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I took Plan G Plus when I started Medicare and thought, "I'll never use it, I'm never sick." That didn't last long and I was so glad I had that G plan. I had a huge hospital bill for 5 days and only out of pocket was my Plan B deductible.
I have Plan F. I'll turn 70 in a few months and so far I haven't came close to taking much advantage of it. On the other hand, I'm very comfortable knowing that if I need it, I have it. When my younger brother turned 65, I tried to get him to get a Supplemental Plan, but he went with an Advantage Plan instead. Considering our rural location, he would need a 200 mile round trip for just about anything other than a simple doctor's visit and could easily need to go much further to find doctors in the network.
I just retired as an Insurance Agent. You are explaining how insurance works for retirees truthfully and accurately. Unfortunately not everyone listens until it is too late and then they place the blame for their situation not on their bad decisions but on other factors. I have a lot of respect for the work you are doing. Thank you.
this guy makes me want to have tooth extractions with no sedative. Pick the worse possible case, protect yourself from the 0.00000001% issue and piss your retirement savings away on the plan G premiums.
I got plan G at age 65 after using my work associated health insurance exactly twice in my life. At age 66, I was diagnosed with cancer. 4 surgical procedures, 20 weeks of chemo, 33 sessions of radiation, not to mention all the evaluations prior to treatment (MRIs, PET scan, etc)....my OOP cost was a little over $200 each calendar year. As all my procedures were outpatient, I did not incur the hospital deductible. I'm hoping to be moved to yearly check ups after my May visit....but even those visits with the associated tests are not cheap. The best thing is that I didn't have anyone telling me where I could or could not get treatment. Of course I had my Medicare B, D, and supplement premiums
wow - that's why we pay the G premiums - a great reminder of what can happen to a perfectly healthy person - sorry you went through that nightmare and hope you have smooth sailing for the rest of your Journey on this planet
My hospital billed $174K for a total knee replacement, my Medicare Advantage knocked that down to just under $16K. My cost was under $300.00. How the hell does this happen? Why the outrageous $174K billing??? American Healthcare is Effed up!
@@beoz658 - Are you sure it cost him nothing? according to everything I hear, including this video, if you have an advantage plan, you would be paying co-pays and percentages until you reach your out of pocket. Even with plan G, you at least have to pay the deductible.
Medicare pays the hospital and physicians a fraction of the billed charge. They are also capped at what they can charge a patient. Hospitals and physicians could not survive financially if they only treated Medicare patients. Private insurance patients subsidize the care of Medicare patients. No one, private insurance or Medicare pays the 'billed' charge. The billed charge is set high because Medicare only pays a small percentage of that charge. Yes, American Healthcare is messed up, but everyone is so afraid of 'socialized medicine'. Socialized Medicine works in just about every other developed nation and every ciitizen is covered and no one goes into debt over medical care.
Keep the videos coming!!! They never get old. I am an Ambassador for UHC here in NEO and I love helping people get through difficult situations finding resources to get them help with whatever is going on in there lives medically. These videos keep me sharp and loaded with tons of information to share back to the community!
I’m having a nightmare trying to get the medicine I need with UHC! I don’t know what to do and I have 1 day to decide. Change it to regular Medicare and a Part D or stay with the nightmare. God help me.
Excellent presentation and 100% accuracy! What is not mentioned is if the initial hospitalization is Observation (out patient designation) and the costs associated with that type of hospital related service(s). That’s part B.
@MedicareSchool Thank you for the easy to understand video. We are not Medicare age yet but are following friends'advice to read up on this stuff now while our minds are still 'young'. That said, I don't think we'd want to deal with the Advantage Hoops when we are old, gray and time deprived. We will just pay for the Supplement and be done with it.
I work for the state of Texas, who continues insurance coverage into retirement, including an option for an Advantage plan. It includes a lot of stuff not included in Medicare, almost all at zero cost. A co-worker's wife was on our Advantage plan when she had a stroke. Ambulance, ER, ICU, testing, etc. was zero dollars out of pocket. Our state government isn't known for being generous, so the lesson seems to be that Advantage plans need some serious regulation.
My wife and I are on a Aetna Medicare Advantage plan. She was 71 years old at the time two years ago.We live in a rural area in Georgia. Wife had a an AFIB episode. Ambulance ride to the hospital, overnight stay and ambulance transportation to a larger regional hospital 80 miles away. She spent two days at the regional hosp. undergoing tests and observation. Underwent a heart ablation procedure to treat AFIB issue. Total bill was over $400,000 Our out of pocket was $500 for the ambulance rides and $350 for the hospital stay and ablation procedure. There was no delay in getting approval fro these procedures. The monthly premium for the Advantage Plan is $0 per month. The Advantage plan has saved us thousands over the years.
That’s right and if you live in larger metro area with good hospitals and drs you should be taken care of just fine. How about all the yrs you had your AP before you used it.
That’s right and if you live in larger metro area with good hospitals and drs you should be taken care of just fine. How about all the yrs you had your AP before you used it. Referrals are no big deal. Pre authorizations could be an obstacle but not always.
Depends on where you are. Nevada is the worst. My brother and sister-in-law have had nothing but long waits, long drives, terrible communications, and cancelations with serious medical issues. He's lucky he got through a drawn-out lymphoma battle. Now, my sister-in-law has been canceled twice by the oncologist. Their primary is trying to expedite that situation. It's despicable. They have Humana Advantage Plus. They do get perks, but Nevada and health care don't go together well. Especially, on a limited income.
Great Video. Your videos plus the experience people I know on MA plans make me glad that my wife and I are on original Medicare and a G supplement. I just had a minor skin cancer treated. No pre-approvals, denials, networks or any crap like that. Just went and had it done. A while back I read a story of a man on MA who had deadly malignant Melanoma. With all the pre-approval delays, it was 7 months before he was treated. This is not what you want when facing cancer.
Brilliant comment. Advantage is a trade-off. You may save a couple of thousand $$ per year. The cost may be your life, due to your reduced freedom of choice. You decide.
@@MerryTrader Pretty much the truth. One commentor said that with original Medicare, you and your doctor make the decisions about your health. With Medicare Advantage, the insurance company makes the decisions about your health.
You should add on a counselor to your program. I recently had a patient with numerous back surgeries resulting in infections. The wife told me he is in ICU and needed to go to hospice, but she was not ready for him to go to hospice, so he is occupying a bed that is costing her hundreds a day. Her denial will cost her thousands of dollars in end. Families need to be aware of the lack of communication will put them in debt very quickly.😢
Had to go to our local in PA geisinger clinic to find out I was in AFib. Transported from clinic to geisinger ER via ambulance. Was in ER for about 5-6 hours being stabilized. Have geisinger gold advantage plan (no monthly cost). Ambulance ride was no charge, had $90 co-pay for ER.
Good Job, Very well explained. Just two corrections, One is a Typo "Carotid Artery STENT" not STINT. Second, The specialist fees per visit is $50 but only $50 was entered but you said it was about $500. With $50 it accounts for only one visit by one specialist only !!!
@@wayneguy6043 I am 82 and my wife is 81 and we pay approx $292 and $276 a month each, respectively. The reason for moving from Plan F to Plan G is that the pool of Plan F people is diminishing each year which will cause the costs per individual to increase. If I am wrong on that issue please correct me.
If you have plan F, keep it. It’s so generous that new to Medicare people cannot even get it. My 95 year old mother in law has Plan F. What a godsend when she fell and had to have surgery. Tiny copays. Because of when I was born Plans G and N are best I can do.
I have a UH MA PPO. My hospital bills were over $105,000 and my out of pocket was $1,5000. So it was almost break even compared to the G plan yet I get vision, dental, hearing, gym membership, and $700 in healthcare products like toothpaste. You can’t beat that.
With Advantage people get sucked in with the $0 premium. They may be good from 65 -75 years old but then things happen and they need to pay big bills. With Plan G you are paying more upfront but it will pay off in the long run when you need it.
@@juliebutler8241Everybody gets sick eventually. No one dies healthy, unless they get hit by a truck! I've known people who have done everything right, grown their own food, ran marathons, you name it. No one is immune. Sure, you can improve your odds that you stay healthy longer, but there are no guarantees, and sooner or later something will get you!
@@juliebutler8241 I've known people to eat like crap and smoke cigarettes and live into their 80s and seen people eat right, exercise and do every single thing right and end up with cancer. Shit happens a lot is your genes too
Exactly! Ask an advantage plan if you can go to a rehab facility after a broken hip. They’ll either deny or give you very few days. Vs Medicare where you have 100 days.
Have an F plan since I eventually will need a 2nd heart valve replacement. My insurance would not let me change to the G plan due to the cost of this surgery. Don’t want to change to advantage plan since I want to choose my doctor & hospital.
I have been enrolled in original medicare + supply for 2 years but still check all information regarding medicare as often as I have time. Original medicare still beats advantage plans most of the time. Good information. Thanks
I had problems swallowing requiring a CT scan and a barium swallow. Subsequently I underwent surgery with an overnight stay. My total cost $55. No Medicare D payments, no supplemental insurance payments. Thank you Kaiser Advantage.
Not likely, I’ve had Kaiser for multiple years prior to Medicare, they took care of all my needs. Now on Med Adv with Kaiser and the only thing that’s changed is the annual deductible is no longer an issue, and my MOOP is 5k less than before.
Kaiser almost killed my cancerous younger sister - Kaiser wanted to “wait and see” if the tumor grew. She then went to Stanford who promptly and aggressively removed the cancer. She is in remission now, years later.
The premium quoted by my agent for a 2025 G plan for my 70 year old wife in Miami-Dade County is between $300-350! That’s almost 3 times the number used by Marvin. This sunshine is EXPENSIVE!
We are all healthy until we are not. We all do not use insurance until we do. I've watched numerous videos, so many you would think I get tired of watching them. But no, I so look forward to them and watch from beginning to end. Just so grateful for all the awesome easy to understand explanations on how it all works. I will never get tired of them and even after I go on Medicare I will continue to watch. 65 and 4 months, still working, not collecting yet but the time will come. I absolutely love the "G" Plan and I would tell anyone if they can afford it to get it, or even look at the "N" Plan. But I will never ever recommend the Advantage Plan. I have a friend on an Advantage Plan. He had an appointment 60 miles away from home with a specialist and when he got their the lady at the desk told him they do not take his Humana Insurance anymore. Too many stories like this one. maybe it will change one day but I am not taking any chances with my health in the insurance companies hands. Awesome Video!
@@BJ-5779…..Yeah, that worked for my mother-in-law….until it didn’t. She thought she was so smart having Cigna Medicare Advantage, because she was one of those very active, healthy seniors. But shortly after she turned 92, she had the typical ‘fallen and hurt my hip’, situations. That was last year….she is still haggling with her insurance to get an MRI approved so that she can get help from a pain management center……still waiting! My husband had neck surgery on four vertebra, bill was over $216,000.00. But he only had to pay the deductible of $226.00, plus his monthly premiums, and his Plan G supplement took care of the rest, along with Original Medicare. Oh, and we both had MRI’s last year….never needed prior approval, just went and had them done! If we had been on an ‘Advantage’ plan, we would both STILL be waiting.
He went there before and they took his insurance. They decided not to anymore. He shouldn't have to call every time and ask if they still take it. Plan "G" for me.@@BJ-5779
So strange here in Sacramento County some Hospitals are not accepting Original Medicare g supplement. But Sutter Health Care will accept UHC Advantage HMO
BJ, read what u posted. "Nothing wrong with the Advantage plan if your healthy".. You've already developed a serious case of denial and need treatment before it's terminal and drains your savings. Advantage Plans cost more out of pocket every year. Your setting yourself up for huge bills and subpar care when your going to need it the most.
For over, 16 years, we have had a plan F. It has been worth it! My husband has had several operations that require a specialist from that we would not have had available with an Advanage plan etc. We have only had to pay out under $1000 for chiroprator or some special issues. Cost more but we are so fortunate. It was a good decision back in 2008 Thanks for you information to retirees.
The bottom line (talking about cost) is you always pay. Choose to pay when the big medical issue is performed with Advantage.. or up front in manageable budgeted monthly premiums under A,B & Supplement G. Now… the topic of freedom of where and which doctor & hospital, or having to get pre approved, having to have your primary doctor refer to specialists.. is also an issue between the plan options.
Thank you for this video because it has enlightened me to the reality of my situation. Due to chronic medical conditions after my brain aneurysm and stroke, I couldn't possibly be medically underwritten for any supplemental plan.
Also worth noting, I am pretty sure you need a part D (drugs) to go along with your Medigap plan G.many are inexpensive I already have plans to switch from my advantage plan to the G plan and a D, drug plan
Interesting that you are planning to switch from Advantage to original medicare. It’s my understanding that you are going to go an underwriting to see if you qualify. After a year in Advantage is almost impossibly to switch back
@@mypphh97 I was told that since I am leaving an employer sponsored group plan there would be no underwriting if I switched to a Medigap plan. I will find out next month when I apply for plan G to start in January.🤞🤞
My husband had a knee replacement with plan N. We pay before surgery $20 consultation, $20 cardiologist release, $20 primary physician clearance, $20 visit before surgery with nurse practician. I am not sure how much we need to pay for staying him in a hospital for 2 days ( they billed part B for anesthesiologist job, for surgeon visiting him next day and some other pt visits in a hospital. Right now we paying 3 times per week $20 for his pt ( 3 month). If you put all this copay together it is a lot more than difference between plan G and plan N premium.
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I have G high deductible. 366 for the year.. it would be More if i paid it monthly. Like car ot house insurance paying monthly payments they charge 5 dollar service fees . Service fees add up. Does take discipline to save up and avoid those fees . I just pay in full . Well worth the trouble.
My OHS was $340k! Humana negotiated it down to $240k! My final bill was $4200. Since G would cost me $150/mo and we pay zero with out Advantage Plan, we would have spent $9k on plan G premiums. We have saved $4800 so far with our Humana Advantage Plan!
I have a Humana Advantage plan, which I have had no problems with. I have some dental coverage with it, which is nice. All my doctors take it with no problem and zero premium. So far, so good!
Marvin, you are a natural at teaching folks about medicare, thank-you for what you do. But, please know that saying (at 12:09) that a Plan G policy will cost about $125 can be misleading. Many about to go on Medicare live in Florida, as I do, and i just had a call with one of your representatives, and a G plan was quoted at between $190 and $227 - that's a far cry from $125. At $125, i'd take a G plan all day long, but at $200 or so, i have to consider the N plans as well.
Thank you for this, while the numbers we use in our videos are based on averages asides from the few states that have much higher premiums such as CA, NY and FL. We do appreciate this feedback and will take into consideration.
Been there done that in January. Almost two weeks in ICU before stable enough to be transferred for surgery to a heart center for surgery. I don’t remember any of this. De stabilized on transfer and back to the ICU in new hospital. Was there 10 days and had surgery. 1 week in ICU, 3 days in step down. Surgery alone $100,000. Moved to rebab for another 2 weeks. Home healthcare for three months. I have Supplemental Plan ❤ Cost to me……..drumroll----ZERO, YUP ZERO!!!! $000,000,000 OPP’s……..Plan “G”. $174.00 a month
I'm still working, so I decided I'd make myself afford the plan G. I just turned 66. I've had a procedure done that cost about $12,000, visits to primary, specialists, and even the ophthalmologist. I've only paid the $240. I take only a heartburn med but had to buy part d. Found a cheap one for $11. My G plan is UHC through AARP. There is no increase due aging til I'm 68. But may pay cost of living and / or inflation increases.
The one factor you did not mention was a drug plan. There are some very good deals on meds in the C or advantage plans. Purchase plan G and one must buy a drug plan in addition. My husband died a year and a half ago. So I am on half his pension and social security. I wish I could afford G and a med plan but the options are scarce in Maine. Thank you for all you do, bless you.
My wife has a thread of cancer in her breast. It was outpatient surgery, we were gone from the house for 9 hours. The hospital billed our insurance over $180,000. It seems that your average costs might be optomistic.
Are the services they're providing, while requiring advance skills and knowledge and sometimes expensive equipment, really worth $3000 a day? Does that sound like a fair price for what they're providing?
The most important difference for me is physician choice. I am totally not willing to give that up to save a couple hundred dollars a year to choose a Medicare (dis)Advantage plan.
I’ve had a supplement insurance with my Medicare for 21 years. I would not give it up for anything. I’ve had hospital stays and never had to pay a dime any time ago to Specialist doctor anything I don’t pay anything I just walk out the door. Local State Farm agency is who I use
Plan G is your best bet if you can afford the premium. Advantage gives you a bunch of crap like useless dental, vision and other benefits that are not of high value, Good video
Thanks. Pre-authorizations + network requirements make Advantage plans useless unless you absolutely can't afford the monthly premiums. Of course, you end up paying more for an Advantage plan and you're at the mercy of insurance companies who exist to under-serve you and maximize their profits. Also, Plan G prices rise a LOT faster than the rates for Plan N - also something to consider
The hdG bill would be the same as the G other than this years $2800 deductible. A lot of that would be made up with the monthly premium difference. Here in Florida G is $186 and hdG is about $60 a month, at this time if you had to pay the deductible every other year it would be about a break-even proposition. As long as you are reasonably healthy the hdG could save you a lot of money. Who knows what the future holds? Once you sign onto a plan it's difficult to switch plans in most states.
I have the plan G and I really like it despite the $250 deductible. I had open heart surgery back in April of 2023 and was in the ICU for 5 days so I am so glad that I got this plan after plan F was done away with.
I will turn 65 next year. Which plan is best. I require prescription drug care. I heard an Advantage plan is difficult to leave for a Supplemental plan. Thanks for your help.
i have Tri-Care for life and recently changed to an advantage plan after consulting with your councelors. I like the additional benefits that the advantage plan has over conventional medicare. Will my tri-care for life cover those copays you refer to? Thank you!
125 part G 20-30 part D 174 part B That’s 329 a month at the bare minimum of prices and not including dental, vision, hearing , over the counter benefits, transportation. That’s all separate insurances you will have to add to that 329 a month which can be up to 500 dollars a month for complete insurance. Almost 6000 dollars a year. Part c is no premium and comes with dental vision hearing. Yes it has co pays when you see a doctor but most plans are capped at 3000 dollars a year and the rest is free. So even if you had a bad health year your paying half what you would pay for supplement. And what if you healthy? You pay nothing but the part b which is 4000 less than a supplement you may or may not use. For people on low income like most people on Medicare, a supplement plan is not affordable for them, which is why there is a part c option. Supplements increase every year with no cap, most clients will go to part c after a couple years of supplement because it’s not affordable anymore.
Advantage plans if PPO work well that's why 50% of people use them. People are scared into buying supplemental plans issused by insurance companies that are in it to make money just like advantage insurance companies. The premiums you pay with supplemental eat up any savings. My Advantage PPO covers all my doctors cancer hospital etc.
@@cgilleybsw Real question. I don’t know what you mean. What part is BS? Also, not sure what you mean by grow up. Am I being naive about something? Thanks.
I am embarrassed that our government allows fracking which releases tons of greenhouse gas Methane, destroys water tables and aquifers that supply humans, just so Energy company CEO's can collect millions and bribe politicians (and now with the crooked SCOTUS, even the courts). Healthcare is like any other business in a Capitalist society, especially the USA who legalized bribery of politicians with the disastrous Citizens United v FEC ruling in 2010.
@@cgilleybswWhat a bunch of crap! Why is our healthcare so confusing!! This guy sounds like a used car salesman. For profit healthcare that only cares about profits and share holders is evil!!!
My hospital cost for getting a pacemaker added up close to $200k. They negotiate final bill down dramatically. I think to around $15k. I ended up paying maybe a $20 doctor co-pay only under plan N. I was wondering how much this would have cost under advantage and would they have negotiated the bills down as much?
I live in the northeast. Please do a similar video using numbers from New York City numbers. An MRI around here starts at $1000. Outpatient surgeries probably in the multi 10s of thousands. That $300 outpatient figure must be for a pet with a vet.
As another commenter noted, you postulated 10 specialist visits @ $50, which would be $500 total, but you wrote $50 (ruclips.net/video/BClz3V39jm4/видео.html). That would make the total cost $4,050 instead of $3,600 for this MA hypothetical. Throw in a couple "surprise" bills from out-of-network providers, and you'd be even more in-the-hole.
An important thing to note about the MOOP on an Advantage plan. It only counts towards medical care and if the patient has any treatment done that is not approved by the plan. It will not count towards that MOOP. Plus anything done that is not approved by the plan the patient pays 100% towards that procedure.
If I start out at 65 years old and live to 95, do premiums increase as I age? I expect to need more medical care as I get older. Is there an age where this math changes so a different plan is cheaper at 95 than when I was 65.
I was watching the part about A and B only and I don’t think it’s accurate. The co-insurance is 20% but for doctor’s visits Medicare limits the amount they can charge. It’s usually $20. Also, when you talked about the amount that you have to pay the 20% copay on, that amount should be reduced by Medicares approved amounts. For a normal hospital stay with surgery , original Medicare would be sufficient. The only reason to get a supplement is for the unforeseen risks that could happen. I’m probably going to go with a plan N just because I get most of my medical care from the Indian health service.
Friend of mine had a stroke. # different hospitals, 2 week stay with 5 days in intensive care, his estates portion of the bill? $0, because he had an F Plan. Too bad they discontinued them.
Ok. Have a question here. Since I’m new to Medicare and disabled my only income is social security. I just lost my duel Medicare and Medicaid benefits. All These financial costs are overwhelming to me. What plans should I get to cover these expensive costs
That depends on where you live and what is available to you. Give us a call we'd be happy to review plans with you. You can reach us at 1-800-864-8890.
If someone is generally healthy and needs 1 surgery in 5 years the total cost of advantage plans is @ $1800 oop (for the hospital co pay of 1 surgery) plus maybe 100 per year of co pays = 2300 total for the surgery year and zero or low co pays for the remaining years. If you have a G plan you pay $1,740 (premium and deductible) yearly which amounts to $8,700.00 in 5 years even without surgery. Had I selected a G plan at todays price when I retired in 2017, I would have paid $13,920 by now with no surgeries. The Advantage plan has paid for regular wellness checks and dental care and eye care and hearing care had I needed it. In 7 years I have paid less than $700. Do the math before you decide.
Don't forget about accidents, they can take you out just as badly as an illness. I was working on a tree and got smacked by a large branch. Crushed arm required surgery, concussion dictated a life flight trip ($42,000 alone). Ongoing physical therapy too. So thankful I'm on regular with a G.
So if I understand correctly, with the Advantage plan you will have greater costs than if you have standard Medicare with a supplemental plan however you pay no monthly premiums. In case of hospitalization, the costs with an Advantage plan will not make you go bankrupt -- i.e. you might have a bill of $3-5,000 more or less
If you have Medicare Parts A, B, and G, it's advisable to consider enrolling in a Medicare Part D prescription drug plan for comprehensive coverage of prescription medications and to avoid potential late enrollment penalties. www.medicare.gov/
Good presentation but you are missing a couple of things about Medicare A and B allowing procedures. They will pay for surgeries that are "approved" by Medicare. But not all are approved. So, in my case, I am a board-certified plastic surgeon that does a lot of breast reduction surgeries for patients with huge breasts. It's a life-changing procedure. Medicare will NOT do pre-authorizations for this procedure, and if you do the procedure, they may or may not pay for it. So, I can't tell the patient whether or not it will be covered for sure. We won't know until we submit the bill. And they don't post the requirements for coverage so we are guessing. When I do a reduction case Medicare (only the really big breasts) will always deny the payment at first and then my office has to appeal it. and it takes me 8 to 10 months to get aid for the case. However, Blue Cross of Alabama has published criteria for paying for a reduction and will pre-authorize it, so using a Part C plan overseen by Blue Cross is easy to work with and the patient knows it will be covered. I have a similar issue with the procedure to remove excess upper lid skin to improve blocked vision. Very difficult to work with Medicare. They are tough with the procedure that are in the "gray area" of being absolutely medically necessary. Thanks for your hard work.
Here is a link for a video on Tricare. ruclips.net/video/JJYauUj8MWU/видео.html Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
You dont just do a plan G you will drop advantage get medicare A and B again plus plan G. Everything I hear is advantage is great as long as you dont get really sick. Also on “regular” medicare you can go to any doctor anywhere in the U.S. No in network doctors etc. No pre-approvals needed. where as with an advantage an insurance company is deciding on your health care not your doctor.
This excellent presentation is very informative. In fact, every video I have watched by "MedicareSchool" has been done very well. However, this presentation tries to make a comparison with the plans covered, and they leave out a fourth alternative for comparison purposes-Medicare Advantage with a Hospital Indemnity plan. Why leave this option out? The second plan covered was someone getting A & B plus a supplement plan (gap). So, a gap plan for the Medicare Advantage plan (Hospital Indemnity plan) should have also been included to accurately compare these four situations. As presented, this was a bit disingenuous and slightly misleading.
We have a separate video that covers hospital indemnity plans in detail. In some cases, viewers may not qualify for those plans, as they often require underwriting after a certain age. To keep our videos clear and concise, we focus on specific scenarios in each one. This way, we can highlight details without blending topics together, which helps avoid unnecessary confusion. ruclips.net/video/9ik52BPL2CQ/видео.html
My expenses on a $200K hospital bill would be a little above $9.16/day. Depends upon drugs used. January 2023, I had. Right carotid artery stent emplaced. My cost was ZERO.
I wish you would talk about the other supplement plans, besides G and N. I get that they're your favorite, but the other plans may suit some people better.
G and N are the most comprehensive and available plans in the country, however if you give us a call we would be happy to discuss the other supplemental plans with you. 800-864-8890
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I wished your company hired remote customer agents. I’d love to work for you.
I took Plan G Plus when I started Medicare and thought, "I'll never use it, I'm never sick." That didn't last long and I was so glad I had that G plan. I had a huge hospital bill for 5 days and only out of pocket was my Plan B deductible.
Same here, 2 months after reaching 65, had a huge hospital bill, only paid the Plan B deductible.
I have Plan F. I'll turn 70 in a few months and so far I haven't came close to taking much advantage of it. On the other hand, I'm very comfortable knowing that if I need it, I have it.
When my younger brother turned 65, I tried to get him to get a Supplemental Plan, but he went with an Advantage Plan instead. Considering our rural location, he would need a 200 mile round trip for just about anything other than a simple doctor's visit and could easily need to go much further to find doctors in the network.
I have Plan F as well. I love it. My former employer subsidizes part of the premium though.
With plan N you would still have those benefits with a lower premium and annual rate increases.
Smart choice!
I just retired as an Insurance Agent. You are explaining how insurance works for retirees truthfully and accurately. Unfortunately not everyone listens until it is too late and then they place the blame for their situation not on their bad decisions but on other factors. I have a lot of respect for the work you are doing. Thank you.
I agree! Some of the world's "best kept secrets" are because folks didn't take time to learn it, like this video/tutorial.
this guy makes me want to have tooth extractions with no sedative. Pick the worse possible case, protect yourself from the 0.00000001% issue and piss your retirement savings away on the plan G premiums.
@@cgilleybsw 0.00000001% chance of having health issues that make Plan G worth its premiums? LOL.
I got plan G at age 65 after using my work associated health insurance exactly twice in my life. At age 66, I was diagnosed with cancer. 4 surgical procedures, 20 weeks of chemo, 33 sessions of radiation, not to mention all the evaluations prior to treatment (MRIs, PET scan, etc)....my OOP cost was a little over $200 each calendar year. As all my procedures were outpatient, I did not incur the hospital deductible. I'm hoping to be moved to yearly check ups after my May visit....but even those visits with the associated tests are not cheap. The best thing is that I didn't have anyone telling me where I could or could not get treatment. Of course I had my Medicare B, D, and supplement premiums
wow - that's why we pay the G premiums - a great reminder of what can happen to a perfectly healthy person - sorry you went through that nightmare and hope you have smooth sailing for the rest of your Journey on this planet
My hospital billed $174K for a total knee replacement, my Medicare Advantage knocked that down to just under $16K. My cost was under $300.00. How the hell does this happen? Why the outrageous $174K billing??? American Healthcare is Effed up!
the outrageous bill of 174k is a tax dodge. buy writing off the 158k they never pay taxes
The difference is a loss and in turn they pay no income tax
My friend 70 years old just had open heart surgery. With UHC Advantage it cost him nothing WTH!
@@beoz658 - Are you sure it cost him nothing? according to everything I hear, including this video, if you have an advantage plan, you would be paying co-pays and percentages until you reach your out of pocket. Even with plan G, you at least have to pay the deductible.
Medicare pays the hospital and physicians a fraction of the billed charge. They are also capped at what they can charge a patient. Hospitals and physicians could not survive financially if they only treated Medicare patients. Private insurance patients subsidize the care of Medicare patients. No one, private insurance or Medicare pays the 'billed' charge. The billed charge is set high because Medicare only pays a small percentage of that charge. Yes, American Healthcare is messed up, but everyone is so afraid of 'socialized medicine'. Socialized Medicine works in just about every other developed nation and every ciitizen is covered and no one goes into debt over medical care.
Keep the videos coming!!! They never get old. I am an Ambassador for UHC here in NEO and I love helping people get through difficult situations finding resources to get them help with whatever is going on in there lives medically. These videos keep me sharp and loaded with tons of information to share back to the community!
I’m having a nightmare trying to get the medicine I need with UHC! I don’t know what to do and I have 1 day to decide. Change it to regular Medicare and a Part D or stay with the nightmare. God help me.
Marvin always makes Medicare easy to understand. We need him to discuss what insurance companies have the lowest rate increases.
Correction: at 18:05 you mentioned seeing Specialist 10 times at $50 each would be $500 not =$50. Not a huge deal, but want people to keep focus.
I saw that same mistake in this video. Good catch.
That is the copay, not the total cost. I am not aware of any copay for a specialist that is $500.
He corrected it when he got to the total numbers.
@@LTVoyager because he said you would probably see around 10 specialists making it $500.00. Just an error in his addition.
Excellent presentation and 100% accuracy! What is not mentioned is if the initial hospitalization is Observation (out patient designation) and the costs associated with that type of hospital related service(s). That’s part B.
Understanding the nuances between advantage and supplemental options is crucial for healthcare decisions. Your analysis provides valuable clarity.
@MedicareSchool
Thank you for the easy to understand video. We are not Medicare age yet but are following friends'advice to read up on this stuff now while our minds are still 'young'. That said, I don't think we'd want to deal with the Advantage Hoops when we are old, gray and time deprived. We will just pay for the Supplement and be done with it.
I work for the state of Texas, who continues insurance coverage into retirement, including an option for an Advantage plan. It includes a lot of stuff not included in Medicare, almost all at zero cost. A co-worker's wife was on our Advantage plan when she had a stroke. Ambulance, ER, ICU, testing, etc. was zero dollars out of pocket. Our state government isn't known for being generous, so the lesson seems to be that Advantage plans need some serious regulation.
My wife and I are on a Aetna Medicare Advantage plan. She was 71 years old at the time two years ago.We live in a rural area in Georgia. Wife had a an AFIB episode. Ambulance ride to the hospital, overnight stay and ambulance transportation to a larger regional hospital 80 miles away. She spent two days at the regional hosp. undergoing tests and observation. Underwent a heart ablation procedure to treat AFIB issue. Total bill was over $400,000
Our out of pocket was $500 for the ambulance rides and $350 for the hospital stay and ablation procedure. There was no delay in getting approval fro these procedures. The monthly premium for the Advantage Plan is $0 per month. The Advantage plan has saved us thousands over the years.
That’s right and if you live in larger metro area with good hospitals and drs you should be taken care of just fine. How about all the yrs you had your AP before you used it.
That’s right and if you live in larger metro area with good hospitals and drs you should be taken care of just fine. How about all the yrs you had your AP before you used it. Referrals are no big deal. Pre authorizations could be an obstacle but not always.
The resetting of your MOOP is the only real scary part, but if you went ten yrs without even using it you’re probably ahead.
Are you really that crazy
Depends on where you are. Nevada is the worst. My brother and sister-in-law have had nothing but long waits, long drives, terrible communications, and cancelations with serious medical issues. He's lucky he got through a drawn-out lymphoma battle. Now, my sister-in-law has been canceled twice by the oncologist. Their primary is trying to expedite that situation. It's despicable. They have Humana Advantage Plus. They do get perks, but Nevada and health care don't go together well. Especially, on a limited income.
Great Video. Your videos plus the experience people I know on MA plans make me glad that my wife and I are on original Medicare and a G supplement. I just had a minor skin cancer treated. No pre-approvals, denials, networks or any crap like that. Just went and had it done. A while back I read a story of a man on MA who had deadly malignant Melanoma. With all the pre-approval delays, it was 7 months before he was treated. This is not what you want when facing cancer.
Brilliant comment. Advantage is a trade-off. You may save a couple of thousand $$ per year. The cost may be your life, due to your reduced freedom of choice. You decide.
@@MerryTrader Pretty much the truth. One commentor said that with original Medicare, you and your doctor make the decisions about your health. With Medicare Advantage, the insurance company makes the decisions about your health.
You should add on a counselor to your program.
I recently had a patient with numerous back surgeries resulting in infections. The wife told me he is in ICU and needed to go to hospice, but she was not ready for him to go to hospice, so he is occupying a bed that is costing her hundreds a day. Her denial will cost her thousands of dollars in end.
Families need to be aware of the lack of communication will put them in debt very quickly.😢
Thanks!
No problem!
Had to go to our local in PA geisinger clinic to find out I was in AFib. Transported from clinic to geisinger ER via ambulance. Was in ER for about 5-6 hours being stabilized. Have geisinger gold advantage plan (no monthly cost). Ambulance ride was no charge, had $90 co-pay for ER.
Good Job, Very well explained. Just two corrections, One is a Typo "Carotid Artery STENT" not STINT. Second, The specialist fees per visit is $50 but only $50 was entered but you said it was about $500. With $50 it accounts for only one visit by one specialist only !!!
Brilliant comparison.....your message is clear. I have plan F and obviously need to consider going to a plan G. Excellent information.
How much is your F plan a month?
@@wayneguy6043 I am 82 and my wife is 81 and we pay approx $292 and $276 a month each, respectively. The reason for moving from Plan F to Plan G is that the pool of Plan F people is diminishing each year which will cause the costs per individual to increase. If I am wrong on that issue please correct me.
I just read they are ending the "F" plan for anyone who was not eligible in 2020 or earlier.
If you have plan F, keep it. It’s so generous that new to Medicare people cannot even get it. My 95 year old mother in law has Plan F. What a godsend when she fell and had to have surgery. Tiny copays. Because of when I was born Plans G and N are best I can do.
I have a UH MA PPO. My hospital bills were over $105,000 and my out of pocket was $1,5000. So it was almost break even compared to the G plan yet I get vision, dental, hearing, gym membership, and $700 in healthcare products like toothpaste. You can’t beat that.
With Advantage people get sucked in with the $0 premium. They may be good from 65 -75 years old but then things happen and they need to pay big bills. With Plan G you are paying more upfront but it will pay off in the long run when you need it.
Only if you eat processed crap. I eat the proper human diet. You are what you eat!
@@juliebutler8241Everybody gets sick eventually. No one dies healthy, unless they get hit by a truck! I've known people who have done everything right, grown their own food, ran marathons, you name it. No one is immune. Sure, you can improve your odds that you stay healthy longer, but there are no guarantees, and sooner or later something will get you!
@@juliebutler8241 I've known people to eat like crap and smoke cigarettes and live into their 80s and seen people eat right, exercise and do every single thing right and end up with cancer. Shit happens a lot is your genes too
Exactly! Ask an advantage plan if you can go to a rehab facility after a broken hip. They’ll either deny or give you very few days. Vs Medicare where you have 100 days.
what about all the premiums savings if you are healthy tor the next 10 years? That could add up to 20-30k in savings on the advantage program.
My senior medical advantage plan with Kaiser Plan covers everything.
Have an F plan since I eventually will need a 2nd heart valve replacement. My insurance would not let me change to the G plan due to the cost of this surgery. Don’t want to change to advantage plan since I want to choose my doctor & hospital.
I have been enrolled in original medicare + supply for 2 years but still check all information regarding medicare as often as I have time. Original medicare still beats advantage plans most of the time. Good information. Thanks
Thanks for sharing, we're happy to help!
Thank you, great information 🙏🏼
Just got the plan g before I retire I went to complete physical check up.
I had problems swallowing requiring a CT scan and a barium swallow. Subsequently I underwent surgery with an overnight stay. My total cost $55. No Medicare D payments, no supplemental insurance payments. Thank you Kaiser Advantage.
BS
Not likely, I’ve had Kaiser for multiple years prior to Medicare, they took care of all my needs. Now on Med Adv with Kaiser and the only thing that’s changed is the annual deductible is no longer an issue, and my MOOP is 5k less than before.
Kaiser almost killed my cancerous younger sister - Kaiser wanted to “wait and see” if the tumor grew. She then went to Stanford who promptly and aggressively removed the cancer. She is in remission now, years later.
I had a heart valve replacement, over 140 thousand have Medicare with a supplement, I paid approx 160.00 out of pocket.
The premium quoted by my agent for a 2025 G plan for my 70 year old wife in Miami-Dade County is between $300-350! That’s almost 3 times the number used by Marvin.
This sunshine is EXPENSIVE!
Excellent information. Thank you
We are all healthy until we are not. We all do not use insurance until we do. I've watched numerous videos, so many you would think I get tired of watching them. But no, I so look forward to them and watch from beginning to end. Just so grateful for all the awesome easy to understand explanations on how it all works. I will never get tired of them and even after I go on Medicare I will continue to watch. 65 and 4 months, still working, not collecting yet but the time will come. I absolutely love the "G" Plan and I would tell anyone if they can afford it to get it, or even look at the "N" Plan. But I will never ever recommend the Advantage Plan. I have a friend on an Advantage Plan. He had an appointment 60 miles away from home with a specialist and when he got their the lady at the desk told him they do not take his Humana Insurance anymore. Too many stories like this one. maybe it will change one day but I am not taking any chances with my health in the insurance companies hands. Awesome Video!
@@BJ-5779…..Yeah, that worked for my mother-in-law….until it didn’t. She thought she was so smart having Cigna Medicare Advantage, because she was one of those very active, healthy seniors. But shortly after she turned 92, she had the typical ‘fallen and hurt my hip’, situations. That was last year….she is still haggling with her insurance to get an MRI approved so that she can get help from a pain management center……still waiting!
My husband had neck surgery on four vertebra, bill was over $216,000.00. But he only had to pay the deductible of $226.00, plus his monthly premiums, and his Plan G supplement took care of the rest, along with Original Medicare. Oh, and we both had MRI’s last year….never needed prior approval, just went and had them done!
If we had been on an ‘Advantage’ plan, we would both STILL be waiting.
I agree with you. Just started Medicare and got Supplement. No pre-approvals, no worry about whether a doctor may or may not accept you.
He went there before and they took his insurance. They decided not to anymore. He shouldn't have to call every time and ask if they still take it. Plan "G" for me.@@BJ-5779
So strange here in Sacramento County some Hospitals are not accepting Original Medicare g supplement. But Sutter Health Care will accept UHC Advantage HMO
BJ, read what u posted. "Nothing wrong with the Advantage plan if your healthy".. You've already developed a serious case of denial and need treatment before it's terminal and drains your savings. Advantage Plans cost more out of pocket every year. Your setting yourself up for huge bills and subpar care when your going to need it the most.
For over, 16 years, we have had a plan F. It has been worth it! My husband has had several operations that require a specialist from that we would not have had available with an Advanage plan etc. We have only had to pay out under $1000 for chiroprator or some special issues. Cost more but we are so fortunate. It was a good decision back in 2008 Thanks for you information to retirees.
The bottom line (talking about cost) is you always pay. Choose to pay when the big medical issue is performed with Advantage.. or up front in manageable budgeted monthly premiums under A,B & Supplement G. Now… the topic of freedom of where and which doctor & hospital, or having to get pre approved, having to have your primary doctor refer to specialists.. is also an issue between the plan options.
Thanks! It is beyond merely helpful to have comparisons gathered together.
I keep learning thanks to you
Glad to help
Thank you for this video because it has enlightened me to the reality of my situation. Due to chronic medical conditions after my brain aneurysm and stroke, I couldn't possibly be medically underwritten for any supplemental plan.
Glad that we could help, if you have any questions please give us a call 1-800-864-8890.
I’m 66 and I have plan G and it costs me $206 a month. Before I turned 65 it cost me $675 a month
Also worth noting, I am pretty sure you need a part D (drugs) to go along with your Medigap plan G.many are inexpensive
I already have plans to switch from my advantage plan to the G plan and a D, drug plan
Interesting that you are planning to switch from Advantage to original medicare. It’s my understanding that you are going to go an underwriting to see if you qualify. After a year in Advantage is almost impossibly to switch back
@@mypphh97 I was told that since I am leaving an employer sponsored group plan there would be no underwriting if I switched to a Medigap plan. I will find out next month when I apply for plan G to start in January.🤞🤞
My husband had a knee replacement with plan N. We pay before surgery $20 consultation, $20 cardiologist release, $20 primary physician clearance, $20 visit before surgery with nurse practician. I am not sure how much we need to pay for staying him in a hospital for 2 days ( they billed part B for anesthesiologist job, for surgeon visiting him next day and some other pt visits in a hospital. Right now we paying 3 times per week $20 for his pt ( 3 month). If you put all this copay together it is a lot more than difference between plan G and plan N premium.
Good information. Finally I listened to someone who gave a good explanation.
Wonderful to hear! If you have any questions you can contact our office for help as well at 1-800-864-8890!
My advantage plan has a $2600 max out of pocket for the year which includes prescriptions.
do one about nursing home care . like 8 to 10 days and youre out in an advantage plan.
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I keep seeing these low costs for plan g in these videos. But why is my supplemental plan in Florida over $200, and that's for planN?
Costs are a function of domicile state, age, and how large the pool of retirees is for a given insurance company.
Supplement premiums vary depending on State/geographic location. Premiums in Florida are higher than average.
Thank the republicans
I have G high deductible. 366 for the year.. it would be
More if i paid it monthly. Like car ot house insurance paying monthly payments they charge 5 dollar service fees . Service fees add up. Does take discipline to save up and avoid those fees . I just pay in full . Well worth the trouble.
@@tioswift3676 Top five states that had the highest Supplement premiums in 2023: New York, Connecticut, Washington, Florida, California.
My OHS was $340k! Humana negotiated it down to $240k! My final bill was $4200. Since G would cost me $150/mo and we pay zero with out Advantage Plan, we would have spent $9k on plan G premiums. We have saved $4800 so far with our Humana Advantage Plan!
I have a Humana Advantage plan, which I have had no problems with. I have some dental coverage with it, which is nice. All my doctors take it with no problem and zero premium. So far, so good!
For my artery stint, the Hospital bill was 167,000 but was adjusted to 116,000
Can you change to a different G plan during open enrollment or do you have to stay with the same company?
Marvin, you are a natural at teaching folks about medicare, thank-you for what you do. But, please know that saying (at 12:09) that a Plan G policy will cost about $125 can be misleading. Many about to go on Medicare live in Florida, as I do, and i just had a call with one of your representatives, and a G plan was quoted at between $190 and $227 - that's a far cry from $125. At $125, i'd take a G plan all day long, but at $200 or so, i have to consider the N plans as well.
Thank you for this, while the numbers we use in our videos are based on averages asides from the few states that have much higher premiums such as CA, NY and FL. We do appreciate this feedback and will take into consideration.
Been there done that in January. Almost two weeks in ICU before stable enough to be transferred for surgery to a heart center for surgery. I don’t remember any of this.
De stabilized on transfer and back to the ICU in new hospital.
Was there 10 days and had surgery. 1 week in ICU, 3 days in step down.
Surgery alone $100,000.
Moved to rebab for another 2 weeks.
Home healthcare for three months.
I have Supplemental Plan ❤
Cost to me……..drumroll----ZERO, YUP ZERO!!!! $000,000,000
OPP’s……..Plan “G”. $174.00 a month
I'm still working, so I decided I'd make myself afford the plan G. I just turned 66. I've had a procedure done that cost about $12,000, visits to primary, specialists, and even the ophthalmologist. I've only paid the $240. I take only a heartburn med but had to buy part d. Found a cheap one for $11. My G plan is UHC through AARP. There is no increase due aging til I'm 68. But may pay cost of living and / or inflation increases.
The one factor you did not mention was a drug plan. There are some very good deals on meds in the C or advantage plans. Purchase plan G and one must buy a drug plan in addition.
My husband died a year and a half ago. So I am on half his pension and social security. I wish I could afford G and a med plan but the options are scarce in Maine. Thank you for all you do, bless you.
I have Never paid more then $350 for any stay or out patient surgery. Knee Surgery was $100, a 4 day stay for pneumonia.
In my opinion the best healthcare coverage in the U.S. for people over age 65 is to have Medicare A&B plus Tricare For Life.
Not EVERYONE can get Tricare!
My wife has a thread of cancer in her breast. It was outpatient surgery, we were gone from the house for 9 hours. The hospital billed our insurance over $180,000. It seems that your average costs might be optomistic.
Are the services they're providing, while requiring advance skills and knowledge and sometimes expensive equipment, really worth $3000 a day? Does that sound like a fair price for what they're providing?
The most important difference for me is physician choice. I am totally not willing to give that up to save a couple hundred dollars a year to choose a Medicare (dis)Advantage plan.
My understanding is that in certain major urban areas Advantage plans are widely accepted
I’ve had a supplement insurance with my Medicare for 21 years. I would not give it up for anything. I’ve had hospital stays and never had to pay a dime any time ago to Specialist doctor anything I don’t pay anything I just walk out the door.
Local State Farm agency is who I use
You do pay- monthly. Your premium is paying up front.
Thank you very much for useful medicare information.
Our pleasure! If you have any questions just give us a call at 800-864-8890.
Plan G is your best bet if you can afford the premium. Advantage gives you a bunch of crap like useless dental, vision and other benefits that are not of high value, Good video
Thanks. Pre-authorizations + network requirements make Advantage plans useless unless you absolutely can't afford the monthly premiums. Of course, you end up paying more for an Advantage plan and you're at the mercy of insurance companies who exist to under-serve you and maximize their profits. Also, Plan G prices rise a LOT faster than the rates for Plan N - also something to consider
The G plan sounds good, but i didn't hear you say how much if any that it pays on medication.
If you have a Supplemental plan, you'll need to purchase a separate Part D drug plan. Supplemental plans typically don't offer drug coverage.
@@MedicareSchool thanks
Is your pricing at Medicare rates or what the Hospitals and Doctors charge?
Love to see this typical Advantage plan pitted against an HD G supplement in the same set of circumstances.
The hdG bill would be the same as the G other than this years $2800 deductible. A lot of that would be made up with the monthly premium difference. Here in Florida G is $186 and hdG is about $60 a month, at this time if you had to pay the deductible every other year it would be about a break-even proposition. As long as you are reasonably healthy the hdG could save you a lot of money. Who knows what the future holds? Once you sign onto a plan it's difficult to switch plans in most states.
I have the plan G and I really like it despite the $250 deductible. I had open heart surgery back in April of 2023 and was in the ICU for 5 days so I am so glad that I got this plan after plan F was done away with.
I will turn 65 next year. Which plan is best. I require prescription drug care. I heard an Advantage plan is difficult to leave for a Supplemental plan. Thanks for your help.
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
i have Tri-Care for life and recently changed to an advantage plan after consulting with your councelors. I like the additional benefits that the advantage plan has over conventional medicare. Will my tri-care for life cover those copays you refer to? Thank you!
It's a lot to take in, but he did a great job explaining each option.
Thank you!
125 part G
20-30 part D
174 part B
That’s 329 a month at the bare minimum of prices and not including dental, vision, hearing , over the counter benefits, transportation. That’s all separate insurances you will have to add to that 329 a month which can be up to 500 dollars a month for complete insurance. Almost 6000 dollars a year.
Part c is no premium and comes with dental vision hearing. Yes it has co pays when you see a doctor but most plans are capped at 3000 dollars a year and the rest is free. So even if you had a bad health year your paying half what you would pay for supplement. And what if you healthy? You pay nothing but the part b which is 4000 less than a supplement you may or may not use. For people on low income like most people on Medicare, a supplement plan is not affordable for them, which is why there is a part c option. Supplements increase every year with no cap, most clients will go to part c after a couple years of supplement because it’s not affordable anymore.
Advantage plans if PPO work well that's why 50% of people use them. People are scared into buying supplemental plans issused by insurance companies that are in it to make money just like advantage insurance companies. The premiums you pay with supplemental eat up any savings. My Advantage PPO covers all my doctors cancer hospital etc.
I’m embarrassed our government allowed for an Advantage program, knowing they will benefit insurance company CEOs who pay the politician.
oh complete and utter bs. grow up
@@cgilleybsw Real question. I don’t know what you mean. What part is BS? Also, not sure what you mean by grow up. Am I being naive about something? Thanks.
I am embarrassed that our government allows fracking which releases tons of greenhouse gas Methane, destroys water tables and aquifers that supply humans, just so Energy company CEO's can collect millions and bribe politicians (and now with the crooked SCOTUS, even the courts). Healthcare is like any other business in a Capitalist society, especially the USA who legalized bribery of politicians with the disastrous Citizens United v FEC ruling in 2010.
This guy sounds like a car salesman!
@@cgilleybswWhat a bunch of crap! Why is our healthcare so confusing!!
This guy sounds like a used car salesman.
For profit healthcare that only cares about profits and share holders is evil!!!
My hospital cost for getting a pacemaker added up close to $200k. They negotiate final bill down dramatically. I think to around $15k. I ended up paying maybe a $20 doctor co-pay only under plan N. I was wondering how much this would have cost under advantage and would they have negotiated the bills down as much?
Correction: You mean Part C not Plan C.
OMG
You did not take into account the prescription, dental, and eye coverage costs and benefits.
I live in the northeast. Please do a similar video using numbers from New York City numbers. An MRI around here starts at $1000. Outpatient surgeries probably in the multi 10s of thousands. That $300 outpatient figure must be for a pet with a vet.
Great video! Easy to understand . Thank you
As another commenter noted, you postulated 10 specialist visits @ $50, which would be $500 total, but you wrote $50 (ruclips.net/video/BClz3V39jm4/видео.html). That would make the total cost $4,050 instead of $3,600 for this MA hypothetical. Throw in a couple "surprise" bills from out-of-network providers, and you'd be even more in-the-hole.
An important thing to note about the MOOP on an Advantage plan. It only counts towards medical care and if the patient has any treatment done that is not approved by the plan. It will not count towards that MOOP. Plus anything done that is not approved by the plan the patient pays 100% towards that procedure.
If I start out at 65 years old and live to 95, do premiums increase as I age? I expect to need more medical care as I get older. Is there an age where this math changes so a different plan is cheaper at 95 than when I was 65.
Cost can increase with age.
I was watching the part about A and B only and I don’t think it’s accurate. The co-insurance is 20% but for doctor’s visits Medicare limits the amount they can charge. It’s usually $20. Also, when you talked about the amount that you have to pay the 20% copay on, that amount should be reduced by Medicares approved amounts. For a normal hospital stay with surgery , original Medicare would be sufficient. The only reason to get a supplement is for the unforeseen risks that could happen. I’m probably going to go with a plan N just because I get most of my medical care from the Indian health service.
Great work...interested in drug plan costs for 2025...any info?
Friend of mine had a stroke. # different hospitals, 2 week stay with 5 days in intensive care, his estates portion of the bill? $0, because he had an F Plan. Too bad they discontinued them.
They haven’t discontinued plan F. If you were born before
1955 you can still get plan F
Ok. Have a question here. Since I’m new to Medicare and disabled my only income is social security. I just lost my duel Medicare and Medicaid benefits. All These financial costs are overwhelming to me. What plans should I get to cover these expensive costs
That depends on where you live and what is available to you. Give us a call we'd be happy to review plans with you. You can reach us at 1-800-864-8890.
If someone is generally healthy and needs 1 surgery in 5 years the total cost of advantage plans is @ $1800 oop (for the hospital co pay of 1 surgery) plus maybe 100 per year of co pays = 2300 total for the surgery year and zero or low co pays for the remaining years.
If you have a G plan you pay $1,740 (premium and deductible) yearly which amounts to $8,700.00 in 5 years even without surgery. Had I selected a G plan at todays price when I retired in 2017, I would have paid $13,920 by now with no surgeries. The Advantage plan has paid for regular wellness checks and dental care and eye care and hearing care had I needed it. In 7 years
I have paid less than $700. Do the math before you decide.
I had dual pacemaker cost was 194,000 for got just how much insurance paid. I paid about 6,000 on my part
Awesome way to lay it out!!!!
Don't forget about accidents, they can take you out just as badly as an illness. I was working on a tree and got smacked by a large branch. Crushed arm required surgery, concussion dictated a life flight trip ($42,000 alone). Ongoing physical therapy too. So thankful I'm on regular with a G.
Just had hernia surgery . Hospital cost $15,687 my cost $797. I have HDG plan. Love it.
I'm interested in the same, but can't get a straight answer on costs
What is HDG
@@jennifermonical6865 High deductible plan G
@@jennifermonical6865High Deductible G plan……which is $2800 deductible…..of which I have and pay $55 a month….
You should pay $0
is that premium on top of medicare price?
Yes, another premium on top of the Medicare Part B premium.
If you have just in January accepted an advantage plan, can you change back to a regular Medicare plan with the g.
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
I have plan K and live in Florida. If i move to another state, will my premium change?
You're golden with MA until, God forbid, you get really sick. Pay now, or pay later. It's unavoidable. Senior healthcare in America. Sigh.
So if I understand correctly, with the Advantage plan you will have greater costs than if you have standard Medicare with a supplemental plan however you pay no monthly premiums. In case of hospitalization, the costs with an Advantage plan will not make you go bankrupt -- i.e. you might have a bill of $3-5,000 more or less
Do I need a D plan if I have A,B and G?
If you have Medicare Parts A, B, and G, it's advisable to consider enrolling in a Medicare Part D prescription drug plan for comprehensive coverage of prescription medications and to avoid potential late enrollment penalties.
www.medicare.gov/
Good presentation but you are missing a couple of things about Medicare A and B allowing procedures. They will pay for surgeries that are "approved" by Medicare. But not all are approved. So, in my case, I am a board-certified plastic surgeon that does a lot of breast reduction surgeries for patients with huge breasts. It's a life-changing procedure. Medicare will NOT do pre-authorizations for this procedure, and if you do the procedure, they may or may not pay for it. So, I can't tell the patient whether or not it will be covered for sure. We won't know until we submit the bill. And they don't post the requirements for coverage so we are guessing. When I do a reduction case Medicare (only the really big breasts) will always deny the payment at first and then my office has to appeal it. and it takes me 8 to 10 months to get aid for the case. However, Blue Cross of Alabama has published criteria for paying for a reduction and will pre-authorize it, so using a Part C plan overseen by Blue Cross is easy to work with and the patient knows it will be covered. I have a similar issue with the procedure to remove excess upper lid skin to improve blocked vision. Very difficult to work with Medicare. They are tough with the procedure that are in the "gray area" of being absolutely medically necessary. Thanks for your hard work.
As a retired military, I have Tricare for life as a supplemental to my A & B, could you address this situation?
Here is a link for a video on Tricare.
ruclips.net/video/JJYauUj8MWU/видео.html
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
If I just signed up for an advantage plan the other day, can I change to a plan G next year? Thank you
I believe you have a grace period and can switch this year.
@@michaelsd284 Thank you
You dont just do a plan G you will drop advantage get medicare A and B again plus plan G. Everything I hear is advantage is great as long as you dont get really sick. Also on “regular” medicare you can go to any doctor anywhere in the U.S. No in network doctors etc. No pre-approvals needed. where as with an advantage an insurance company is deciding on your health care not your doctor.
Give us a call at 800-864-8890 or schedule an appointment at www.medicareschool.com
This excellent presentation is very informative. In fact, every video I have watched by "MedicareSchool" has been done very well. However, this presentation tries to make a comparison with the plans covered, and they leave out a fourth alternative for comparison purposes-Medicare Advantage with a Hospital Indemnity plan. Why leave this option out? The second plan covered was someone getting A & B plus a supplement plan (gap). So, a gap plan for the Medicare Advantage plan (Hospital Indemnity plan) should have also been included to accurately compare these four situations. As presented, this was a bit disingenuous and slightly misleading.
We have a separate video that covers hospital indemnity plans in detail. In some cases, viewers may not qualify for those plans, as they often require underwriting after a certain age. To keep our videos clear and concise, we focus on specific scenarios in each one. This way, we can highlight details without blending topics together, which helps avoid unnecessary confusion. ruclips.net/video/9ik52BPL2CQ/видео.html
My expenses on a $200K hospital bill would be a little above $9.16/day. Depends upon drugs used. January 2023, I had. Right carotid artery stent emplaced. My cost was ZERO.
I wish you would talk about the other supplement plans, besides G and N. I get that they're your favorite, but the other plans may suit some people better.
G and N are the most comprehensive and available plans in the country, however if you give us a call we would be happy to discuss the other supplemental plans with you. 800-864-8890
Several, like F, are not available to people who turned 65 on or after Jan 1, 2020.
many people don't realize how expensive injectable medications can be - my 20% on injections every 3 weeks is $2000.