Medicare Lies - Part 1

[@MedigapSeminars]

New Printable 2024 Medicare Rates & IRMAA: medigapseminars.org/wp-content/uploads/2023/10/2024-Part-APart-B-IRMAA.pdf What topic would you like to see covered?

[@jdenino6022]

I would like to know the cost of an average Medigap plan for a man about to turn 65 along with how much the cost for a drug plan for a 65 year old man because the prices on the Medicare.gov site are very high when I looked into the prices. Some of them were $500 a month....is that normal for a Medicare supplement plan? Not too many people can afford the Part B premium plus another $300 - $500 a month.

[@skykitchen867]

While working, I paid outrageous monthly costs to Anthem Blue Cross just to get benefits. Then the yearly premium increases practically broke me. Then it was a high deductible, co pays, having to get a mother may I for a procedure. Couldn't see all doctors. When I retired, wasn't going to go through all that crap and selected original medicare and a supplemental with my prescription coverage all through AARP. Couldn't be happier! My dental and eye coverage is covered by my retiree plan from my employer. No fuss no muss, if the doctor accepts medicare assignment you are on your way. No mother may I's to go through. Low deductible. No wait for approval process. Gives me peace of mind of any surprises from these money hungry insurance companies. To each is own. Great video thank you for posting.

[@MedigapSeminars]

98% of doctors that accept Medicare accept Medicare assignment. Glad you made a good choice with a supplement.😃

[@tomschmidt381]

I'm old enough to remember when Medicare Advantage plans first came out they were called Medicare Risk, because the government transferred risk to private insurance and it was supposed to save money. One thing I think important when contemplating the differences between traditional Medicare and Advantage plans is how can the insurance companies afford expensive TV marketing, direct mail and make a profit while having folks pay lower premiums than a Medicare Supplement? There are too many moving parts to the US healthcare system and folks need to invest an inordinate amount of effort the make the best choice and making a mistake can be devastating to family finances.

[@MedigapSeminars]

I agree.

[@sandralybrand9425]

I caught part of a Senate hearing on Medicare and Medicare Advantage plans. I found out that the government gives the companies that sell Advantage plans get $12000 a year from the government per person in those plans! It also brought out how they deny medical care that Medicare would pay for!

[@wendykay3195]

I am an agent that sells both advantage and med sup plans, I have been listening to your seminar and I am very thankful that I am selling ethically with the correct information. I was listening very carefully.... I think taking everything into concideration that the person is saying is important and watching out for them doing the right thing is held in my heart regardless of a sale. It's not about the money it's about helping them. The reason I listened so carefully is because I wanted to see if there was something I didn't understand.

[@MedigapSeminars]

I am glad you were able to listen and watch. My website is also a great source of information on anything Medicare. medigapseminars.org/new-to-medicare/

[@LouisWilen]

Matthew is the most honest and accurate presenter anywhere on Medicare, Supplements, and Advantage plans. His presentations are also the most clear of any on the internet.

[@MedigapSeminars]

Thank you...and I agree! LOL

[@bobbyfrompittsburgh1633]

As a voluntary AARP Tax Preparer for Seniors I am often surprised by how little many of the people I see have no idea how to deal with their finances or taxes. Even though I did graduate work beyond University, when I became Medicare eligible I was totally confused with all the different possibilities - both within the employer options as well as the private options. Your videos were and are tremendous at cutting through all the mis-directions and confusing articles. I refer clients to your websites for the real deal. Thank you. Thank you. Thank you.

[@MedigapSeminars]

You are welcome. You can find even more on my website . like medigapseminars.org/are-medicare-premiums-tax-deductible/ and medigapseminars.org/hsa-and-medicare/

[@Jody-kt9ev]

Very good video. I am very glad that my employer provided agent steered my wife and I into regular Medicare plus a supplement a few years ago. The fact that Medicare Advantage plans have limited networks make it obvious that Medicare Advantage is not as good as regular Medicare. I personally knew someone who was denied care by a Medicare Advantage plan. They just overruled the doctor as you mentioned. As to the "Shiney Object" of dental insurance, ask how much it will cover toward dental implants. My employer provided dental insurance only covered 10%. Dental insurance is pretty much a scam.

[@douglascurto4877]

Just yesterday I went to a seminar to a AT&T UHC advantage plan that is being rolled out for retirees 2024 there were many misleading statements. My favorite was every doctor that takes Medicare will take this plan.

[@jdenino6022]

That is clearly bs the dr can choose to take it or not.

[@MedigapSeminars]

I have caught several major insurance companies and wholesalers in that lie. It frustrates me because they are using a play on the word "can" to intentionally mislead. The agents listening are lead to believe it's just like a supplement, then they sell the plan spreading the lie and have no idea what they are saying is not the truth.

[@jdenino6022]

@@MedigapSeminars I called UHC for a list of doctors and asked them very pointed questions which I recorded the answers. My husband is getting all upset bc I told him he should opt out of the Advantage plan his union offered. Why tf do senior citizens have to be put in a position to worry about whether a doctor 1,2,3,5 or 10 years from now will be accepting a MA plan if they happen to come down with some health condition? This is nuts. Our country has a horrible healthcare system.

[@MedigapSeminars]

@@jdenino6022 you might find this of interest. Becker's is the leading publication for Hospital management. www.beckershospitalreview.com/finance/hospitals-sour-on-medicare-advantage-8-things-to-know.html "The reasons behind Medicare Advantage contract terminations vary by system and by payer offering the plan. Some systems have cited steep losses amid excessive prior authorization denial rates and slow payments from insurers. Others have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates. The Medicare Advantage landscape is constantly changing, with some health systems dropping only certain MA carriers and maintaining relations with others due to renegotiated contracts. For example, Brunswick-based Southeast Georgia Health System will terminate its contract with Centene's WellCare Medicare Advantage plan in December but will remain in network with Aetna, Anthem, Humana and UnitedHealthcare MA plans. "

[@jleechadwick]

I had Medicare Advantage, but decided to do original Medicare and a Plan G supplement. I got a Part G and Plan D approved. I won't be doing the Medicare Advantage again. I'm 67, so I want to have that Plan G to help pay the 20% that Parts A & B don't pay.

[@MedigapSeminars]

great!

[@WhiteRosez007]

Matthew I just wish so much that I had researched more on You Tube about Medicare. I looked as sources afterwards. You are such the Expert and make things so clear.......I looked as sources afterwards. I only trust your advice and another broker. I had such a hard time understanding the coverage lingo even when I had Major Medical let alone choosing Medicare coverage. In the end and after several weeks of researching, and navigating the Medicare site made a good choice on my own in the end. I heard of my supplment insurance company for decades, checked its financial rating and reviews. I realized that setting up my health plan was like creating my own Major Medical plan.....but what stressful experience all around....goodness!! I am referring my friends to you!

[@kimr3755]

Your seminars have helped me tremendously pick the right plan for me. Thank you.

[@maxinecasalbore9572]

I listen to all the seminars including your competitors. You are by far the most informative. That said, its very hard to tell someone to drop out of their retiree benefits bc as you know they may NOT be able to go back if they change their mind later on. More importantly, people need to know if their employer will be reimbursing their part B or IRMMA. Some large employers pay either one or the other. I caution everyone when making the choice about leaving their employers retirement plans UNLESS they are absolutely clear about what other benefits they may be losing. Thank you again for all you do. I am the spouse of a retiree from NYC and also a broker for more than 40 years.

[@MedigapSeminars]

Our role is to provide the pros and cons of the decisions they face, without bias. Many of the worst plans in the country attempt to keep people by threatening that if you leave, you can't come back. With experience, you get to compare what happens to those who leave vs those who stay.

[@jdenino6022]

My husband has great coverage as an early retiree of the NYCDC Carpenter’s union but once he goes onto Medicare we were advised that he would be switched to a UHC Advantage plan. The prescription plan is through express Scripts as it is now but it will be a different prescription plan version than what he got before age 65. His dental plan is separate for retirees with a $1500 limit and his eye glass plan is from GVS. He usually gets his glasses from Costco or Sam’s club anyway. I told him to consider opting out of the UHC plan. I’m worried about this.

[@jdenino6022]

@@barreloffun10 yes he can ‘opt out’ of the plan the union offered to the members. His older brother enrolled in the advantage plan and he says he an his wife like it. His other brother enrolled in a supplemental plan and said that he was told supplemental plans were better than advantage plans. So my husband is confused about what to do. I’m the one who does all of the reading and watches all the videos online.🤨

[@MedigapSeminars]

@@jdenino6022 I would encourage you to go to my website medigapseminars.org/ and click on the talking head video in the lower right. Choose the Medicare mini-course. It's four brief videos that will help you understand Medicare and the difference between a supplement and an Advantage plan. This is critical to making a good decision. If you prefer one longer video, watch this medigapseminars.org/medicare-explained/ NY is a special place in that you have a perpetual open enrolment for a supplement, if you do not trap yourself in an Advantage plan. After you have watched the above, please reach out to us at medigapseminars.org/contact-us/ Lastly, by the way, NY is a perfect place for this plan: kzbin.info/www/bejne/q6fFm6uudsdlqsksi=9RrpHsNuO5L44SNM

[@BrittMFH]

It really isn't an advantage to go on that employer's plan because he could probably get a similarly cheap Advantage plan himself. Now if the employer were offering a supplement, I would jump on it.

[@MedigapSeminars]

@@BrittMFH Unions and large employers can have Advantage plans designed just for them that, initially (with emphasis) have better coverage than what is commercially available. Still, it's an advantage plan with all the drawbacks of any advantage plan.

[@jdenino6022]

@@BrittMFH they stopped offering the supplement plan back in 2017 according to the research that I did. He was still in his 50s back then and didn’t pay attention to when the switch happened. We were on a great BCBS. plan since the early 2000’s with the union. His union decided to switch plans to UHC years ago unfortunately.🤨

[@MusicFandom]

I am dual eligible and my Medicare starts in 2 weeks. I have Molina wanting to sell me on a dsnp plan (Complete Care) She tells me there is never a cost to me. I can see the plan says $8850 Max out of pocket. When I asked her about it she says Medicare requires them to have it on the summary page but they work with Medicare to waive the Out of pocket. I have no clue what to believe but I have my suspicions.

[@MedigapSeminars]

Go with your gut feeling. Get a second opinion, call your local SHIP office. We do not work with DSNPs (dual special needs) because you have the ability to change plans once per quarter.

[@MusicFandom]

@@MedigapSeminars Thank you.. That is true, I keep forgetting that. If something doesn't work out, I only have to deal with it for 3 months max.

[@anthonymedeck7081]

You are the smartest man I’ve listened to about Medicare and believe me I’ve done a lot of research. I posted a Question on you’re video about 15% excess charges are dead. Will definitely be checking out you’re part 2 next. Hope you might take a minute to answer that Question on the previous vid. Thanks

[@MedigapSeminars]

I answered it. :-) 🙂

[@vjb488]

Thank for this clearly stated information. Nothing is free.

[@MedigapSeminars]

Glad it was helpful!

[@mdonblacktoday]

As a BRAND NEW AGENT I have just started watching your videos, and I must say YOU ARE A VERY KNOWLEDGEABLE BROKER. I had no idea MA plans had so MANY ISSUES...INCLUDING BEING INVESTIGATED BY THE SENATE. It also seems to me that insurance companies are deliberately NOT PAYING EQUALLY COMPETITIVE COMPENSATION FOR MEDSUPP SALES AS OPPOSED TO MA PRODUCTS.

[@sunflowermarcia7277]

That's why I have original with a supplement.

[@jimbetzing3587]

Good evening all!

[@MedigapSeminars]

hi

[@lindabrewer3243]

Thank you for the "truth".

[@MedigapSeminars]

You are very welcome!

[@elizabethwatson4145]

Thank you so much. I thought I knew something about this, but I learned so much more!!

[@SharonD7]

Thank you. So worth watching your very informative videos.

[@robertf2691]

Why would you pick a doctor not in your ppo? Under Medicare Advantage? If you are working for medicap, wouldn’t you favor supplements rather than Medicare Advantage? Sounds partisan to me. Isn’t Medicare advantage similar to my corporation medical insurance plan? So what’s better about Medicare? What if you’re pretty healthy? Why would you pay excessive monthly premiums with original Medicare?

[@MedigapSeminars]

1. A Medicare Advantage Plan is designed to be the actuarial equivalent to Medicare A & B without a supplement. It is not equal coverage to Medicare A & B plus a supplement. 2. An Advantage plan replaces your original Medicare. It does not supplement it. You give up the Medicare you earned for a privatized version controlled by an insurance company. For more, see medigapseminars.org/medicare-explained/ People who research Medicare overwhelmingly choose a supplement over any alternative.

[@Dumbluck14]

I was watching MASH.

[@MedigapSeminars]

MASH is much more entertaining

[@maxinecasalbore9572]

One more thing when using your calculator. I didn't see the part D included in your calculations. Thanks Max

[@MedigapSeminars]

Part D needs to be looked at separately. Once the firm maximum out of pocket with Part d is in force in 2025, creating a calculator that includes Part D will be doable.

[@charlesetheridge9380]

Man!!!! You are awsome!!! 6:04

[@MedigapSeminars]

Thank you!

[@gordygunst2514]

It seems that most of the information pertains to people reaching the age of 65..I recently have been approved for SSDI and will be eligible in a few months for medicare with a bunch of different options. I'm only 58 is the information you are providing in your videos the same for someone on SSDI? Thx

[@MedigapSeminars]

Great question. It depends on your state. There is no federal mandate requiring insurance companies offer Medicare supplement plans to people under 65. Some state do, some do not. Of those that do, most offer at a very high price relative to age 65. The first thing i suggest is getting in touch with us so we can go over your state rules and your options. Second, no matter what you do, you will have a brand new Initial enrollment when you turn 65. medigapseminars.org/contact-us/

[@BarbaraFrost-p9i]

Very informative.. thanks

[@MedigapSeminars]

you are welcome

[@denisecarrier6866]

Thank you. You make it easier to understand.

[@MedigapSeminars]

You are so welcome!

[@edf2953]

I am a recent subscriber and enjoy your videos. In this video you said the maximum out of pocket costs for Plan G is $240. I thought the maximum out of pocket is $226; I e; the Part B deductible. Perhaps you are referring to the Plan G deductible for 2024? Can you clarify. Thanks.

[@MedigapSeminars]

Yes, the maximum out of pocket for the consumer with Plan G is the annual Part B deductible. For 2024 that is $240. medigapseminars.org/wp-content/uploads/2023/10/2024-Part-APart-B-IRMAA.pdf

[@edf2953]

@@MedigapSeminars Thanks for the clarification. I wasn’t aware that info was available. ,,

[@cherylalmstrom7301]

I am researching for my husband and I as to best choice for us, Medigap supplement or Medicare Advantage. I find your videos very informative, but we do have a different situation that I am hoping you can address. Our Primary Care doctor is a “Direct Care” doctor, and no longer participates in any insurance. We pay him a subscription amount, monthly and we have unlimited medical care and access to the medical services he provides. Are you familiar with Direct Primary Care? We are struggling with how to choose which insurance because we still do need insurance. I am finding it just a bit more complicated.

[@MedigapSeminars]

I am familiar with Direct Care and it really doesn't change anything in the argument of Medicare supplement vs Advantage. Where is impacts you is the decision of which Medigap Plan. As we get older and / or lose our health, a significant portion of our medical care is with specialists. You will still want to have your choice of specialists, not just the one that happens to live near you. Have you considered the HD plans? kzbin.info/www/bejne/q6fFm6uudsdlqsksi=WsXQmO5eeMbuG2z7

[@cherylalmstrom7301]

Thank you. No, I have not, as I have not completed my homework/research as yet. I have been exploring MA and Medigap plans and it just seems as though there are Pros and Cons to both. We were on a BCBS Medigap plan and then switched to a MA HMO plan and now wish we had not switched. Working with a Direct Primary Care doctor does not fit well (or at all) with an HMO. So now we need to switch again. I am trying to educate myself enough to understand all the complexities of Medicare Insurance. This certainly is not easy.

[@patpp]

Medicare advantage is costing more to the government and the consumers Healthy enrol into MA, sick pushed over into the Traditional Medicare Sick in the MA, more likely to be pushed into bankruptcy and Medicaid etc. MA does not pay well to doctors, nurses and hospitals causing people not to go into these professions Big salaries paid to MA personnels should be spent on salaries of health care providers

[@MedigapSeminars]

Yes, Medicare Advantage costs more to the government than consumers. Re: "Healthy enrol into MA, sick pushed over into the Traditional Medicare" oooh, absolutely not. How do you know when you are going to get sick? I have seen people whose heath I envied at 65, and fighting for their life at 67. NEVER make a decision about your health insurance based on your current "good" health. Because when your health changes, you are stuck with that type of plan. * Get today the plan you will want when you are sick or injured.*

[@brianmueller7913]

My doctor said that Original Medicare pays doctors up to 40% more, per procedure, than MA plans. He said that most of the best doctors in this country will take Original Medicare. Not so with low paying MA. I learned this the hard way when I injured my hand and was denied by the best hand surgeon. I ended up paying that surgeon cash to fix what a low paid in-network doctor did to me. I am now on Original Medicare and have the best insurance in the country.

[@MedigapSeminars]

@@brianmueller7913 That is why a lot of hospitals and doctors are leaving Medicare advantage plans. That and the fact that they will not pay or delay payment

[@brianmueller7913]

@@MedigapSeminars Yep! The insurance companies (MA Plans) cost the govt more and give us and their doctors less...with their greedy hands in the middle of it. Paying doctors more and quicker with Original Medicare attracts the best doctors.

[@margaretalletson84]

Great explanation as always.

[@MedigapSeminars]

Glad you liked it!

[@villabuck6391]

Interesting

[@maxinecasalbore9572]

Can you tell me what states you use as an example when using your calculator? None of the states I work in have the rates you quote. All are quite a bit higher. I work in NY, Ct, NJ, Fl, NC and PA

[@MedigapSeminars]

don't recall. Other than NC and PA, you have three of the five most expensive states for Medigap 🙂

[@sb6759]

My employer offers "Group" Retiree Atna PPO Advantage plan and max.out of pocket costs 750 dollar....should I accept? Or should consider Supplemental plan? Please reply

[@MedigapSeminars]

Here is a calculator I designed to help you figure that out. medigapseminars.org/compare-employer-plan-to-medicare/

[@EfrenNahedhumaran]

👋

[@richardnowacki2869]

Are you part of Christ Westfall group

[@MedigapSeminars]

No, but he and I are friends. Why do you ask?

[@richardnowacki2869]

Because I ask his agent something about Part N and she asked me where I seen that and his agent said you work with him. So a assume that your in the same company. The question i asked was about part N and urgent care paying a CO pay. Because he claimed that urgent care didn’t charge a CO pay but I believe he now says it does

[@MedigapSeminars]

@@richardnowacki2869 I will talk with Chris about one of his people saying i work with him. I am sure he would not support anyone being less than truthful. That said, in my Plan N 2023 video kzbin.info/www/bejne/qpm6qHisqbKLec0 published about a year ago I explain how this changed. What happened is that during the pandemic CMS / Medicare allowed doctors to use the same billing code for urgent care and telehealth that they normally used for in office visits. That code is the one linked to the $20 copays for office visits for Plan N. So with that change, telehealth and urgent care can now have a copay if you have a Plan N.

[@barnabyjara4751]

1 who cares if I can choose a doctor. I don't know medicine so I can't tell if a doctor us good or not.

[@MedigapSeminars]

OK. Question: what do they call the person who graduated last in Medical school?

[@MedigapSeminars]

......doctor

[@barnabyjara4751]

@@MedigapSeminars No billionaire has graduated at the top of their class. Bill Gates, Mark Zuckerberg and Jeff Bezos were all school dropouts. Being at the top of the class just tells me how good you are in answering exam questions. It tells me nothing about your integrity, your continuing education and your caring as a doctor.

[@kathys53]

Replay crew here.

[@MedigapSeminars]

replaying the video?

[@kathys53]

@@MedigapSeminars No, missed the premiere. You were very clear.

[@mikeburchett-bs3qw]

👍