'Too many Americans are left in limbo': Advantage Plans Fixed? 😱

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In today's video, Marvin Musick from Medicare School discusses the real deal with Medicare Advantage plans. He tells us why these plans might not always be the best choice even though they sound great with no premiums and extra benefits. Marvin points out that big insurance companies are making a lot of money but not always delivering on their promises, leaving many seniors in a tough spot. He explains the problems like limited doctor choices and the hassle of getting treatments approved.
Marvin also shares some good news about changes coming in 2024 to make Medicare Advantage plans better. The government is stepping in to ensure these plans are more like traditional Medicare and to cut down on the red tape. He walks us through what this means for people on these plans and how it could make things easier. Marvin's way of explaining things makes it simple to understand what's been going wrong and how it might get better.
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[@MedicareSchool]

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[@wk7060]

Do not have any problem with the network of doctors, but CMS needs to crack down on the Advantage Plan carriers to follow the rules of Medicare.

[@JohnJohn-wr1jo]

wk7060, why would they? It's not Medicare... Completely different set of rules and regs despite what their bloodsucking sales people claim.

[@CrazyCat23637]

Is there a way to find out which insurance companies comply with Medicare rules and which ones don’t?

[@joannejohnson85]

NONE of them do. There are NO preauth requirements for traditional Mcare or restrictive networks

[@kittyskid1]

The ads are so misleading.

[@JanetVaughn-cm3et]

Enforcement has ALWAYS been an issue & never done. I believe nothing will change as they have gotten away with it for so long, they will continue. If change ever comes it will be so slow & many years to overturn this. I'll be dead by then, so will not help me. Manpower to Enforcement is key, but that too will Never happen.

[@ChrisSadowski-pp1np]

Most people are best served by choosing traditional Medicare, getting medigap N or HDG, pickup part D right away to avoid the 1percent penalty each month, and avoid insurance and just pay dental and vision with cash (HSA).

[@Itsme-jv4cd]

My cardiologist wants me to have a remote monitoring every 3 months. My Popular MA plan won't pay for it however Medicare says it is a covered benefit that they will pay for every 3 months.

[@BJ-kv4zg]

I hear you talking nonstop about your Plan G and N. However, I. CANT. AFFORD. IT. Please stop making us feel less than human by going on and on about how bad Advantage plans are.

[@joannejohnson85]

If MA is all u can afford then u hve no choice. IMO this vodeo is to make you aware of whats going on with MA's Hopefully, these issues wont affect you.

[@SusieQ450]

Everyone in Washington should be on one these plans, I bet changes would start happening. Unfortunately I think they all get lifetime gold star paid for healthcare so they don’t feel our pain.

[@PatriciaGould]

Sadly, you are mistaken. Prior to 2014, members of Congress were allowed to purchase health insurance through the Federal Employee Health Benefit Plan, the exact same benefit and payments as all Federal Civil Service employees, including myself and my husband as letter carriers and retirees. After 2014, all members of Congress could no longer pay for a FEHBP and had to enroll in plans specifically created under the ACA (Obamacare) that only covers the DC area or they could buy private insurance which many of them do.

[@Jody-kt9ev]

From all the videos I have watched and articles I have read, it is my opinion that Medicare Advantage should be shut down completely. MA is costing CMS more per patient than original Medicare and a bunch of MA fraud investigations are ongoing. With the savings, supplement plans (and possibly vision and dental plans) could be provided for low income seniors.

[@joannejohnson85]

Here..here

[@rosaliesherrouse7589]

I have Humana and so far have never had to wait more than a week for a prior authorization. I have Osteopenia, osteoarthritis and CKD stage 3, COPD ...never a smoker. I suffer from Gerd and Vertigo. I will soon be having another knee replacement. The lady at the Neurologist office scolded me for having Humana because of prior authorizations slow them down. I also have Medicaid so she said I didnt need Humana. But Humana pays thousands on my medication where Medicaid wont pay much. Should I be looking for another supplimental plan? I dont know whatvto do.😢

[@Bugsybear2]

I work for a state Medicaid agency. Medicaid is the payer of last resort - in every state. If you drop your Medicare, Medicaid will not pay.

[@rosaliesherrouse7589]

I only want to drop medicare advantage , not Medicare A&B.

[@wk7060]

Question? When you apply to get off the MA plan, does that disenroll you from your current MA plan prior to acceptance from the applied supplemental plan?

[@HeresMyView]

Suggestion: Pls identify or LIST ALL those insurance companies that abuse, violate, circumvent, cheat or ignore compliance with CMS guidelines and requirements. This allows Medicare applicants to make informed decision to avoid such companies. Thus, these collaborations will put pressure on insurance companies to comply with the rules of Medicare Advantage or lose applicants. Don't depend on CMS enforcement only.

[@wk7060]

In order to put pressure on CMS to enforce the rules by Advantage Plan carriers, there should be a stipulation by Medicare that would let Medicare recipients to go back to Traditional Medicare without medical underwriter approval. CMS allowed MA to be an option for care.

[@g0989]

There is no underwriting to go back to traditional Medicare. But there is to get a Supplement with that, in most situations.

[@henrylam8792]

Problem is if you eliminate medical underwriting, everyone will go back to original Medicare and the Advantage plans will be out of business.

[@CathyTheMichiganGirl]

@@henrylam8792 I doubt everyone would switch to Traditional Medcare, as many can’t afford a Medigap plan.

[@g0989]

@@henrylam8792 There is no medical underwriting to go back to original Medicare. But there is underwriting to get a Supplement along with the original Medicare, in most states. A few states don't allow underwriting for Supplements, but those states tend to have the highest premiums in the Country for those Supplements. Most people will not take the risk of unlimited out-of-pocket copays with just original Medicare, so they will get either a Supplement, or replace Medicare with Advantage. So Advantage plans would likely survive if underwriting for Supplements were eliminated nationwide, as those who couldn't afford the Supplement premiums, or those who have lesser medical needs would be more likely to chose Advantage in order to avoid those premiums.

[@garybollrud8968]

My spouse has traditional medicare. $175 part B, $180 supplement, $50 part D. I have a medicare advantage plan. I pay $50 per month total including part B. Guess which plan we have more billing denials and authorization problems with? Hers....facts.

[@hypermiler12314]

Did you get Plan L? Plan K? Sometimes you get what you pay for. Plan G and N are worth the cost.

[@joannejohnson85]

You just wait

[@cdgerhart]

He seems biased against Advantage programs. You know he's an insurance agent and I bet he gets higher commissions for the gap insurance.

[@MedicareSchool]

We treat all Medicare plans equally, including Medigap and Advantage options. Our goal is to find the best fit for each client's unique needs. While Advantage plans might be a good choice for some, they aren't always the best option. Since Medigap plans often get overlooked, we make sure to thoroughly explain them. Our commitment is to unbiased service, carefully considering your specific needs and preferences.

[@marcryan5399]

My understanding is that CMS pays far more for Traditional Medicare than for Advantage plans. So what's the incentive to enforce these rules. If you eliminated the barrier's to switch between Original Medicare and Advantage plans, the problem would solve itself?

[@joebush5463]

answer me this question if they delay so bad doctor says you need this now and the person dies why has nobody sued

[@g0989]

I'm guessing it might be difficult to prove the patient would have lived if they had gotten the recommended treatment. If it was a condition that had been deemed life-threatening unless treated immediately, then prior-authorization would not be required. I've had outpatient procedures performed in the past for non life-threatening conditions. Standard statement in the patient authorization form always states something to the effect: "No warranty, express or implied, provided for services rendered. Results not guaranteed."

[@JohnJohn-wr1jo]

Joe, Insurance companies in this country are practically untouchable. Sister in law died last summer after her Advantage carrier denied her acute care rehab after a stroke. Would only pay for regular rehab. Family and regular rehab challenged the denial. Took 9 days to get reversed but on day 8 she choked on her own vomit and nobody realized it until she was unconscious and practically dead. Rushed to the hospital and spent 5 weeks in ICU and never woke up. Moved to long term care and died 5 months later. Family has consulted with 3 attorneys and none will go after the insurance carrier. Every one told her we can sue the home but we could never get a dime from the carrier and it would cost more than we could ever win to sue them and likely lose anyway.

[@threeftr3349]

@@JohnJohn-wr1jo Sorry for your families loss. What an awful situation your family went through. I hope people read your family's story, and take heed and find a way to have traditional Medicare with a supplemental.

[@BJ-kv4zg]

@@threeftr3349 You are all way too sick and I don't believe any of this.

[@rickw9008]

If you switch from a MAPD to a MedSup between 1/1-3/31 does that also allow you to enroll in a stand alone drug plan?

[@MedicareSchool]

yes, you will have the option to enroll in a drug plan. Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com

[@Pinti9]

CareMax is in network with Medicare Advantage. Is it worth getting?

[@MedicareSchool]

Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com