I understand this Medicare situation better.

[@door2416]

THE BEST EXPLANATION OUT THERE. I went with Matthew last year and am so glad I found this video. I went with original medicare and a supplement (N) and added a part D drug plan. My supplement is $95 per month and my drug plan is 11.00. I think the insurance companies rely on the uninformed to sell their advantage plans to.

[@christinerhiner7318]

Too bad many Seniors will never learn to use KZbin. So informative! Thank you.

[@MrGlendale111]

I was able to keep my BC/BS from my employer when I retired. When combined with Medicare I don't seem to have any Medical Bills any longer. I still have a copay for prescriptions thru the BC but usually not much. I'm thankful I get to keep my employer Health plan. For those that have the Advantage or Supplement Plans. It must be a chore picking the right one for your needs.

[@MedigapSeminars]

You seem to think you have something better than a supplement. That is not correct. Your current BC/BS Plan is acting as a secondary insurance to Medicare. It's not as good as a supplement and is probably much more expensive. You will find its weaknesses when you need it. Medicare supplement benefits never change and are not limited to a network. Medicare supplement holders do not have shop their plan every year. That's Medicare Advantage. But, the do get to choose whichever Part D prescription drug plan is the lowest cost to them each year. Unlike your BC/BS, their prescription plan is not linked to their healthcare and can be managed seperately.

[@karenpeters2433]

My husband got his insurance through your agency last year, and you’ve been great. Got the plan F-HD and an annuity. I would definitely recommend that combination to anybody looking to save money on their insurance plan.

[@MedigapSeminars]

Hi Karen. I am so glad you like your coverage. The FHD with annuity savings account are a great combination. The Plan F-HD is a great value in states that mandate all policies be issued as either Community Rated or Issue Age, like Florida, CT, NY, Washington State and others.

[@boatman222345]

If they gave Nobel Prizes in explaining Medicare insurance options I'd nominate you for one! This and other of your videos are simply far and away the best I've seen in terms of explaining the lambrinth complexities of Medicare insurance. Despite having spent a lifetime researching a wide variety of highly complex technical matters I found choosing a Medicare insurance plan a bewildering experience. After many days of research I eventually sought guidance from a local Medicare volunteer group. Imagine how I felt when 10 minutes into my session the adviser told me that I obviously knew more about Medicare options than he did. Eventually I turned to a local insurance broker who talked me into selecting a Medicare Advantage plan. I suspected at the time that he was motivated more by his commission than by my best interests and after watching your video I now understand why. Sadly as I have suffered from Type 1 diabetes, rheumatoid arthritis, and other chronic illnesses for 50 years it looks to me like I am headed to disaster as more serious medical consequences of those diseases appear. Is there anyway I can switch to traditional Medicare at this point in time after being on Medicare Advantage for more than 10 years?

[@MedigapSeminars]

thank you

[@almitraprice6248]

I recommend your channel to all my new Medicare eligible patients. Thank you

[@hometips4women45]

Appreciate you confirming that I got ripped off by insurance agent who just wanted to make more money off the advantage plan ...

[@MedigapSeminars]

Sorry to hear that. If we can help in any way, please reach out to us. If you wish to get out of a Medicare Advantage Plan and go to Original Medicare (and apply for a supplement) you can do so from Jan 01 through March 31 of each year. 800-847-9680

[@sharonb.campbell2934]

I need to switch back to original medicare plus a supplement! I can't believe I switched to an advantage plan!

[@MedigapSeminars]

We will help. Thank you for calling today.

[@HandmadeByLinanne]

I hear you, Advantage plans are the worst IMHO!

[@brendavartenisiand.6393]

Thank you sir and all the rest of you for your input. Each year my Original Medicare increases in premiums and/or deductibles while paying less for services. My separately paid prescription plan, putting it plainly, is nothing but a joke and as we all know, prescription prices have skyrocketed! Greed has reached its highest levels in today’s world. 😞 I intended on changing plans this year in hopes of taking care of my swiftly declining health, which includes a life threatening untreated lung disease that has now entered a more advanced stage, but I’m completely at a loss as to which plan is best and affordable for me. I must say that I’m feeling completely defeated at this point and My life is certainly looking much shorter. God bless you all🙏🏻

[@oveidasinclair982]

Look at United American and their High Deductible plan G, a lot of agents will not talk to clients about them because the commissions are low. Don't let the words high deductible scare you, get your head wrapped around the plan details and you'll see that you can't beat it with a rubber stick.

[@crochetnut1114]

While my state is under a “Stay at Home” order due to COVID-19, I have had plenty of time to do my homework and devour any information I can find between original Medicare and Medicare advantage plans. My cousin found one of your videos and sent it to me. I have watched three or four in a row and I am continuing to watch more. Thank you for speaking so clearly and making everything understandable. At this point I think I know which Choice to make. Although it is pleasant not to be interrupted by commercials while watching your KZbin videos, you might consider monetization because you definitely deserve it!

[@shandraloggins5468]

Fascinating, thank you for speaking so clearly to us.

[@williamevans7882]

I thank you so very much for taking the time to help me understand the complex turns found in Medicare for Seniors.! I am 82 years old and needed THIS ! God Bless you !!! Look me up in HEAVEN!!!!!

[@bethnewton7964]

Thank you. I never fully understood Medicare Advantage. I do now -- and know that I don't want it! Also, "Breaking Bad" is the best show that has EVER been made. :) And yes, I do understand your analogy.

[@MedigapSeminars]

Thanks Lizzy! 😃

[@sharonadcock5041]

I’ve been on a blue advantage plan since 2016, (disability) I turned 65 oct and changed filled form out for bcbs supplemental plan and was excepted, (without health ?) however even after requesting blue advantage with bcbs say that I want be switched back to original Medicare until jan1,2022 I’m showing to have both PFFS advantage plan and plan g supplemental plan both active My agent says they have to disenroll me in advantage plan for original Medicare to kick in with my supplemental plan? No one seems to know I have two insurance cards that are both active but can’t get an understanding of why I’m not back on original Medicare? Can you give me some insight please? Thanks

[@marilynp.abellanosa5367]

I would like to use this company to help me with all confusing Medicare…I’m 2 months away to become 65 years old. Thank you 🙏

[@MedigapSeminars]

That would be wonderful Marilyn. If you use this form to provide me the information I need in order to help you, we can schedule a call. medigapseminars.org/quotes/medigap-quote-request/

[@janicefoundas9163]

This is the best video on choices for medicare and advantage plans. Hes right on about Advantage plans just think about how many times your regular ins denied a request for DME or medication when u were working!

[@esc447]

My husband is a state retired employee and enrolled in medicare advantage PPO plan. He was turned down by one doctor because they only accept original medicare. It was a blessing because he found a better and compassionate doctor that listens to his patient. Never had a problem with any procedure etc. He was in Israel and had to go to the emergency department. The whole ED treatment, meds, doctors have been paid by the PPO insurance. It took 2 months but they paid it all. Thank you for your information. I will keep your information in mind when it is my turn to apply for medicare.

[@peterbarnes7118]

I was interested in going to an advantage plan until I saw this video, thank you. Oh and I see my provider is charging me $127 instead of the listed $119, now I know why thanks to another video of yours that I watched! Thanks,Pete

[@MedigapSeminars]

Amazing what happens when you have all the facts :-) If yu would like my recommendations feel free to call us 800-847-9680 or request information by email medigapseminars.org/medicare-supplement-specialist-independent-medicare-insurance-broker/m-quote-request/

[@ruthpettis8800]

This is the best explanation I have found for the pitfalls of the Advantage plans. The examples of problems individuals had encountered helped me understand the problems one can encounter with Advantage. I've been searching to understand better the differences, and this video confirmed my concerns. Thanks so very much!

[@r.k.bansal1458]

Thanks for this educational video. There is one other big problem with both Medicare Adv HMO and PPO plans, If you are ever in a hospital even for a day, you get several bills from different service providers. While the hospital may be in your HMO or PPO plan, many of those service providers are not. Obviously, the insurance company will insist that you pay their bills in full. This actually had happened to me. I live in Texas and wrote to the Texas Department of Insurance and their advise was that I should try to negotiate with service providers. When I was in the hospital, I had no way to know or control who operated on me. But I was stuck with thousands dollars worth of bills.

[@MedigapSeminars]

Thank you for sharing this. You're right, of course, and I should have mentioned it. This cannot happen with Original Medicare and a supplement

[@vintagechild4418]

This is absolutely correct which I did not know, as a nurse past retirement age and working 3 days a week, I write the letters of necessity for my patients with MS. I am always busy, I consider them the “ death Squads” . Yes they have final say and yes even with appeal they can say no.

[@abishop5628]

Thanks for the terrific info. After hours of research on a Advantage plan I decided to stay with my supplement company and Medicare. I never had a problem with the supplement paying for any service. I was just trying to keep the monthly premium down.

[@G.G.8GG]

You cant imagine how deeply I appreciate this frank and factual look at advantage plans. My sister was in one. Low premiums but a two day stay in hospital just to check out some issues cost her many thousands. I don't have many thousands so this is vital to know. I'll be calling you soon.

[@MedigapSeminars]

Thank you for your comment Esther.

[@riceski]

Paid for reply I bet

[@MedigapSeminars]

@@riceski I feel sorry for you Gary if you think that a person can't say something nice without being paid. Esther is not paid to make that comment and, for what it is worth, I have not yet heard from her. If you were just a little observant you would note that I have many comments like that in most all of my videos. You would also notice that more people comment and like my videos than any other KZbin channel. Maybe I just explain things better than others.

[@spmartinez79]

I work in the medical field, very good explanation. Thank you.

[@w9fcc]

Excellent! The analogy from “Breaking Bad” was very good and a good example. My local hospital is pushing their HMO Advantage plan in mailers and TV advertising. A rule of the thumb I’ve adopted is: If a company is spending millions on advertising for something, you can bet it’s not to your “advantage”, but their profit.

[@Mary-vk1go]

Very True

[@jamesthompson3336]

All I can say is thank you for this message.

[@timsatterfield9752]

I am a new independent agent, and this was extremely helpful to me!! I will now be able to inform my clients so much better!!!

[@rgkeen7315]

This has been the best explanation of Medicare Advantage. Thank you!

[@MedigapSeminars]

You are welcome. #MedigapSeminars < Click here to see my other videos

[@davidyoung6331]

Keep in mind that under a Medicare Advantage plan, you have a choice of primary physician. But you don't have a choice for radiology (x rays / scans) nor do you have a choice for lab companies to get labs done. In our community, it takes 5 week to get a CT scan done, if you have a medicare advantage play. For straight Medicare, it takes just a week. The insurers for the medicare advantage plan contract with the radiology group under a "capitation" agreement. This means that the radiology department gets paid the same (pre-arranged) amount of money every month. It does not matter how many scans they do in that month, they get paid the same total amount. There is no incentive to do more scans. And therefore they limit the number of scans done and this puts off scheduled appointments for 5 or 6 weeks. These insures also contract with only one subspecialty group. So your gastroenterologist may do endoscopies all day but have no interest in figuring out why your liver is inflamed. Go to another gastroenterologist? Nope. The contract is just with that one gastroenterologist. All of your lab tests must be done at one laboratory (typically a very large company where all the lab tests are run at one distant location.). There are a few labs that require that the test be done within a few hours of the blood draw and therefore must be done at a local hospital. Good luck getting these done. And I can't begin to tell you how terrible it is if the insurances pay oncologist by capitation for the costs of chemotherapy. My advice is to stay away from Medicare Advantage plans.

[@piaquadio1]

I wish someone had explained all this to me when I turned 65. I was immediately pushed into an Advantage plan because at that time I couldn't afford a Supplemental plan.

[@christinerhiner7318]

An advantage plan is cheaper than supplemental Medicare plans?

[@piaquadio1]

@@christinerhiner7318 Yes--Advantage plans are cheaper, but as the video said, they come with hefty co-pays if you are hospitalized. A $6900 co-pay would throw me into bankruptcy. Also, as was mentioned, insurance companies can decide which test you can have and which you can't. This doesn't happen on a Supplemental plan. For these reasons, I'm going to bite the bullet and pay the monthly fee and have only a $185 co-pay per year plus all other expenses paid for.

[@commonsense7803]

@@christinerhiner7318 Yes, but each Advantage plan is different, and if you're healthy and on no drugs, you'll save a bundle with most Advantage plans. I like mine, have had it for 3 years now, and I've had no problems. Maximum MOOP is only $3,500 or so, and most docs in my area accept my plan. But like the video states, number of stars an Advantage Plan has is VERY important. I wouldn't go with less than 4 or 4 and a half.

[@KarlaJoblin-ez8id]

Thank you so much for this information. I have watched many of these videos. Some of the others mention that some agents recommend MA plans because of the higher commissions, but you are the ONLY one who told us how much higher they are and that MA commissions are 2 to 5 times higher and increase each year and last for as long as the client keeps the plan. That should be illegal. It almost ensures that most agents will push the MA plans even though they are rarely in the best interests of the client. Greed is a powerful motivator and I would imagine that most agents can't resist that temptation. Thank you for putting the best interests of your clients above your financial gain. God bless you (and the few other agents who do this)!

[@joycem8490]

I and my friends are using Medicare advantage plan but We do not belong to those four groups that you mentioned in your video.

[@MedigapSeminars]

Every rule has its exceptions :-)

[@JP-gv9sb]

Fantastic! Don’t even think about choosing a Medicare plan without first watching this video.

[@richardbrunelle4305]

Great videos! There is so much detail missing in the promotional material we are given and expected to make an "informed" decision. Thank you for making these details available.

[@teripittam6640]

I’m so happy I’ve been watching your videos. You make it easier to understand this complicated information. I made the right choice for me, and that wouldn’t have happened if I hadn’t watched these videos!!! Thank you

[@Roscoe_B]

Caught me off guard with the Breaking Bad analogy...spot on. Thanks for a great presentation !

[@MedigapSeminars]

Thanks SunKing. I am glad to see that people get it. It was a great show too!

[@sdbpost]

Very useful. I decided early on that I'd probably not get an Advantage plan but watched to the end anyway. It's clear to me, at least, that the Advantage plans must have been entirely initiated by insurance companies wanting to boost profit margins, and probably allowed by regulators and elected officials in their pockets. Thanks but no thanks!

[@cindychurch925]

Very informative and well presented! You present the information in a very easy way to understand, process and compare the different options. You have a knack for modulating your voice and cadence. Helps to follow what you are saying! New subscriber. Looking forward to watching the other videos. I work as a registrar at a hospital in the ER. So many patients have no understanding of the different options available to them. Thanks again. Oh. I didn't watch Breaking Bad but think the analogy was a good one

[@MedigapSeminars]

Thank you Cindy. That is a very nice comment and I appreciate it.

[@Sparkernp]

I'm turning 65 in 2020 and have been exploring my MC options. Thank you for convincing me that I want a supplemental plan, not an advantage plan! Also, I thought your "Breaking Bad" analogy was a good one. Loved that show!

[@stellabella8224]

Thank you for great information. This is what seniors really need to make good choices.

[@MedigapSeminars]

You are welcome Stella

[@barbaraatkins3008]

Yes I seen that show and remember also movie with Denzel Washington kid needed surgery HMO denied

[@scentofthesun6672]

Excellent! I am so happy I was given this information when I needed to make this decision.

[@MedigapSeminars]

Glad to have helped!

[@07sadie25]

Thank you for this very informative video. I have done a lot of research on Medicare. I have really wondered why the Government is pushing so hard for people to join the Advantage plans. Now I get it. I almost fell for this, this year. " Possible no monthly premiums and no copays or deductibles " the ads are yelling at us. I thought how can this be? Now I get it, just don't cover anything !!

[@grammytina373]

Thank you, now I'll watch your video on the supplemental programs.😊

[@kazukoono7220]

We have a AARP Medicare UnitedHealthCare Advantage Plan and the most difficulties is getting someone who is trained. Every phone call was extremely long and never resolved.

[@bryanmason850]

You did a great job. Loved Breaking Bad. I am an accountant and also licensed in Life and Health. However, I do not offer any Medicare Preferred Plan. Several companies are requesting that I take the AHIP test and offer plans through them. I am still on the fence and don't know if I need to go down that path. My goal is to take care of my clients and do what is right for them. I wrote my Master Theses on the Great American Fraud called Life Insurance. The medical insurance field seems to be the same. Thanks for your information.

[@charlesrichardson8635]

Thanks for the numbers for insurers rejecting necessary medical procedures! WOW! Your two major points are succinct and clear!

[@MedigapSeminars]

Thank you Charles. It's frightening that these facts are skipped over when other agents present Medicare Advantage to their potential customers.

[@bposkier51]

This is all new to me due to the fact that I'm still working and have a good private insurance plan. So I need to get serious about my knowledge to move into full Medicare coverage based on wise decisions, great video BTW. I retire soon and have an exception that I can delay using medicare for now without incurring (form 1095-B) a higher cost later. My research continues. Thanks for your work, great job Matt!!

[@roxanneholt-abernathy3698]

This has been so very helpful for me to understand the Medicare nightmare confusion. Now I'm able to make a good decision in my Medicare.

[@MedigapSeminars]

I am glad my videos have helped.

[@reedsawyer5704]

Matthew, thank you for these videos. I am studying for my insurance certification, and these videos are invaluable. Great job!

[@leealexander3507]

I shared this to Facebook where my friends are family nearing Medicare age will see it and make an informed decision. Thank you for helping people to be able to do that.

[@MedigapSeminars]

Thank you Lee. Have you seen my latest that compares Medicare Advantage Plans to Medicare Supplements? kzbin.info/www/bejne/rqiadpx-Ypqcn80

[@John-ys7zz]

I am glad I found you. I was about ready to sign up for an advantage plan. Thanks for this information.

[@MedigapSeminars]

You are welcome John. I hope you let us compete for your business: medigapseminars.org/medicare-supplement-specialist-independent-medicare-insurance-broker/m-quote-request/

[@1shakasean]

I am newly Health licensed in the state of Florida. I am thankful and impressed with your videos. I was focused on MA-PD plans and you have opened my eyes. I will learn about Medical Supplement plans and make sure my priority is to introduce this first, if it does not meet their needs, then help them make an informed decision with Medicare Advantage plans.

[@spectator1123]

This is a very clear and concise explanation of Medicare Advantage Plans. I hope you have the same videos on Medicare Supplement Plans and the MOOP vs. Original Medicare. Does one need a stand-alone PART D for Original Medicare? Thanks for the informative video. I didn't realize the decision making part of these Advantage plans until now.

[@MedigapSeminars]

Hi, actually I do have a video on exactly what you are describing. I have shot the video and it is in editing now. I expect it to be published by the weekend. Ir will be titled "Medicare Supplement Plans Explained".

[@foreverfree56]

Yes, I watched that program, but I didn't catch the theme of his dilemma until you brought this up. My current employment insurance is an HMO/PPO type of deal. I always wondered why my insurance would not cover certain medications, and treatments. I certainly do not want this kind of neglect in my retirement years. I choose choice. the only thing now is to find a supplement I can afford. thank you for your clear information.

[@49oldmachinist43]

i learned more on this one video than all the years since I've retired, thank you, I now have all my medical in the VA system, that do you think about the VA system?

[@MedigapSeminars]

Hi OldMachinist, If you had enough service to qualify for TrciCareforLife, that would be ideal. With the VA there can be some issues. Many Veterans will get a high deductible Medigap plan so that if they want to seek care outside of the VA they can with limited financial risk. I have a video on F-HD. The premiums are very, very minimal.

[@erinpeacexo1854]

@@MedigapSeminars Hi. My husband is covered with the VA system as well. Everything is covered as long as you go to VA doctors and hospitals. Drugs are covered as well. He recently enrolled in medicare but does he need to get anything else? What is TrciCarefor Life?

[@haroldrosenthal8572]

Thank you. I did not know about the 3 month open enrollment if you find your plan inadequate. That was very helpful.

[@reopat14]

The Best video I have ever seen on Advantage Plans. They are being pushed with maybe dental, eye care But .......

[@MedigapSeminars]

Thank you for kind words Raymond

[@cesarebeccaria7641]

Best information ever. Should be required watching for anyone getting near 65. One point you raised make me wonder about my Plan G insurance company. Companies new to Medicare or spinoffs of an old company may be a risk. United World Life Insurance Company is advertised as a subsidiary (or affiliate?) of Mutual of Omaha. Indeed their letterhead has Mutual of Omaha and its logo in bold type and United World Life in smaller print. My third year with this company is coming up. Should I be looking elsewhere or just reevaluating my coverage? Your Advantage video convinced me to stay away from that scheme.

[@MedigapSeminars]

Cesare It doesn't hurt to reshop your plan, especially when you reach your young 70s. The best priced plan when you are 65 is seldom the best priced plan when you are 72 +. Yes, Mutual of Omaha seems to play a shell game with its many subsidiaries. It's a good company, but you need to be aware of what can happen.

[@fourftr]

I just subscribed and thanks for looking out for us The advantaged plans, you have scared the poop out of me

[@MedigapSeminars]

I didn't mean to scare people. But I do believe everyone has a right to be fully informed about their healthcare, so that they make the right choice for their specific situation. As it stands right now, the Kaiser Family Foundation is suing CMS (Medicare) to get them to release audit results that show the amount of abuse these plans have been found to do on a regular basis. This includes over billing the government (our $) for literally $Billions. So, no sugar coating from me.

[@100perdido]

I had a supplement plan and was sold an advantage plan, then developed a heart condition and now can't get my supplement back. I was put on a waiting list for 6 months to see the cardiac specialist I needed. Be careful and do not give up your supplement plan if you can afford to keep it.

[@MedigapSeminars]

Words of wisdom, thank you

[@sussanalee430]

Don't know about yours, but mine, a govt plan Blue cross blue shield, strongly suggested "suspending" DO NOT CANCEL my (retiree) supp plan. Go try the MAPD and come back to original supplement by simply unsuspending. I received the same mail from OPM Office of Personnel MGMT. Another fact I discovered that I could kick myself - as long as I have a plan equal or better than Parts ABCDEFGIMANUT I never need to enroll in part B. Like a fool, I did after 6 yrs of retirement, enrolled in part B, now paying extra $135.60 to my supp of $160 for 2-4 visits a year. I also lost freedom of choice. I can't see my chiropractor anymore under Part B! What if I quit Part B forever? Right now, Parts A&B + Fepblue = $0 MOOP, $0 copays, $0 emergency, $0 everything, I think.

[@MedigapSeminars]

@@sussanalee430 Those government plans are more like a Medicare Advantage Plan; the insurance company controls your healthcare, benefits change every year and costs rise. Of course they want you to "suspend" . They make a lot of money off you and don't want to lose you as a source of income. Also, there are Federal Gov plans that are not creditable coverage for Part B. You don't enroll in Part B and when you finally figure out you would be better off with a supplement you face a huge penalty.

[@KS-xb3cg]

Helping my parents understand the options. Thanks!

[@D__Lee]

Thanks! You saved me from making a big mistake. I started watching one of your videos daily and they have made me an informed consumer.

[@MedigapSeminars]

Great. I hope you give us the opportunity to compete for your business. 800-847-9680

[@stevemay1647]

I want my doctor to decide what I need for my best health, not a greedy Insurance company. I also may want to travel some before I die and want to be covered wherever I am. I was considering an advantage plan because of the advertised perks like dental coverage, so thank you for explaining why I don't want to do that.

[@MedigapSeminars]

You are very welcome Steve

[@debbiecarlson3394]

I'm so happy I found your videos. This month I'm supposed to decide on all this as I turn 65 in April.

[@MedigapSeminars]

I am glad you found them too. Please call us at 800-847-9680 for our personalized recommendations. Our services are free to the consumer.

[@debbiecarlson3394]

@@MedigapSeminars even at this time of night?

[@MedigapSeminars]

@@debbiecarlson3394 9 am to 6pm eastern :-)

[@jessiejohnson742]

Thank you so much. I was getting ready to change to advantage, because my medigap has priced me out. I can't pay it anymore. So now I think I will keep my medicare A and B along with my drug .........and forget the the rest.

[@MedigapSeminars]

If you are with the wrong insurance company, price increases can be brutal. That's what we help prevent. Feel free to contact us if you want to see more price stable companies. medigapseminars.org/contact-us/

[@mariofuentes4090]

You are simply a phenomenal person for providing the explanations the way you do, sincerely, thank you.

[@MedigapSeminars]

You are welcome

[@regina5818]

Thank you I’m finding out about this the hard way

[@firedmyboss]

Very informative.... at 67, I am blessed with good health. Like so many of the rest of the general working public, all I have ever known was company medical insurance, or the exorbitant cost of COBRA when ever there was a change or termination. There is much more that I need to learn, know, and understand.

[@TheFelishadavis]

Yes, I can relate to the Breaking Bad series, I absolutely love it.

[@MedigapSeminars]

Thank you for commenting Felisa. Feel free to reach out if we can help answer other questions or provide recommendations. 800-847-9680

[@joemagryan]

Thank you Matthew for sharing the truth about Medicare Advantage (DisAdvantage) I can only add from my wife's illness we went through 4 months of Delay, Deny, and ultimately Death . Keep spreading the word to counter all these TV ads pushing Advantage policies

[@freethot333]

Thank you Matthew! :) Extremely informative and clear. I'll be watching many more of your clear and honest presentations, That's for certain! :) I'm 71 and currently in good health, but cataracts are beginning to be an issue and I'm interested in finding out what would be the best plan to cover that. I'm currently on UPMC for Life simply because the premiums were pretty low and they include YMCA membership.. probably NOT the smartest reason to choose a plan, huh? :/

[@mnizet1]

Under what circumstances would you recommend a m.a. plan to a post kidney transplant patient?

[@teetrav]

A far as breaking bad, I used to have a market place insurance and I needed 20 physical therapy sessions, but the insurance company only approved 4. I totally understand the Breaking Bad example.

[@MedigapSeminars]

That is very common with Medicare Advantage plans as well.

[@gregorypreston4500]

Great info in a confusing minefield of costs for seniors that need as much help as they can get. Thank you.

[@MedigapSeminars]

You are welcome Gregory. If you haven't already, please subscribe so you can see my other Medicare videos (40+)

[@isaavedra3267]

This video was extremely helpful. My family has a senior over 65 and another who will turn 65 in February 2020. The older senior is enrolled in Part C supplement and Part D. Thanks to this video I learned that each of them will have to be managed differently and more likely at different costs. I will continue to watch the other videos in the coming day, but this was a great start.

[@MedigapSeminars]

FYI If a person is healthy enough to qualify, you can move out of a Medicare Advantage Plan and back to original Medicare from January 01 through March 31 of each year. Please reach out to my office for details if you wish.

[@george3737]

I am a retired Actuary FSA, became very concerned about my Medicare Complete PPO. I am at a higher income level and have to pay the Obama surcharges on my Medicare regardless of being in Medicare Supplement or Medicare Advantage, the surcharges being twice as expensive as for Plan F. I thought Medicare Complete PPO was better than original Medicare but realized the Devil was in the Insurance company options to deny benefits. The so-called extra benefits are cheap give away benefits and not material to the value of the insurance.

[@nbigroup-2690]

if your are in network.. insurance companies arent going to deny anyone

[@nbigroup-2690]

being in network is easy to figure out... if it as an emergency..or accident. you will NOT be denied. lots of misinfo out there

[@george3737]

@@nbigroup-2690 The Commissions are higher in Dollars for selling a Free product than a Supplement. Insured gets a narrow network of providers and a more restrictive pre-approval of procedures than Medicare even in the narrow network. There is a myth that Medicare Agents are not motivated by money, but only the insureds welfare.

[@douglasjensen8986]

Very well done, even though I think I was already well-informed. I have an Advantage HMO plan with a company that get 5* every year, and I have been very satisfied. There are several very large multi-hospital/health care groups where I live, all accepting all HMO and PPO advantage plans, and I have never been denied any care in about 15 years. My plan is fairly expensive by my income level, but for my case it is extremely cost-effective, my treatment and drug OOP costs plus premiums are a very small percentage of the "list" prices. However, this upcoming re-enrollment period, I think I will look into Supplement plans to stay up to date. I have subscribed to your channel.

[@MedigapSeminars]

Hi Douglas - thank you for commenting. It's not that all Advantage plans are bad all the time. They are not. It's just that as when you give a for profit entity control of your health care decisions, you are rolling the dice. They can have a change in management, change in ownership, change of doctors ...many things that you have no control of. For me personally, I find that scary.

[@janicecentrello1555]

Can’t thank you enough for this video. Yes it has made up my mind for me.

[@petesheppard1709]

Thank you. My 65th is in January, and my ignorance is nearly total. I'm binge-watching videos, and your's are very helpful!