MASSIVE UPDATE Medicare Advantage Disruptions Are Coming - How To Prepare

[@MedicareSchool]

✅ Watch the internet's #1 Online Medicare Educational Workshop for FREE: medicareschool.com/master-med... ✅ To get 1 on 1 Help from our Team, Schedule a Call Here: medicareschool.com/talk-to-a-..

[@karenwoodall9680]

Kik Kik k ok I Kiki k ooo kook

[@JaniceHefner]

@@karenwoodall9680

[@nancyhale5054]

Just listening to this they are better informed than the local senior helpline here in Idaho, more like the amazing broker I went thru Indiana, he didn't charge me a dime though - sounds like this place does, I'm pretty young though and wouldn't have called him with a problem. Idk do they charge?

[@lisaw6855]

Having this change EVERY YEAR is a crock. Especially with AGING people.

[@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

[@marciabutler987]

Your pain will lessen on animal based eating.

[@janetabrowne5719]

This is the truth.

[@roxyjohnson5112]

Docs now work for corporate healthcare, which is, sadly, all about greed for the upper managers. In some systems, they are unionizing due to their treatment. Today, it’s rare to see a doc in private practice. They have 15-20 minutes to see a patient and the next one is waiting. Generally, the one nurse in the clinic or office manager processes the referrals. It’s bad for us boomers.

[@GearMaven]

My elderly 93-year-old mother went low carb healthy fat Wheat Belly diet and was able to stop 9 Rx medications! Never too late

[@jacquelinedevlin6381]

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

[@MedicareSchool]

Glad you enjoyed it!

[@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

[@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.

[@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

[@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! 😮😮😮

[@kenike007]

What a sick reality...healthcare should not be for profit,especially for seniors!

[@USARealityCheck]

Yes, it is. I would argue that healthcare should never be for profit, regardless of age, if you are a citizen or legal resident.

[@lisagulley8051]

Don't forget- the illegal migrants are getting free healthcare!! Makes ,me so mad- I worked 46 years as a nurse and now my benefits are being cut...

[@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.

[@gregcurl7367]

Was drafted back in the early 70's, hated it. But now that I'm 70 having the V.A. as my health care provider is a life saver. Love the V.A.

[@maryfrench1940]

my husband has accessed VA since retirement and we have been so well cared for. We are very happy. We both carry private insurance as well.

[@gregcurl7367]

@@maryfrench1940 Yes, I still carry parts A&B on my Medicare. Alot of Vets don't, I just like some backup.

[@yolandagibson9807]

I have A&B, a supplement and Medicare advantage. I want to be covered🥹

[@beckygarner86]

Thank you for your service. I worked at VA for over 32 years. Just retired, miss seeing the veterans.

[@dolliscrawford280]

We have to drive so far for the VA. The drive has more congested traffic, also harder as we age.

[@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.

[@recoveringbaptist2023]

I like Medicare Advantage plans because I get Silver Sneakers (free gym memberships).

[@rosapineda8644]

Make sure you review your Part D plan because those do change every year

[@jodihackney2]

A lot of us can't afford the supplement plan, like me so I'm back on advantage plan.

[@cathykrueger4899]

I watched Advantage plan marketers in the early years. It was very underhanded. The current marketing is so deceptive I don’t understand why the government allows it. And Advantage plans drastically slow down healthcare delivery. Valuable nursing services are wasted on telephone calls to plans that seem to have denial as their default mode. Sometimes they delay care to the point that patients’ health is compromised. There just isn’t enough oversight and of course the driving force is greed. Advantage plans have been detrimental to healthcare in this country.

[@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.

[@MsNancyH]

Agree! E. Tennessee here, and our Humana Gold Advantage plan has been, and is still WONDERFUL! "copay per day you're in the hospital." .. ? Whaaaat? Not us! ONE copay on admittance and if you go in via ER, that copay is waived. And, I can't recall the last time we paid anything at all for medications.

[@ga6589]

All the more reason that it's a good idea for you to read the proposed changes you receive from Aetna. There are providers in my state that are dropping Aetna Advantage plans for the very reasons outlined in the video.

[@billl7625]

My wife and just received a letter from Aetna and they will no longer offer our Freedom Plus plan. We live in south Georgia near Statesboro.

[@dianetodd9719]

​@@billl7625I also got the same letter!!!

[@AaronStephens-jl2pm]

@@billl7625 I received a letter that my Signature Plan will dropped in 2025. Disappointed… my agent is searching for another plan.

[@WandaMiley]

I think you explain everything about Medicare better than anyone else I’ve heard. I know watching your videos helped me a lot when I turned 65. Thank you!

[@MedicareSchool]

That is great to hear, thank you so much!

[@BAMtastico]

I'm turning 65 later this year and doing my analysis of the different options. The concerns I have with Traditional Medicare is that to have complete coverage, you need to add a supplement plan to cover deductibles + a prescription plan + dental plan + vision plan. When I add up the annual premium of these plans, they are greater than the annual MOOP than the Advantage plans in my area.

[@valereehansen4378]

For an older person all of these complications basically amounts to ELDER ABUSE. It takes it's toll physically as well as mentally.

[@bryanfoxx2292]

To me the MAIN thing that they do NOT stress, to we the people , that your health care provider's contract does NOT run from Jan.1 through Dec. 31, like OUR, we these people's, contract is. Thus you go to check to make sure your provider(s) is going to take MED. ADV. as of Jan. 1 of the upcoming year only to find out say in May or June that your provider has decided to no longer take Medicare Advantage. Now those people are stuck trying to find another hospital or specialist or any other health care provider. So BE AWARE!!! DON'T forget every working person has paid all their working life to receive this benefit. This is taken out of everyone's salary.

[@mariemills-ff8qy]

Important information

[@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 ?"

[@luchiayoung]

No because we dont have it.

[@tanyarobinson1146]

Always get preauth numbers and call reference numbers. Be sure the office is billing under correct codes. That is often the problem.

[@nancyl-cwood1167]

I HATE that the ins companies decide what you need, which isn’t what the Dr said & make a decision of what THEY SAY YOU NEED‼️‼️

[@fayeb.5855]

I’m on traditional Medicare w/a Med Supp plan, thank goodness.

[@lindawhite3361]

I will stay on Medicare Supp as long as I can afford it! It’s more expensive but no hassle and no copays!!!! I have an amazing broker who handles my issues which are very few.

[@karabinb4514]

I just know when it’s time I’m going gap..I won’t do a MA plan after being a claims processor for a MA plan for 10 yrs..

[@happycook6737]

I agree with you. MAs suck. They trick vulnerable seniors.

[@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.

[@ga6589]

My husband and I both have BCBS supplemental plans and our premiums have not gone up the past few years. As a cancer patient at the Mayo Clinic, he needs no prior authorizations or referrals for anything. He also had hip replacement without any delays. My SIL, who is on an Advantage Plan, had to wait nearly a year in extreme pain before it was finally approved. You get what you pay for.

[@johnmccarthy8466]

Kaiser too.?

[@GearMaven]

My folks were happy for past 15+ years on fabulous MA plans in So. CA, but I feel trepidation for 2025!!

[@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.

[@Peachlady222]

My husband and I are on his employer retirement Medicare Advantage plan. The insurance company notified our provider that on September 1 we must have pre approval for chiropractic care. We were not notified. We don’t need pre authorization for urgent care. Our provider is considered in network. I called the insurance company to ask why something that has been covered for years (preventative care) is not covered as of September 1. I was told they still cover it but it is coding. The paperwork involved to get approval involved my provider giving the insurance company so many clinical notes about our care that it would be a burden. The insurance company seems to not want to cover any preventative care.

[@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

[@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

[@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?

[@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...

[@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

[@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!

[@dogbone1065]

It's all about getting more money and less care. It's not an improvement, it's to get you to expect less and except it

[@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

[@fayeb.5855]

At least 70% of procedures require preauthorization w/Advantage plans. Also, in-network requirements. No preauth w/traditional Medicare and we can see any doctor nationwide (excepts Medicare).

[@joedanis2889]

​@@fayeb.5855Pre-authorization is not required on Advantage PPO policies, only HMO Advantage plans.

[@5boysandamom]

I use a broker and have for the last 3 years. We have an annual conference and decide what's best for me.

[@Tutujls]

My broker and I connect in October to review any changes.

[@colemant6845]

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

[@MedicareSchool]

It is our pleasure!

[@shirleychen7412]

Plan N Best. New to medicare and healthy.

[@browneyes8513]

Thank you Mr Marvin for educating me. I have been in Medicare for over 10 years and never know the differences. I was on disability and rolled over to ss. When i just got the Medicare The doctor office told me to get on the group rather because they don't accept just Medicare and I keep that since then. Thank God that I am still healthy, just go to the doctor for a check-up a few times a year, so hopefully, I can switch to plan N or G now. I talked to you last year, so now is the time.

[@MedicareSchool]

It is our pleasure!

[@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...

[@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

[@Amanda-rv8to]

Not everyone has the choice to not use an advantage plan

[@fayeb.5855]

What? Any senior at age 65 can take traditional Medicare.

[@beverleyhagaman7344]

I heard that if you go from a traditional Medicare supplement to an Advantage plan that you can't go back to the traditional Medicare supplement without proving insurability. If your health deteriorated then you are out of luck.

[@happycook6737]

​@@fayeb.5855Some seniors didn't save enough money for retirement so they think they are getting over by having a MA plan which looks cheaper and dangles free "extras" like a gym membership but may end up costing them their life in refused or delayed medical care, lack of providers accepting that MA, etc.

[@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!

[@jeanenehinton-ds8xf]

I have had an Advantage Plan for years, since 2018. I have had no issues with the same company since then. My monthy cost went up by $5 (total per month is $39). Only change I have noticed is that my meds cost me nothing. They used to cost me $10. Scare tactics.

[@DebraMooney-y3n]

We should have the same choice as congress. Adter all we pay them.

[@RRalphy96]

Thank you for all the information.

[@phyllisbrink9924]

There's For Profit and then there is Greed.

[@Deba7777]

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

[@MedicareSchool]

Glad it was helpful!

[@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

[@fayeb.5855]

I received the ANOC for my Prescription Part D plan.

[@Anything-q1i]

Advantage plans are only advantageous for insurance companies. Rip-off is a more accurate term. People were lured into these plans and now they are at a DIS-ADVANTAGE.

[@sherrymeadows8758]

Agree!!!

[@ronaldpelleteri9454]

A wealth of valuable, educational information especially for those new to Medicare. The video is excellent and I applaud the presenter.

[@MedicareSchool]

Glad it was helpful! We are here to help if you ever have any questions please give us a call at 1-800-864-8890.

[@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.

[@kendallbeesing]

I currently work as an office manager for a Medicare brokerage. We’re expecting to make over 300 plan changes. How are you able to meet with so many clients and review so many plans within this time frame? I NEED a “day in my life during AEP” from you. But I definitely need to know how you’re able to contact, review, and meet with so many people!!

[@MedicareSchool]

That is a really fun idea! We will likely start that up! Be on the lookout!

[@wk7060]

Needed more CMS accountability for years, good.

[@Slp75]

Why are the insurance companies and individual agents pushing supplemental insurance? If 50 % of people are already on advantage plans and they project more to be on them in the future what is the big push for supplemental? I was on a supplemental 5 years ago. By the time I bought the supplement, the drug plan and the dental ,at the age of 75, I was paying $450 a month. At that time I had high blood pressure and had 1 surgery for basil cell cancer (skin cancer). The insurance salesman was honest and told me you’re not going to be able to afford this in the future. I can’t imagine what I would be paying now at 80! Just remember you may be in great health at 62 or 65. I was doing fine up until 75 but things changed and there is no way I could get on supplemental insurance now. I’m lucky enough to be on an advantage plan that is associated with a large university medical facility where there is every medical discipline available with several providers in each discipline. I have been very satisfied with all of my doctors and healthcare professionals. Healthcare is still under the control of insurance companies and the rule is don’t take anyone if they even stubbed their toe! May you all have a future of good health.

[@Slp75]

Jim is that you?

[@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.

[@br8150]

I fight this all the time for my Mother who is 85. You have to be a full fledged ATTORNEY to understand these policies. Then you get one and you fight for benefits and keep the medication COSTS straight. Why do they make this so difficult for older people. Every year you get hit with all the companies screaming they have the best plan, so you sit at a table and read through the MOUNTAIN of legal Mumbo jumbo of information and compare company by company TRYING to find one you can financially afford, that has the best benefits for you, only to find out you get screwed one way or the other. Once you get in one here comes the “donut hole” you fall into and can’t get out of. Your costs skyrocket in the donut hole. Things should be easier and fully beneficial for old people. They work all their lives only to be done like this when they can no longer work. They have LESS MONEY than anyone else and they face all of this. The medication cost is overwhelming in the donut hole.

[@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!

[@lizj7236]

Hallelujah - this Man has a rare ability to perfectly explain the existing ridiculous highly complex Medicare coverage mess.

[@MedicareSchool]

We're are glad that we can help!

[@48661]

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.

[@susanb9892]

Employer-based health insurance is having similar issues with doctors leaving or not accepting new patients. My general practice doctor of 14 years has a 5-month wait to get an appointment!

[@nettie3485]

Yes it is.

[@PhilipElsenbaumer]

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

[@MedicareSchool]

Great to hear!

[@christinefrances5598]

I loathe we live in a time where some suit at an insurance company decides what my medical needs are and not my doctor.

[@suehendrickson8257]

The person deciding on your prior Auth is not a suit. It is someone with little education, little ability to understand the medical situation, and no hierarchy in any organization. I'm a physician sickened by the terrible changes that make patients (and doctors) suffer.

[@Lymansradio]

Excellent presentation. Thank you.

[@MedicareSchool]

Glad you enjoyed it!

[@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.

[@lindakelley4332]

​@@kwilliams2239ok, however I will and would use it. SO get over it!

[@AriesRising4444]

Wrong. My stepfather just spent 11 days in the hospital before passing away. Total cost- copays $1;625.

[@kwilliams2239]

@@AriesRising4444 I broke my arm and had two outpatient surgeries to put it back together "right" (it still isn't great). The second was under SS. The (retail) hospital bill was over $60K. Since there was automobile insurance involved, I, well the auto insurance, had to pay Medicare back about $5K, and the Advantage co-pay, $250, I think. That's a hell of a Medicare discount (Medicare pays 80%). That makes the entire bill $6K, or 10% of the retail bill. I'm surprised that hospitals take Medicare.

[@lorobogers4198]

Our hospital system is cancelling Aetna advantage contract. They could not come to terms. They also are cancelling Aetna commercial, so there’s that 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.

[@valerieb8006]

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

[@MedicareSchool]

Glad it was helpful!

[@michaelwhite9513]

Don't forget the huge profits the Insurance Companies are raking in. This is the bottom line: they are in the business to make money and not provide you health care.

[@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.

[@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

[@susanb9892]

@@janehaefner9438 you are only fined if you join later. Keep insurance with your employer as long as you can. Then you’ll have an open enrollment period to find Medicare coverage with no penalties

[@nanciwheatley-durando9342]

​@@janehaefner9438I THINK YOU CAN SAY NO TO PART B & PART D BUT ONLY FINED BY PART D MEDICARE IF YOU CHOOSE TO SIGN UP LATER ON. NOT PART B. YOU WILL HAVE TO PAY OUT OF POCKET EVERYTHING EXCEPT PART A COVERS HOSPITAL COST.

[@DRSTEVEPODCAST]

Great information!

[@MedicareSchool]

Glad it was helpful!

[@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.

[@robertbangkok]

Very little emphasis from you on the horror of the "30 Questions" people have to answer in order to switch back to original Medicare. It's almost impossible to qualify.

[@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.

[@MrOttomotto]

@BobWilliamson I am truly sorry to hear of your son. I pray that God may bring some comfort to your family.

[@patriciagray5157]

Yet they have plenty of money and help for illegals non citizens.

[@nanciwheatley-durando9342]

SO VERY VERY SORRY!

[@nanciwheatley-durando9342]

​@@MrOttomottoYES INDEED, ONLY GOD CAN BRING COMFORT. GOD BLESS THIS FAMILY ALWAYS

[@sherrymeadows8758]

@@patriciagray5157Exactly!

[@cachi-7878]

Thank you! Always informative!

[@MedicareSchool]

Glad it was helpful!

[@leatharay3565]

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

[@billybarnes9208]

It took me 3 months to get a cat scan approved. May God bless everyone 🙏

[@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.

[@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.

[@MedicareSchool]

You are so welcome, our team is always here to help. You can call us if you have any questions 1-800-864-8890.

[@bobwilliamson5993]

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

[@janetabrowne5719]

People keep talking about Nationalize health Insurance. I have lived in two countries with national plans. Never had a problem or waiting for services. I am seriously looking to leave. Why Americans accept this crap in their older years. Sad.

[@nanciwheatley-durando9342]

IT WILL BE WORSE WITH NATIONAL HEALTH INS. WAITING FOR 6 MONTS TO A YEAR TO BE SEEN BY A DOCTOR. I KNOW PEOPLE IN ENGLAND & CANADA & THEY HATE SOCIALIZED MEDICINE

[@happycook6737]

If you want to see a failing system look at the NHS. My friend's husband was diagnosed with colon cancer at age 50 while they were living in China. He returned to the UK. 6 months later (waiting list) he was finally able to get surgery but by then the cancer had spread. He got the initial surgery and they basically opened him and closed him up. When he came to, those doctors told him it was too late and the cancer was too widespread. 😭Delay in care, rationed care, cost containment KILLS people whether by national healthcare system or MA plan the results are bad. Have friends in Canada who struggle to get care too. That is another socialized medical system at work. Insurance companies are bad. We need to go back to the 1940's when my grandpa was a doctor. He had his own office and his RN collected payment when people were able to pay. He got paid in cash or chickens or homemade pies or people did chores for him etc. He never turned anyone away and he made house calls even in the middle of the night. Today's doctor's want to be rich, work only during office hours, etc. They don't even know their patients! Sigh

[@julieduree9210]

I never signed up for a advantage plan,I choose my own Doctors,not in house doctors.

[@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.

[@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.

[@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.

[@lindahidalgo1804]

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

[@janiswenger3350]

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

[@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!

[@andrewdalessandro9277]

Not Affordable not Care just an Act. Good information 🇺🇸🇺🇸

[@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.

[@godislove5751]

@@ChrisSadowski-pp1np What is HDG?

[@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.

[@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.

[@thomasmorris2245]

Thank You Marvin

[@MedicareSchool]

Happy we can help!

[@aquastar7990]

Every year at this time your warnings of the Medicare Advantage Plans. I’ve been on them for over 9 years and love the savings I pay $10 instead of the the full Medicare cost. That’s a HUGE savings. I think you doctors don’t want this because it does control the prices you get.

[@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

[@carolyn6290]

Awesome video, Thank You. I will be calling your toll free number during open enrollment!

[@MedicareSchool]

We are looking forward to hearing from you!

[@TheBuddy1939]

Thank you very much

[@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.

[@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!

[@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

[@pattyyoung7483]

Excellent information as always. Thank you

[@MedicareSchool]

You're welcome!