What Happened To The Medicare Industry? (The Scary Truth) 😱

In this video, Marvin Musick from Medicare School discusses the shift towards profit first practices within Medicare Advantage plans and the effects on patient care. He goes over the financial interests of insurance companies and the challenges faced by Medicare beneficiaries, including issues related to plan enrollment and switching. The Medicare industry has been criticized for being overly profit-driven, with insurance companies and brokers potentially prioritizing earnings through commissions and residuals over the welfare of patients.
Problems such as restrictive policies, delays in care due to prior authorizations, and conflicts over payment between providers and insurers highlight systemic issues. Nearly one-third of Medicare enrollees are in Advantage plans, which has raised alarms about the control and motivations of private insurers. Watch now to learn more...
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[@MedicareSchool]

✅ Watch the Internet's #1 Online Medicare Educational Workshop for FREE: get.medicareschool.com/45V4Rbw ✅ To get 1 on 1 Help from our Team, Schedule a Call Here: get.medicareschool.com/3PuKFq3

[@miguelguillengonzalez9803]

Thank you, Marvin, for telling the truth and opening the eyes to many people before they apply for Medicare. Marvin for President!!

[@mikeodell9688]

Thank you Marvin for speaking the truth on this critical subject.

[@lauratopliffe8179]

A good agent goes over both options with you, learns about your needs and recommends the plan based on your needs.

[@hap1666]

Thank you sir, for a well presented and needful video. I only wish my patients had seen it before they signed on for their Medicare disadvantage plans. As things stand now, only the insurance companies are getting anything good out of this. The patients get crap care, particularly when they need subspecialty care, the physicians are drowned with extra paperwork, overworked and underpaid, and the taxpayers are paying a fortune for all of this abuse. Sadly, the insurance companies are making enough money to buy lobbyists, and thence the government, which promulgates to policies that sustain this entire disaster.

[@MedicareSchool]

We're happy we can provide as much information as possible!

[@leaderdreams128]

The problem is that, in today's economy, the vast majority of people cannot afford a supplement plan. The other issue is that no one explains this to people, so that if they can afford a supplement plan, they do not know they only have a six-month window without having to go through an underwriting process. One thing is for sure: it is all about the money, and in most cases, the agents are not the ones making the money; it is the companies they work for and the providers.

[@laurahelbling5363]

MA turns out to be more expensive. Yes premiums should be lower especially Part B since we have already overpaid during our working years. Part B should be $0 as well like part A. Supplements pay the gaps in A and B.

[@gpants3633]

I really appreciate you, Sir. I’m 64 now but have been watching you for quite a while to make sure I have enough knowledge to prepare for the Medicare process. Thank you very much.

[@MedicareSchool]

Happy we can help!

[@evansdolyna7]

As a Nana, I also enjoy the fact my supplemental plan G covers me in all states as I still truck drive and plan to travel at least out of my ZIP code when fully retired. My only 2 issues in the beginning were finding a Medicare Doctor taking patients and when I had preventive care, the Doctor wasn't coding correctly. That took 6 months to fix. I live in SoCal and thought these things weren't an issue, but I was wrong. No matter what, ask questions and be diligent in your care. Nothing is perfect. Love these videos, I share them often. Good work Medicare School!

[@douglaswilkinson5700]

After a 15 year hiatus I started to suffer from migraines. With Medicare + supplemental "I" chose the neurologist!

[@embun1945]

Thank you Marvin, excellent information on the History of Medicare from 1965 to 2024 present.Thank you.

[@maryanne9884]

Thanks to you, I switched from an MA plan to Original with a supplemental plan and will never look back. I was lucky to be within that six-month period.

[@user-hg3xt1ps5d]

Marvin, again sir, thank you for keeping us educated! I promote your site to those needing an education before them starting with Medicare. If not for me finding you, I would not have completely understood how it all worked. I initially started with an Advantage plan a few years back as the differences in my two choices were not explained. I am now with a supplement plan after passing underwriting last year.with one of your agents. I sincerely thank you for all the education you provide with integrity, and the care you show your viewers. I Thank you!

[@MedicareSchool]

We're happy we could help!

[@leealtmansr.3811]

As many have said, Thank You for speaking up and informing us.

[@situationrod5648]

Thank you for clearly explaining the difference between Medicare Government sponsor and Medicare advantage 3 party for profit a quicker way to die there profit is more important than your health delay tactic and many hospitals will not accept advantage. Thanks again I subscribed and gave it a thumps up👍🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏

[@MacchiatoSwirlGirl]

Managed care is gosh awful, hate it..I hope I never have to have it again

[@madstarr2]

Marvin, thanks for highlighting the issues! This video should be a mandatory watch before anyone signs up for a managed plan!

[@MedicareSchool]

Glad it was helpful!

[@garyclark979]

Marvin, you tell the truth in a world filled with liars. I am a PhD biomedical scientist, so I fully understand the games being played by these deceptive medical insurance companies. I do not need Medicare yet, but I am going to use your service when I do need it! I wish that I could personally meet you. Continue your great educational videos sir!

[@MedicareSchool]

We're happy to hear we're helping everyone receive the proper information for Medicare. We look forward to hearing from you when it's time, thank you kindly!

[@KeithRicken-cm6sb]

While I agree with much of your content, the fact is that I consider prescription drug coverage, vision coverage, and dental coverage to be necessary components of my health care - they are not optional or supplemental, because they have a lot to do with my overall health condition. Paying for those ON TOP of supplemental premiums which increase at 12% per year I can be financially daunting, even ruinous. There is more broken about this system that reimbursement rates to providers!

[@mmane257]

turning 65 in november.i will choose a supplemental N plan.i’m so happy i did a lot of research before reaching this decision.i am a subscriber to your channel.thanks for all the information you provide.

[@MedicareSchool]

We're happy we could help in your process!

[@nanner3200]

My husband (disabled for several years) will turn 65 in a year so we can finally get him off advantage! (he has United) He's had 2 failed back surgeries and last Halloween he fell and broke his leg in 2 places just getting the mail. It took until the day before Thanksgiving for him to be able to get surgery! All due to the wait of approval. He's still messed up and not healing correctly. Also regarding his back....the good/recommended docs around here won't even look at him to see if he can be improved in some way. He's been referred to Mayo but they won't take his insurance. DO NOT fall for Advantage! (no pun) The only "perks" he's ever used was one eye exam and of course RX. We didn't get advantage for him for those. It was all we knew at the time he had to sign up. Of course he would not pass underwriting so we wait.....

[@daleandrew3292]

Excellent presentation and spot on. As a Reimbursement Manager for a large nonprofit hospital system, I would add that the insurance companies are playing the payment denial games for commercial plans at an even greater level and making it nearly impossible for hospitals to make any profit. All while for profit insurance companies make billions in profits.

[@ron8566]

Excellent info. Thank you.

[@lindabunce5133]

Another stat that's looking bad for MA is comparing patient outcomes and comparing the hospitals you have a choice of. The MA hospitals are not the best specialty care. Remember, they look to cut costs to increase their profits in the way they provide care within the hospitals...from maintenance to staffing ratios. As a retired RN, I can tell you this: One doctor is not the same as another and one hospital is not the same as another. PEOPLE, do your research. Ask friends and family in the medical profession who and where would they go. Spend more time choosing your health plan than you do making a car purchase.

[@daviddoss2804]

I did research for over 6 months before I signed up for Plan N in march of this year

[@torvicd1]

Unfortunately, the health industry is about profit. Pre-authorizations were created to manage providers requesting unnecessary services. it's a constant fight on who gets to keep the government money.

[@miguelberrios19]

Your statement is so true, many doctors are ordering unnecessary medical procedures for more profits. So, who can you trust?😮

[@realscotthogue]

You are absolutely right. These insurance companies are not the government and can't print money, there has to be some reasonable controls. Many MA plans have zero premiums, all have max out of pocket and you can appeal a refusal of coverage. They are a blessing to many seniors.

[@rubygreta1]

Got a G high deductible in NY, where G plans cost over $300. Instead I pay $70. Annual deductible is $2,800, which I save with the lower premium. A no-brainer! They are not easy to find.

[@MikeD_]

Curious if you priced out the N plans in NY? I don't go onto Medicare until later this year, so I'm looking at either a G plan, or a high-deductible G plan, or an N plan. I'm already a no on an MA plan as one of my doctor's and affiliated hospitals has dropped UH's MA plan, and another doctor affiliated with another hospital has dropped a different major MA plan.

[@rubygreta1]

@@MikeD_ www.dfs.ny.gov/consumer_health_insurance/supplement_plans_rates/plans

[@MacchiatoSwirlGirl]

Also to say many doctors here in SCLA they only want PPO. They want control, and they have their pockets in the end of it also...

[@MrGoodaches]

Thank you for this summary with explanations.

[@MedicareSchool]

Glad it was helpful!

[@patrickoconnor7890]

Nobody else explains the details like you. I was watching a different video of someone else who didn't explain it as clearly as you. One of the comments was it left the person confused. I replied by recommending your channel

[@MedicareSchool]

I appreciate that!

[@mariannehuston4050]

Marvin, I really appreciate your honesty informing us of the real deal. I am so glad I did my research some years back and chose the G plan for my husband and I.

[@MedicareSchool]

You are so welcome

[@deborahmorton547]

Excellent presentation, sir, as always.

[@MedicareSchool]

Many many thanks

[@teams3345]

18 months away. I will choose Supplement G.

[@tonynes3577]

Well great information. I'm in an Advantage plan, Kaiser California, still working and okay health at 65, but will probably retire at 67. Being a dual citizen of USA and Canada this makes me wonder if I should move back to Canada for my later years where health problems start inching up and where Canada does not have this Complicated business- profit modal like the USA😮. Although Canada is starting to look at it financially and taxes are really high. Thanks for this info and all your other videos!

[@MedicareSchool]

Happy we can help!

[@williamrogers1219]

If one is poor and can't afford Medigap policies, it is less likely the providers will be able to extract payment. Selecting Medigap policies makes more sense for the affluent as the insurer transfers the risk to the insurance at a modest cost.

[@user-hy4zv8cn6r]

People should understand too that the current administration also has a lot to do with prices For example everybody thinks it's absolutely wonderful that the recent Ira act put a limit on how drug out of pocket prices for seniors. But that has come at a big price to the consumers. Now that the insurance companies have to take on the added cost they are passing that price onto the consumers which is why part dedrug plans are sky rocketing.

[@DanielDeutsch-hl3qn]

Thank you! Maybe you answer this question in another of your videos, and if so, I'd love to get a link, but if not, here it is: after you select a supplemental policy for the first time without underwriting (typically at or near 65, during that "B window"), are you stuck with that same insurance company for the rest of your life if you want to avoid any future underwriting risk? In other words, are you allowed to compare supplemental policies as the years pass and switch freely between companies?

[@MedicareSchool]

You will have to do medical underwriting if you are interested in changing your carrier for your supplement. There are 4 states that allow you to change any time through the year without medical underwriting those are NY, CT, VT and MA

[@douglambert3622]

If the supplement plan company goes out of business does that still apply?

[@douglambert3622]

What About changing supplement plan to supplement plan?

[@MedicareSchool]

Medical underwriting will still be required (depending on what state you live in), to go from one supplement plan to another.

[@michaeltakayama8415]

I know that I can sign up for Medicare Parts A & B, while living abroad, when I turn 65. But, how can I get a Medicare Supplemental Plan, if I will be living abroad, full-time, without a US residence, during my OEP?

[@MedicareSchool]

That would be your IEP, you can make a selection at that time. You can contact our office and we can better assist you 1-800-864-8890

[@johnturchan]

Mention was made of companies who offer Advantage Plans that will work with providers and patients. How do I find the more reputable companies?

[@MedicareSchool]

It's best to meet with a brokerage that works with several carriers that can be presented to lay out several options. Feel free to contact us if you would like some assistance 1-800-864-8890.

[@marianndombek9681]

Can you change from MA to standard Medicare? If so, when can you do that?

[@ggjr61]

Yes. It may need to be during open enrollment though. If you want a supplement too you will need to qualify medically. Your best bet is to talk to a Medicare insurance broker like these people. They can explain it and see if you can qualify medically for a supplement.

[@marianndombek9681]

@@ggjr61 thanks

[@mimi1o8]

You will have to answer 40 questions regarding your health and the insurance has the right to , refuse you in 😑

[@rickdarone]

The quick answer is yes. But that is not advantageous because of the major gap/liability you will have with "standard" Medicare also known as original Medicare. However, if you wish to mitigate your liability with a Supplement plan, that will be ideal to offset your financial risk. Application for a Supplement plan (i.e. Medigap plan) will require you to go through medical underwriting for approval if you are applying outside of your 6 months from your part B effective date. Open enrollment is Oct. 15th through December 7th. It is best to speak with a trusted broker in your area to help you navigate the best option for your health needs.

[@MedicareSchool]

Yes, you can make those changes during AEP (Oct 15- Dec 7). You may be subject to medical underwriting at that time. If you can pass underwriting you'll be bale to transition.

[@nsbd90now]

Every single developed country on the planet has some form of universal healthcare, except for the US.

[@DaystarHiker]

'You have 6 months where you can get any Medicare supplemental plan you want ...without underwriting'. Is that 6 months from the day you apply for Medicare? Or 6 months from the day Medicare starts?

[@MedicareSchool]

6 months from your initial part B date

[@JeanPierreWhite]

While I agree that profit is not in the patients best interest you only mentioned two parties who make profits. Insurers and Agents. Providers also make a profit. The cost of care is what drives premiums up. Insurers can't charge more than 65% of the losses (loss ratio). Healthcare inflation is the underlying issue with regard to seniors healthcare affordability. It is true pre auths put an unreasonable administrative burden on providers, instead of caring for patients they are talking to insurers, time which is uncompensated.

[@TheWilferch]

One reason..... a BIG reason for the high use of Advantage....are the lousy....PUSH, PUSH, PUSH ads we see EVERYWHERE during open enrollment...and NOT A SINGLE ad for MediGap/Supplemental plans.... NONE. No kidding.....we know why......

[@MikeD_]

I have seen an ad for MediGap, but notice I said an ad. A single one. It was from United Healthcare, but even the ad for a Gap plan was also noting their MA plans. So one single ad for a Gap plan vs. thousands for MA plans.

[@TheWilferch]

@@MikeD_ pretty much underscores my point....even with ONE Medigap ad. As they say ..."follow the money".....

[@johnkom2339]

Yep the Joe Namath sales pitches are driven by profit for them and they don't mention the downsides of the plans. Of course not.

[@johnkom2339]

Great and necessary warning. This trend should be reversed. W Bush opened the door for this to happen, to allow all health care to become profit-driven and it's unfortunate. I enrolled in original Medicare with gap. I hope it provides me the real care I need when I do need it!

[@miguelberrios19]

The bashing continues against the Advantage plans. Almost every single video you see, is about these lunny agents trying to destroy these plans. Now, having said that, I would definitely join a supplement plan only if, they make them affordable to many of us on social security.

[@bigd3104]

Did you watch the same video I did? Healthcare providers are dropping MA plans left and right. That alone should speak volumes about M.A. plans to any person paying attention. Unless, of course, you're one of those brokers enjoying double lifetime commissions writing M.A. plans as opposed to writing Medicare supplement plans. 🤔

[@ssharpe26]

Supplements aren’t often affordable, especially in the those guaranteed issued states that he mentions. In New York a BCBS company just raised their premiums by 400%, over $400 for a plan g and just under $400 for a plan N. Not many can afford that, pair that with needing to spend almost $100 for just a DECENT part D plan with just a SMALL deductible. The premiums alone are already more than the maximum out of pocket for most med advantage plans. Supps are fantastic and if they were affordable I’m sure everyone would love to have one. Also, most hospitals that are dropping MA plans, are doing so because they want to be paid more money. Let’s not act like they are not at fault here, notice the majority of them are still in network with certain MA plans (the ones that pay them the most, on the schedule they want). Prior authorization times are an issue at times, I also think a hospital being able to bill anything they want without ever being denied probably leads to some Medicare fraud. Do your research, get a good LOCAL broker, don’t be scared of med advantage plans if you can’t afford a supp. There are many good companies and good plans out there.

[@mjbftl]

It's easy to bash Advantage plans but how about making supplement plans affordable for everyone. There are counties in this country where starting plan G approaches $300. This is clearly not sustainable for someone starting that rate at 65. They will be impoverished by the premiums as they age. It's easy when you live in a county where the medigap plans start around $100 but that is not the case for millions of seniors. This needs Congress to fix so that basically means nothing will happen until it is a crisis.

[@g0989]

@@mjbftl It would help if Medicare Parts A & B had an annual Maximum out-of-pocket limit. You either get a Supplement from a private company (if you can handle the high premiums), or get an Advantage plan with low or no premium, in order to cap your annual out-of-pocket exposure.

[@realscotthogue]

Wow, the agents are evil, the insurance companies are greedy, the seniors are too dumb to know what is best for them and the government will save us. This video is very one sided. There must be a motivate to taking away the advantage plans.