5 Things Medicare Doesn't Cover (and how to get them covered)
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- Опубликовано: 28 май 2024
- www.abtinsuranceagency.com | (888) 465-9728. Today's videos reviews 5 things Medicare doesn't cover. While Medicare does cover many services, many people are surprised to find out about these 5 things that Medicare doesn't cover, and could be hit with unexpected medical bills if they aren't aware. Today I'm sharing these 5 things, along with some solutions on how to get these items covered when you are on Medicare.
It's important to know what you options are when it comes to Medicare coverage solutions, like Medicare Supplement Plans, Medicare Advantage Plans, as well as stand alone policies hat will help offset some of the costs of these 5 things that Medicare doesn't cover.
Free Medicare Supplement Quotes: www.abtinsuranceagency.com
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Dental Solutions for Seniors: • Dental Plans For Senio...
Medicare and Physical Exam Coverage: • Does Medicare Cover An...
Medicare Supplement versus Medicare Advantage Plans: • Medicare Advantage vs ...
Medicare hearing aid coverage:
www.healthyhearing.com/help/h...
www.congress.gov/bill/115th-c...
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00:00 Introduction
02:37 Thing number 1
03:36 Thing number 2
04:25 Thing number 3
05:21 Thing number 4
07:10 Thing number 5
09:56 Behind the scenes
So the elderly sit there at home toothless, blind, deaf, sick, but hey, there's medicare that you must buy. What a racket!!!!
The advantage plans are another scam. You should get a supplement instead.
i wonder everyday if I just can,t OPT OUT of all of this?? and just aske for my money back from all those years of paying into this ??
No sh*t
@@andreavandekleut6379 That would be the dumbest decision that you could possibly make. Medicare is a great deal. You'll never find insurance that cheap. Social Security, is another issue.
Odd. I'm having no problem being covered. So I pay my own vision and dental -- Medicare covered my hip replacement. More than compensation!
Thank you ! No Soc. Sec. coverage for dental and eyes is criminal negligence !
This is mostly cause most dentists DON'T want to be in a network plan like doctors !
The rising cost of insurance, healthcare, groceries, and housing is forcing seniors to live on the streets. This is outrageous. You spend 30 years or more of your life working and your reward: poverty
I worked 44 years and the illegal migrants get the same as me!?
But all the illegals come here get all this and more for FREE!
So, medicare doesn't cover anything that the elderly needs. Imagine that.
Nope they do however cover hospice thou they want to get rid of the old people so they can't past down wisdom to their young
Makes no sense but true!
That’s why a lot of people sign up for advantage plans. They cover that, or at least give you money toward dental, vision etc
Not true. Part A, which you workers pay for, cover all or nearly all hospital expenses, which are huge.
@@robertewalt7789 the main things that happen in age is vision, hearing and dental, neither one is covered!
Dental Care not being covered by Medicare and many Healthcare Insurance Plans is very short sighted. Many health problems are caused by poor dental hygiene.
VERY MANY-California long-term nurse
My father died as a result of abscess tooth! A ww2 veteran and passed away with 88000.00 of medical debt! Isn’t america great!
In 1965 the Dental lobby lawyered up and fought a very long and tough fight to be specifically excluded from all federal legislation involving Medicare and to this day they are off the hook. Learn that what Congress does is to rob you and take money from lawyered lobbysists,
Yup. But the Allopathic model is about keeping people coming back. NOT about keeping people healthy.
@@marvinmartin4692 I'm so sorry!
I've had many abscessed teeth: What a godawful, lousy way to die.
This is the only First World Country that allows that (just fyi).
1) Vision care
2) hearing aids
3) Dental services
4) Annual physical exam
5) Nursing home or long term care
Thank you much!
This should be pinned to the top comment.
It slows for an annual wellness check
Thanks… wish people would get to the point
It won't cover a physical exam, but if you have Dr label it as a wellness check, they will. But, only once a year at the most!
Poor elderly people are treated like crap, so sad 😢
Here’s a good one. I was in the hospital for a month after almost dying of septic shock. My kidneys were damaged because of it and I was placed on dialysis. After the month I was transferred to a rehab facility to learn to walk and care for myself. Transportation to and from the dialysis facility was not covered by Medicare. I was in a wheelchair. How was I supposed to get there, walk?
As a case manager at an acute care facility, I can say that non-emergent transportation coverage is the biggest gap that I have seen.
Here’s a good one!
Why is this not on the news?
Medicare or Medicaid refusing to pay for generic brand, long-term asthma, inhaler the discus. That’s a one time a day inhaler and you don’t have as many asthma attacks or need your albuterol inhaler that’s the emergency inhaler which you’re inhaling five or six times a day, but I think you’re inhaling so so many steroids. It’s not good., so you don’t need that one as maybe once or twice every day or two possibly but sometimes not even using it, so it saves you both health wise and, oh yeah, money supposedly. But, when when my doctor orders, the generic inhaler, the pharmacy gives me a namebrand and I have to pay $70 co-pay. Which I don’t accept, I just get more of my emergency ones, which they cover at least three or four per month. I get 3 month, and I use that three to six or more times a day..
My girls at the pharmacy, they sheepishly tell me it’s because the pharmacies get kickbacks and are paid to give you the premium namebrand, and then you have a $70 co-pay and if you want to buy the generic outright it’s $130.. And they get no kickback from generic.
Thanks Joe.
Well, I can more than afford it. I’ve actually paid for an old old lady older than me because she was crying because her insulin had gone up so high. I thought it was way low because of Donald, but she was falling and I slapped down 200 bucks to cover her stuff and some extra. so why is this happening and why isn’t depressed covering it because the press isn’t honest. Anyone else has this happen?
we have a cold, cold society.
I am new to Medicare. I guess a Medigap supplement would not pick this up either?
@@blueskyes99 Insurance companies are designed to turn a profit. How exactly is adding this profit center to 'affordable' health care make any sense.
My parents turned 65 when I was 18. I filled out the forms and signed both of them up for Social Security and Medicare. It took a total of four forms. But that was before for-profit corporations got involved. I spent two years researching Medicare advantage. I like what I have OK, but if something isn't covered, I go without it. That's what everyone has to do in this capitalistic hellhole. Always remember: people do not matter in "healthcare;" profits do.
True.
In medicine, we say " Government run healthcare doesn't care if you live or die- as long as the paperwork is filled out correctly. In Corporate medicine, they don't care if you live or die, as long as you do it cheaply"
Advantage is a terrible plan.
Precisely right, it's capitalism. Profits matter more than us, even tho we pay them monthly
Stay away from any so called "Advantage Plans". If you remember that you will be fine.
I have recently retired, it surprised me that I pay 178$ a month for Medicare and it barley covers anything. I bought a good advance plan that pretty much picks up everything Medicare does not,Im happy for that. You’d think as we age and all we’ve paid in through the years that Medicare would pay for more.
PLEASE NAME THE "advance" plan so I CAN CHECK IT OUT. rIGHT NOWi HAVE AN ADVANTAGE PLAN & TRYING TRO DECIDE BETWEEN IT AND MEDICARE W/ SUPPLEMENT.
It's obscene what Mcare doesn't cover. If not from a small inheritance from my parents, I would be living on the street because Plan B, supplement, Plan D and copays take up more than half my SS. Also, due to that inheritance, I got kicked off any assistance w/the premiums, right at the time the government raised plan B rates for those getting assistance, assuming that individual states would pick up the difference. The timing left me stuck with the increased premium
I was shocked too, that I’m still paying for Medicare. Been paying Social Security since I was thirteen, I think Medicare payments started around that time. If you want part of your Eye Exams covered, have your Dr. write up Diabetes I Exam.
@@stevenmoomey2115 Diabetic exams do not test visual acuity to the extent that a prescription could be written for correction.
They are looking for diabetic retinopathy
@@LibbyRal You might want to consider a Medicare Advantage plan
Stephanie, I learned early on from personal experience that a simple comparison between Supplements and Medicare Advantage plans is this: Medicare Advantage Plans leave the decision of what medical treatments are allowed to the insurance company, while Supplement Plans leave those decisions to you and your physician. I like it better when I and my doctor decide what treatment protocol is best for me.
Yes. Stay away from Medicare Advantage plans and go with original Medicare and a supplement. Advantage plans are ok…unless you get sick.
@@mindysr That's fine for people who can afford big premiums every month, but most seniors can't.
Eat right; no other protocol needed.
what are some examples of supplements? Im not sure which is going on with me but I feel like a hot potato after cancer treatment complications. Lookinng for primary or doctor that can help with post cancer care. Its so stressful when so happen to come across doctors that do not listen to their patients. Just had stressful stituation at cancer center and called medicare for patient advocate. Idk they had that service and so thankful for it.
@@BrandiXo i have original Medicare and. Mutual of Omaha supplement. The supplement generally covers the 20% that original Medicare doesn’t cover. It is more expensive, but at least in Ohio you can choose almost any doctor. I live near enough to the Cleveland Clinic so that I can go there. At a major, very highly rated teaching hospital you usually have some hope of getting competent, or even excellent care. Original Medicare plus supplement is more expensive, but I disagree with the poster above that it is out of reach for most seniors. It is more expensive (or fatal) to deal with Medicare Advantage programs that don’t have decent physicians in their network, or that will not cover serious or deadly illnesses.
I just retired from a job that had very good health insurance, and now I see the big difference. Being on Medicare is big learning experience and eye opener.
Yes, it can be a big surprise for many that have had employer insurance for most of their lives!
Rather disgusting to find it's so useless and we are forced to use it.
@@1corinth15 Calling it useless is gratuitous nonsense. It's different but hardly useless.
Actually, my husband & I are better off with Medicare supplemented by the excellent health insurance plan his employer offered for retirees. Our supplement picks up our Medicare deductible plus what Medicare doesn’t pay on covered expenses. We’ve only had to get one pre-approval for a procedure. Otherwise, everything has been covered.
@@davidoldham1946 ll
I worked in healthcare for 40+ years. Our healthcare institutions are a prime example of American capitalism and greed at it's best. It's a huge money-making machine. We, as a society have long forgotten about our moral duty to take care of it's citizens in the best way possible. If this is the best we can do then we need to think harder about how to change it.
00
All comes down to voting
Get a job with insurance benefits or what about take good care of yourself, such as weight control? Obesity causes a lot of medical issues. Look around at how many Americans are overweight.
Disgusting to say the least, to profit on the elderly, weak and sick.
@@sonyasmith4577 you’re missing the point… in other first world countries, it is seen as immoral and barbaric to even attach healthcare to a job, forcing them to work. Our entire healthcare system is seen as very inhumane and they see the way we operate our country in many ways as human rights violations as a first world country (and the worlds richest country…). Please wake up and stop bootlicking the very same people forcing us all to die or live in incredible debt.
These 3 things are exactly what Seniors need much more than others- Hearing Aids, Dental Implants and Eyeglasses. Seems Cruel not to cover these.
Thank biden and his tyrannical administration who spent trillions of our dollars for games, and they refused to do anything about the decreasing coverage of Medicare and the medical coverage for those who served our country in the military. There has also been the increase of doctors who are just rejecting patients who are on medicare.
They know that more money in their pocket if they don't cover them.
Which makes the elderly even more isolated. Many can't even connect with people over the phone because they can't hear.
Welcome back and thanks for keeping it simple. Traditional Medicare doesn’t cover vision, hearing, dental, and the old folks’ home. You need to be specific, when you go to your doctor and ask for a Medicare Wellness exam.
My dad and my brother thought my dad was developing dementia. It turned out that the problem was he couldn't hear in certain ranges and this made it impossible to follow conversations, tv shows or movies. It was not like the movies where someone asks you to repeat something because they couldn't hear a word. He did not even realize that he could not hear well. He thought he was losing his ability to process what people said.
We also found out that there are a lot of scams out there related to hearing aids that target the elderly.
The scams are so sad and disgusting
Being there I bought one for a relative it did work as promised 😢
Go to Costco for hearing and vision. Out of pocket is cheaper than a plan.
My mother-in-law had a free trial of a hearing aid with a price tag of a couple thousand dollars. She hated it. She now has a $30 hearing aid which she loves.
My doctor when I was growing up told me that routine physicals were mostly for people without chronic problems. He saw them as a way to catch problems before they became serious. For those of us with chronic illnesses, those physicals may be unnecessary. I always find out from my docs why they need to do a test and why they need to see me again. I’ve avoided unnecessary costs by doing that. I find the annual wellness checks to be a bit of a joke. All my doc does is go over the meds I take, my allergies to medications, and any new diagnoses. Those are addressed every time I see any doctor, which I do many times per year. Those wellness checks are a waste of effort, time, and money for me.
I think it’s ridiculous that three of the things that all people on Medicare need aren’t covered. Vision, dental, and hearing should be included in basic Medicare. Perhaps it’s because we all need them that they aren’t covered. In my experience, insurance generally covers the unexpected rather than the basic needs.
exactly last time I checked my eyes, teeth and ears were part of my body WHY are the separate when it comes to insurance
medicare in puerto rico covers dental glasses and hearing. WHY
@@gaildemski4632 with original Medicare? I find that hard to believe. These things are covered under a medicare advantage plan in most cases which is what I have. I would think since PR is part of the US that they would have the same original Medicare as the rest of us
@@cherylreitz4779 - Hi! I see constantly advertising on tv about Advantage in Puerto Rico. And yes, they receive help for hearing problems, glasses, dental care, preventive care, some kind of transportation for certain purposes and I don’t know what else. But I don’t think it’s different than what you receive in the continent. You could always check asking for: Advantage Health services in Puerto Rico or something like that. You will find the correct info. I don’t have it because I do not have advantage, I need to pay more for mine.
@@adyarym medicare advantage plans are run by private insurance companies. In other words “ you sold your Medicare to them and premium you pay every month go to them” they may have more benefits covered but they may also have bigger deductible, co-pays, co-insurance, out of pocket limit, percentage of cost sharing, etc. sometimes you need preauthorization to see specialist or for some tests to be done. As for meds, goodRx is one of the best sites where you can compare price in your area. Sometimes they were cheaper than with part D insurance.
My annual physical has shown the beginning of problems that my doctor and I can work on when the issues are small and curable. I can't believe Medicare doesn't cover annual blood work. I have always been covered for that since my 20s at an annual physical. One would think blood work is more important when one is elderly.
Well, for that matter, dental, hearing and vision are more important as you age, too. But, there you go. I, myself, was shocked when I first learned that Medicare/Medicaid did not cover those things.
Through my Mothers and Brother in law illness, I realized that
Health care system is an criminal enterprise , scam of the Century .
No one cares for elderly .
@@JennynGA93 Yes, in this country you are covered if you are rich (can afford what you need), and you are covered if you are poor (Medicaid). If you are in the middle you are scwed!
@@JennynGA93 I used to have a PPO. It was a bit expensive, but I was always treated like a queen when I visited the doctor. Soon as I switched to an HMO I never got to see the doctor again. Treated like a step-child, only saw his nurse practitioner.
@@alansach8437 -- EXACTLY Alan, you are a zillion % correct. It's so sad for a country that claims to be the Richest, wealthiest and most powerful on planet earth. To me it is a disgrace... so shameful.
They cover vision care IF it's medical treatment for an issue or disease but NOT regular eye exams for glasses.
It doesn't make sense that Medicare doesn't cover vision, dental, hearing needs for older people. Those are the areas that begin to fail as we get older. Those are the needs we have.
Sure it makes sense, cause the bottom goal is saving money instead of actually giving people good coverage
Medicare does pay for cataracts surgery.
@@zoeyzed5127 Thank you for this valuable information.
Yep! Second, third and fourth things to go!
@@zoeyzed5127 They should pay for cataract surgery under medical.
Happy new baby and thank you for this video! no one can afford long term care and we need more ideas for this!
After moving from one state to another, I found that some things are covered differently than in my former home. I find that really outrageous. My previous agent fought hard to get insulin covered in full and I was thankful for that diligence. Two pharmacists here tell me that’s not possible in my new home. Why, I’m an American citizen over 65 both places. ???
Because individual insurance companies are the ones who provide Plan D coverage . They decide what drugs they'll pay for and which they won't. Plan D is one of the biggest rip-offs around. It was the first one to fine you if you don't have coverage, and you will continue to pay it if you decide to sign up later. The deductible increases every year, and the list of drugs they don't cover also grows w/each year. Equally egregious are the older, generic drugs that they put in the more expensive tiers.
You're absolutely right as your coverage definitely should be nationwide regardless where you decide to reside.
@@bobl9949 as long as insurance companies are allowed, via the McCaron Ferguson act, to underwrite coverage via individual states, this will not be the case. Plan D, drug coverage, is not a part of Mcare. It's covered, like supplements to Mcare Plan B, but individual insurance companies, and is subject to their whims.
If you’re Type II, it’s caused by diet and can be reversed with diet. Buy only unprocessed foods. Basically, stay out of the aisles of the grocery stores except for getting bags of dried beans and legumes, cans of whole beans and canned tomatoes, olive oil, vinegar, spices, tea, and coffee. Corporations are getting rich by making Americans sick, and pharmaceutical companies and health insurance companies are sharing in the profit. Watch Dr. Eric Berg, Dr. Sten Ekberg, Dr. Robert Lustig, and Dr. Jason Fung.
@@genxx2724 don't give bullshit medical advice. My partner was type II and almost died doing that crap. He looked like a fucking cadaver because his body was eating him alive. Fortunately, he gave in and started taking medicine, and COMBINED w/proper food and activity, has so far been able to remain off insulin and maintain healthy blood sugar levels.
I am on Medicare Advantage. I had a dental emergency. Not a dime was covered My cost was 900 dollars. That was paid out monthly. I could not afford the payments. It was a Food Or Dental payment. A volunteer came for a wellness check and shocked me that she had done a GoFundMe to pay for my dental. I was shocked and so grateful. Now I have a bleeding mole on my face and again a very high copay I can not afford. so It is cheaper if I die.
I am sooo sorry and I do under. Due to a back injury I had a spinal surgery and after a year and 4 months I still cannot walk. Walker assisted only due to the pain. My doctor ordered a test to help with that and Medicare will not cover . It is a 3 step procedure in which I’ll need $500 for each step and I can’t work . I’m trying to figure out where all that money went that I paid out for 42 years of working
I am so sorry.... I hope you can get help. This is wrong.
I turn 65 in December, and have started my research for coverage. I must tell you even though you explain it very well i am still very confused. Why do they make it so complicated???
We also found it to be very confusing, so we researched (read and listened to the 'pros') a lot for about one year. This lady and others can help you a lot so keep doing your research! Also, if you have friends or family about one year (or less) older than you, they can be helpful to you as well.
Try AARP.
@@sharond478 Just an FYI. UHC, under AARP has had the highest yearly insurance rate increases. over any other supplement . The discount they give when you first sign on diminishes every year, so your twice yearly increase may be a shock
@@sharond478 AARP /UHC suck and are high. Never found where AARP saved me any $$$.
When my mom had her heart attack and had a 1 week stay in the hospital, the bill was almost $300k. Medicare only paid $28,000. Luckily, they pay for the supplemental Wellcare, which paid for the rest.
????? I was in hospital , ICU for 4 days for P/E, $100,000 and Medicare paid for most of it, supplemental paid the rest. I didn't pay a penny !!
Bottom line she didn't have to pay.
Hi Stephanie, Great video and good info. One thing about Skilled Nursing Care. Medicare Advantage plans are very quick to kick the person out of the skilled facility if they are not showing improvment. Lately, Original Medicare gives them a little more leeway but they are also cutting them off pretty quickly. Just thought it was worth mentioning. Comes up a lot lately.
Is very true When my mom had a 2 strokes 1 heart attack it sent her to the nursing home for sure turn. They don't like to keep you home the long time care Because they will get more money for short care . They tried to kick my mom out with the A short time and they only gave her 4 days notice when it's time for her to leave and that's against the law they have to have to give you 4 weeks notice so my brother Went to the state Made a complaint The state call the nursing home The nursing home was Decided to keep her long term they um they were nervous that we will suit. My dad was a different story he also had dementia dementia no one to care for him at home because my other brother Had a mind of a four-year-old and he cannot help my dad . So we had a fight hard to keep my Mom in the nursing . home
Some of this is because most skilled nursing care facilities are struggling to get TRAINED and SKILLED staff. My experience is most places are 1 star dives with VERY minimal care. We've had more of these facilities SHUT DOWN in my area by State health regulation boards Too many injuries and deaths. Why would Medicare continue to pay for outright patent abuse m
It's the same way with hospital stay.
Why not take care of dad, mom or have in-home care folks, traditional Medicare will cover.
@@mbords01 Medicare does not cover care.
Thank you for your accurate and concise information and wisdom about Medicare. When it comes to healthcare, let the buyer beware.
I am on an advantage plan that pays for my eye exam & $300 toward glasses - gives a discount on hearing aids -pays $2000 toward dental procedures - includes my drug coverage - of course pays 100% for my annual physical - I have a CPAP and it pays for 80% costs with that . And my monthly premium is zero - yes zero monthly premium.
Mrs. Abt, I've just come across your videos and you are GREAT! Many retirees need to know this information. Thank you for your educational and instructional videos.
I have a Medicare Advantage plan. For the most part I am happy with it. It is fairly inexpensive and has covered everything except one prescription for eye drops for cataract surgery prep. The only downside is the doctors they assign you to. Most are focused on preventive medicine. I don't want preventive information. I am 75 and have learned a lot in all those years about how to stay healthy, whether I follow the guidelines or not. I want a doctor to address my current health problems. I don't run to a doctor every week, or month. I only go when I have an issue, which luckily isn't too often. But I do have a chronic back problem. Every time I bring it up it gets ignored. I guess I should have "prevented" it.
Exactly
Me too I am 75 with no health issues I try to avoid doctors and meds, my plan is insisting I allow a person into my home to talk about meds which is stupid since I take none, I might quit them if they keep bugging I think they are maybe pushing boosters, for covid.
@@zoeyzed5127 I have gotten notifications that someone would come to my house, but they never have. I just refuse to answer them. I got the first 2 jabs but only because I was forced to for a cruise. I refuse to get a booster because jab #2 really made me really sick with flu like symptoms, and normally I never get the flu. I don't get flu shots because my family members do and always get the flu after.
Sorry about your back. Have you asked about physical therapy? Maybe you already do it? Backs are so tricky. Operations are usually reserved for absolute last choice because so much can go wrong, making the problem worse. At your age, they probably wouldn't risk it. But they shouldn't be ignoring it either. Insist! Don't let them push you around!!
Choose a different advantage plan that allows you to select your own doctors.
Stephanie, I just watched this video and there is a 6th thing that you should tell your audience.
Insulin is the most expensive drug that you have to buy. While working and having Group Health Care Coverage, I paid 'Out the nose' for Insulin.
I have had a Medtronic Insulin Pump for the past 14yrs. In 2019, my Medtronic rep told me that I should not be submitting my insulin, along with all the other supplies under my Medicare Part D plan
The key is to submit it under Medicare Part B. Yep, that's right. The insulin pump is a 'SYSTEM.'
The SYSTEM consists of:
- The Insulin Pump
- The Reservoirs (Insulin reservoir)
- The Quick Sets (The tap that is inserted for 3-Days)
- The INSULIN
- The Lancets
- The Test Strips
If anyone of those pieces are missing, you do not have a 'Complete System.'
Now, Medicare just DOES NOT like paying for Insulin Pumps, Insulin, etc.
Before one goes on Medicare, they should ask their Endocrinologist to put them on the PUMP.
Medicare will kick, wiggle and scream to pay for these items.
Medicare requires that you have to take a C-Peptide test which measures how much insulin your body produces.
It is IMPORTANT to fast for at least two days before taking this test. AVOID eating carbohydrates that is what triggers high blood sugar an insulin production.
I hope you consider researching this and including it in one of your videos.
On another subject, I learned last year that without a vision plan I had my eyes examined at Walmart. The exam is generally around $90.00. I was asked if I was on Medicare. The test was only $20.00. Now was this only because I was on Medicare, or was it the combination of being on Medicare and Diabetic.
Insulin, Trulicity, Farxiga and Myrbetriq are four of the most expensive drugs to pick up.
My doctor put me on Farxiga before I went on Medicare. I had a coupon that said it was FREE for as long as my doctor prescribed it. Oh, so true, but the minute I went on Medicare, the FREE coverage ENDS! Why should Medicare care if the drug company wants to give it to me for $0.00 - Our government at work.
90 Days of Trulicity breaks down to: $3.89 per day ($327.13 - More or less depending on whether you are before-in-or out of the Rabbit Hole)
90 Days of Farxiga breaks down to: $4.86 per day ($437.19 - More or less depending on whether you are before-in-or out of the Rabbit Hole)
30 Days of Myrbetriq breaks down to $3.19 per day ($95.62 - More or less depending on whether you are before-in-or out of the Rabbit Hole)
My Urologist told me that the patient on Myrbetriq was supposed to run out this summer. It has not. He has given me 9months of free samples to tie me over.
Many older people do not take their medications because of the COSTS!
Very in depth and thorough! Thank you!
Just adding that as of July 2023, insulin for both Part B and Part D is $35/month for each type of insulin. Part D at $35/month was available since Jan., but there was delay on approval for the Part B portion.
At age 67, I had a great doctor in SE PA, for 10 years, but she went into a concierge practice for a patient fee of $1,800 a year, so I opted for a new pcp. I have regular Medicare A & B with a supplement plan. At the new patient visit, he sent me for $2000 worth of bloodwork of which I paid almost $300 out of pocket. Plus, I was billed a certain percentage for his visit. He also sent me to a cardiologist for baseline ekg etc. I paid $100 out of pocket for that. Then he required me to come in for an office visit every 3 months to renew a simple hypertension med that I've taken for 25 years! I think doctors paid by Medicare are either required or incentivized to keep their patients on a hamster-wheel of controlled services & medications. I've moved out of state last month and will search for a DO or a doctor who doesn't take Medicare! I'll pay as I go, for an office visit, only when I need to annually or to get Rx refills or when ill. In 25 years, my docs only required an annual checkup to renew the BP Rx, he wants Medicare to pay him 4 times to do that! I don't consent to being on the Medicare hamster-wheel. I'll consider Medicare as catastrophic only.
No, that was just a greedy doctor
I just tell my dr I can’t afford so many visits.
We have Medicare A and B plus our supplement, the F plan (is no longer available), and pay nothing out of pocket for anything medical, such as doctor visits, blood work, X-rays etc. between both of us it’s just shy of $450 a month.
@@lynnschantz9185 I couldn't afford F but have a lesser one. Most months, I pay way more for the supplement premium than the plan pays for any services . It used to cover the A and B deductible, but stopped doing so. 😤💩
@@LibbyRal Plan G covers everything Plan F covered with the exception of the Part B deductible.
A lot of you guys advise to not sign up for an advantage plan, and I do agree with the reason why. However, advantage plans usually cover all this. So, if you purchase medigap, vision, dental and hearing aids plan, it comes to about $350 a month. Many can’t afford that, so , as it is always, it’s all about THE MONEY!! It’s a shame!!!
Z
That is a BIG consideration on why one should not retire early but never really discussed upfront. THANK YOU for bringing it up.
I guess working couple of years more to ensure one can afford medigap plans and to ensure spouse get a bigger check is worth the later retirement strategy - if one is up to the work routine and the drama at work.
Actually, just my part b, part d and Medigap G plan run 350.00 a month. Forget about adding plans for dental and vision!
Mine is Free. Florida is a great state for advantage.
@@gg80108 mine is $39.00 a month
I worked for a Fortune 100 company that never covered Vision, Hearing Aids or Dental under their healthcare insurance. These were always extra. I always did my research to compare my company's offerings & cost and to what I could get elsewhere or deals available. Thus, I won't have expected Vision, Hearing Aids or Dental under Medicare (Part A & B).
The Medicare Annual Routine Physical Examination would be equivalent to what I had from my company's insurance that covered a Wellness Check.
I'm glad that you pointed these out so I could be prepared. Thank you
This channel is hands down the best, most comprehensive yet easily understandable explanation of all medicare information. Nice surprise with the adorable little ones at the end 💓
Wow what a compliment!! Thank you so much for watching.
I start Medicare December 1 and it’s a darn shame they don’t cover more than what they do……
Thats why I have a Part C advantage plan. It covers all this and much much more. Drugs included in my plan at some of the best rates too. All generics are $1.00 the list goes on and on. Look into one closely as they also have some pretty lame C plans out there.
@@davenone7312 Advantage is private insurance, and they are known for denying claims. They cover more IF they approve it.
@@littlebitofhope1489 - Yes, Advantage is a HUGE gamble, unless you have no assets at all. When Advantage starts denying the big stuff, the destitute can go on Medicaid for inferior care. But since they don't have any assets, there won't be a lien on their homes and everything they have won't be taken before they can qualify for Medicaid. Advantage is only useful for those who have nothing for themselves, and nothing to leave for their heirs.
Great video! Nice family! Beautiful kids! THANKYOU for doing what you do.
A couple more things;
They don't cover elastic garments or supports. For instance, compression stockings, gloves, or arm sleeves to control edema (fluid retention). Orthopedic shoes or braces. Use of a treatment room for minor procedures. Insulin. Many other things that have a nasty surprise bill after the fact and no one warned you.
Beautiful Family! Have followed you for over a year! You talk and explain so simply!
Thank you Mike! 😊
We need to greatly expand Medicaid in this country.🇺🇸
That’s why being in the VA is so important. A vet with a 10 percent rating can get vision care/glasses and hearing exam/aides for free.
I noticed Optometrist charge more to patients with insurance than without. Although I had insurance through VSP, now I tell them I don't have insurance. When I wrrntvthrough VSP, I had to pay a deductible, and the bill was $150. When in say I don't have insurance, a routine exam for glasses, the bill is $35 to $50.
Great tip! Sometimes cash pay can be cheaper.
Happens that way with drugs too. A lot of time cash is cheaper than the copays! We always ask, though at Costco they always tell us before we even ask.
Same with dental expenses. The staff at my dentist's office explained they were so happy not to waste so much time on insurance claims they were glad to give me a lower price for services.
I paid on a credit card, paid it off on the next statement.
@@bettym7346 $700 for oral surgury? Guess I live in an alternate universe but I don't have that kind of money laying around. This was NOT because of poor dental care previously. This was a 35 yr old root-canaled tooth that needed to be extracted all of a sudden. I opted not to have a dental implant since I am so old.
Thank you, always helpful.
Very good information.. well explained.Thanks for.
Those averages for long term nursing home care are a lot higher on the East Coast in NYC metro area. More like 200-250K/year. Another thing Medicare does not cover, nor any insurance, is in-home care for the elderly by private home care agencies. I'm using a local agency for my Mom. They have different levels-companion care, where they can't touch the person and nurse supervised care where they can wash/bathe, etc. For 7 day/week-6 hours weekdays and 5 hours weekends, over $70,000/year. I care for Mom most of the time but need help for several hours as I retired, but still do some part time work from home. Nobody tells you about these home care costs for the very late stages of life when you lose the ability to care for yourself when you go to experts in financial planning for retirement.
Congrats on the new baby Stephanie and thanks for the video!
Diabetes pens? [Ozempic] ... Thank you Stephanie, you are delightful.
This is covered by Part D
Great information once again. Thanks!
Another fantastic video. Thank you so much!
So happy to hear from you!
Mmm I am a nurse of MANY years. I have always been interested in “socialized medicine” BUT the masses are not. Yes, I agree no plan is the best however it is so sad to learn how limiting Medicare is. We are told to take care of ourselves and get regular check ups etc. but seeing what Medicare doesn’t cover in preventative care is so disappointing. You know when you add up quite a bit of your yearly premiums and deductibles then you are essentially paying per year the amount of money Europeans are paying into their taxes. Same difference!? I think the socialized medicine covers more. Anyone from Europe that can verify? Overall it just makes so much sense to TAKE GOOD CARE of YOURSELF.
as someone who works for medicare advantage i can attest it is a great service if you are not constantly ill thats when supplemental insurance is a good stand it instead
Congrats 🎊 on your baby and thank you for helping us to discern among this cloudy mess 😅
excellent and extremely crucial video for learning !!! ..this is really the good to know info before joining either MaPd or traditional plan...awesome! thanks!!
Medicare hounded me to sign up, but didn't, I have other medical insurance, these are the 5 most needed medical coverages. ty for this much needed info.
Does not cover:
1 Eye exams
2 hearing aids
3 dental services
4 full routine annual exams that include blood work ups. Some parts will cover wellness yearly exams but not “full” routine physical exams. Wellness exams yes
5 Long term custodial care is not covered.
Please share this with your young adult children. The younger you are (and assumably healthier) the easier it will be to purchase Long Term Care insurance (Nursing Home care.) My husband and I did not even know something like this existed until my parents both entered a nursing home at the same time! Luckily they had substancial savings, owned their own home, and were debt free. We had a very profitable estate sale, sold their home, and were able to cover their 3 and 5 year stays in the nursing home easily. My husband, who has had cancer twice and I (I have progressive Multiple Sclerosis) could not get nursing home insurance. Our son, age 38, was encouraged to research it and he was able to easily obtain a long term care policy at a very reasonable cost. It’s something to consider!
Long Term Care only covers about 1/2 the cost of a nursing home
@JustAGirl what about aged 60 with two chronic conditions?
I looked into long term care coverages they are not locked in price and can become more and more of an expensive premium the longer you own the policy. Especially if you buy a long term care coverage policy when you are very young, you actually may pay more into a yearly membership it than recoup the benefits of an actual cost . So many will say do not buy one if you are going to pay into it for 30+ years.
So there is a sweet spot to purchasing a policy one which many say is about age 60. Now there is one group of people who can have nursing home long care insurance and that is very very affordable to them........ and that is US government workers, their long term care insurance (if enrolled) is locked in premium and we the US tax payers pick up their tab. Nice huh?
@JustAGirl Agreed, it makes more sense to wait until about age 60 than paying into a policy for decades where the premium will rise numerous times. They promise the premium stays affordable, but insurance companies lie just about as much as a floor rug in a house.
@@AverageJillM They may gig you on that two chronic conditions. They will assuredly ask you how long your parents lived. Insurance vendors who come to my work did, I stated ages 59 and 71 to cancer, and they will not even talk to me anymore nor offer any sort of cancer plan. I am blacklisted.
Thanks for the info. Beautiful family, congratulations on your newest!
Thank you!
Vision: Rather than buying a separate vision plan, consider self-pay. Many places offer exams for around $40 - some free if you buyu glasses through them. Once you get the exam, take the prescription and go on-line to one of the many places that offer glasses for less. There are many options; personally I use Zenni optical. If you're not sure how to do it, you can call and they will walk you through it. Instead of paying hundreds of dollars for glasses, you can often get them for less than $100.
Thanks for rec
Except that the prescription they give you seems to always be lacking some piece of information you need to order online.
I order mine from Zenni for few years now. I have a astigmatism high index with transition bifocals, uv blue ray with the frame for $ 117.00 instead of $ 1000.00 in the store. It is always perfect. You need your PD pupil distance, the place that gives you the prescription has to give it to you and it they do not you can measure it yourself.
GES?
ARE we talking ophthalmologist?
Not interested in anything else.
Thanks
Great information, sad that Medicare doesn’t cover some major medical needs for the older generation.
Sad, my A***...it's downright criminal!
what did you expect. its set up by the insurance company lobbyists to benefit the insurance companies, not the elderly.
Yes. I don't know who decided we don't need teeth or to be able to see or hear. Some of the supplements are coming on line with those things, though, so maybe all will work out . . . soon, I hope.
@@dzymslizzy3641 Yes such a Travesty... We need #MedicareForALL.. We NEED National Health Care like Most civilized Countries have already had- for Decades..
@@womanofsubstance8735 the fascists working in our government did
Thank you for this great informative video. I will review again later to implement into our retirement plan.
Absolutely Wonderful! God bless you and your family ❤️
Thank you!
I get my medical care through the Indian health service and my tribe also provides free hearing aids. But for everyday care , I go to the Indian clinic and get primary care, dental and vision care as well as blood work and prescriptions. It is a misnomer to call it a clinic really. I can get X-rays and ultrasounds, just about anything but surgery. If I ever need surgery I can go to an Indian hospital for that. Medicare is just extra for me.
First off congratulations!!! I have Medicare (thru disability, back arthritis) went onto an advantage plan, I'm not 65 yet 63 & a supplemental plans were just too expensive not being 65 yet.
A lot of folks take that route. You will get a new open enrollment period for Medicare Supplement/Medigap when you turn 65!
@@AbtInsuranceAgency When the card came in the mail I thought it was a scam cause I wasn’t 65 yet. Then I read it & it said if you’ve been on disability for two years, then I qualify. I drove a truck delivering gas for 23 years but this company doesn’t offer medical for life.
This is a fantastic video. It's clear and easy to understand your explanations. Thank you for providing this information.
You're very welcome!
Stephanie, Medicare is so complex to me, I am just now, a year into watching your videos, starting to "get it". NOTE: When I read USA spends 16% GDP on health? It is only now I understand how that number gets jacked up so high. Well, and the army of lobbyists writting our state and national insurance laws. Thanks again for your work to help all of us.
Congratulations on the new addition to the family 🥰
Be very wary about Long Term Care insurance plans. Even an independent insurance agent who sold various types of insurance pointed out that a significant amount of time (months) must pass before their coverage even starts paying out. The cost is so high and the coverage so meager that many found it made more sense to refrain from buying it.
Coverage doesn't typically start until Medicare no longer covers (which I think is 100 days).
Agree Read the fine print!
Congratulations on new baby! Thanks for good and helpful information.
Thank you so much for explaining this very confusing part of medicare.
Thanks Ma'am!!
We appreciate your info videos.
It effects us all.
The thing that surprised me was the lifetime fine I have to pay each and every month until I'm dead because I didn't buy Medicare part D when they suddenly sent me a Medicare plan not because I requested Medicare but because if you file for disability and win then you are automatically enrolled. At the time I was taking no medication so saw no point in buying part D. After a few yrs go by I tried to get Medicare advantage and they said the plan was free however you will have to pay the penalty for late enrollment of medication coverage! This was the first I had ever heard of the penalty and I was shocked! Maybe they could find a better way to let folks know and remind them until they know for a fact the customer realizes the drawback to not enrolling in medication coverage ASAP! I'm totally disappointed in the whole mess! The only way out of it be poor yep you can enroll whenever the hell you want as long as your are low income you will never ever pay this fine that I pay every single month oh and it gets better this fine is determined by the average that everyone pays for medication coverage so this fine goes up each yr! This is sick they need to come up with a different setup. If it's so critical you have Medicare part D then include it when you auto enroll those who have won SSD! Shame on you SSD! I don't even see a point in a penalty when the person doesn't take any medication! Why would any person looking to save money buy insurance for something they have not used in yrs? 🤷
They want you pay into the insurance pool, not just when you need it. And then cost it money.
That happened to me too. They really should do a better job of informing us before a nasty surprise such as a penalty.
Happened to my husband also. Pretty sad state of affairs
Opting not to take insurance until you "need" it is the problem. If that was the way things worked no one would pay until they got sick or needed medications. The system only works when there are healthy (non claiming) people supporting it. Just like auto or home insurance.
You aren't typically eligible for Medicare for 2 years after being awarded Disability, so I'm surprised you 'suddenly' received the plan info. Most people are getting Medicaid from their state until Medicare kicks in.
Lots of important information. Thank you!
Congratulations first of all, and thank you for this information.
Thank you Gail!
This is a very helpful series of videos! I hadn’t planned to retire-ever-if I stay vital and maintain the skills needed to perform well. Last night, however, the spark of inspiration whispered, “ Just look into it.” I hadn’t even started my research (so no AI involved this time), but your video from a couple days ago popped up on my RUclips feed just now. 😳 I will no doubt be in touch.
Even if I had found this video useless, it would have been worth watching just for that priceless surprise ending!!! 😍
🙂
Great information, thank you. It seems penny-wise, but pound-foolish that Medicare doesn’t cover routine full exams. Early prevention not only saves lives, it saves money. I’m not sure which plan I have (it has a pharmacy plan), but I signed up for one of the Medicare HMO plans, Kaiser Permanente, and it’s really easy, no bills, claim forms, etc. If there is a fee for something, it’s small and collected at the time of service. Dental care is a big issue, though. I have a limited dental plan that is included, but haven’t had the courage to go to one of its discount dentists. I want my own dentist, whom I trust, and don’t want skimpy, rushed or second-rate dental services.
My dad had hospice care but he owned his home.There were 4 regular nurses that took care of him till he passed at home.
You have a lovely family! Thanks for the information!
Thanks for another informative video, Stephanie. I'm beginning Medicare August 1 and bought my plans through the Abt Agency! You guys are great. Congrats on the new baby.
Thank you Dante, and we are so grateful to have you as a client!
Congratulations on your new little one, Stephanie! You look great. Best wishes!
Thank you Tina!
May God keep his protective hand upon your baby and bless your baby.
Very knowledgeable...thank you for sharing this valuable information in an easy to understand way.
Glad it was helpful!
Attention Veterans. The Va is the largest dispenser of hearing aids in the world. Once you are in the VA medical system, you can request a hearing test. If you need hearing aids, there might be 2 or 3 co pays of $50, and you can have state of the art hearing aids. If you had a combat MOS ( Military Occupational Specialty) you might get them for $0 co pay.
You can enroll in the VA medical system on line. Do your research. I wanted Phonak Paradise P90's and that's what I got. The retail price is $7500 plus.
Being in the VA medical system has no bearing on your Medicare. I use the VA for expensive RX's with a $8 or $11 copay. I get three RX's through medicare with a $2 co pay. VA RX coverage is credible for medicare.
For the vast majority of Veterans, the VA is not going to provide dental or vision coverage.
My dad is a vet from Korean War. He gets all hearing aids and glasses for free. He got his walker for free, and prescriptions are extremely inexpensive. It pays to check it out if you're a vet.
My hubs is a Vietnam veteran. He was injured in the war and gets all exams and meds, any glasses, shoes, and any other devices free.
Congratulations on your new baby. Beautiful family! 😍
Thank you!
Very informative thank you
Thank you! Thank goodness we have vision and dental plans. I did something right!
I have noticed that my Medicare wellness questions are different from my friends who have similar medical conditions as myself. Could you do a video showing the medical wellness questions that your doctor would normally ask her patient? They are asking me questions that have nothing to do with my health. They ask me if I have fire extinguishers in my home, Fire alarms, carbon dioxide dioxide alarms and oh yeah, do I have any guns in my home? Those don't have to do with my health necessarily. Does anyone else have that problem with their doctor asking them questions that do not pertain to their health. They really throw a fit when I refuse to answer. I find it against my rights to answer some of those questions. Thank you for the informative reply video.
I would be afraid they'd try to "commit" me if my home wasn't up to their requirements !
(At 6:34) During a routine examination,the Doctor discovered that my husband had A fibrillation and put him on a blood thinner. When he saw the cardiologist for an echo cardio gram,he said “good for you that your doctor listened to your heart, A fibrillation is usually discovered after the person has had a stroke!”😬
Wow I’m so glad they caught that early!
@@AbtInsuranceAgency Us too!🫣
GOOD JOB! VERY INFORMATIVE!THANK you!!
Thank you for watching!
Holy Cow! I actually understood everything you said! The first time! Thanks for that....
Wow thanks for that compliment!
I do not have dental coverage anymore since I've gone on Medicare. I have always had really nice teeth and no problems with them.
So I called a dental office and asked them what their cash price would be for a cleaning....here is where they get you...
This one office said that they would be happy to have me come in for a cleaning (at X charge), but that they required that I pay for an initial FULL set of dental xrays (panoramic, etc) and that they also required that I have a full dental exam/assessment ($200 for this alone) with them before any cleaning could be done. So one routine cleaning would cost me about $600 out of pocket.
They have us by our gonads.
HOW do I find a dentist who will just clean my damn teeth, for heaven's sake!?
AMAZING how my comments have been 'flagged'. It's obvious. Not one 'like' or comment.
If you are near a med school that has a dental school, see if they have a free or low cost dental clinic. But understand it'll be students working on your teeth. Shouldn't be too bad for only a cleaning.
Very informative but the end of the video is cuteness overload. 😄 Sandi
Adorable family!♥️thanks for the info.
Thanks for watching!
If you keep your original Medicare then get D + N or G plan. You can then work on getting dental & eye care insurance plan
Stephanie, I have been disappointed with Chiropractic not being covered unless it is considered medically necessary. Most Chiropractors are hesitant to submit bills in and coding it as medically necessary as they think it could be considered as fraud.
Agreed. There are certain codes that Medicare will cover though for chiropractic.
I was surprised that not all the blood tests that the doctor ordered were covered. The phlebotomist let me know ahead of time though. Also, still trying to figure out what to call a check up that will go over ongoing medical issues that wouldn´t be a physical.
Other insurance dont cover all blood tests the doctor ordered either, not just Medicare - very frustrating !
when you go to the Dr. have a specific concern it will be covered not some wellness Bs
Call the labs and negotiate the bill. Maybe they’ll accept the same nominal amount the insurance companies pay.
"follow up appointment"? I also get regular blood tests outside the US. I am dreading returning.
New subscriber here. 👍Found you while searching around the feed. Thanks you for this info. Adorable little family by the way. 😊
Thank you!
Congratulations! Beautiful family.
Well after retiring and going to my Dr of 25yrs, I go to my Annual Wellness visit, supposedly free. Right off the bat I was greeted with a $300 charge upfront. I thought weird, but I’ll get reimbursed. I was wrong. My Dr said they just don’t make any money off the wellness visit and have to charge extra. I was/am pissed. I wish the government and even my Dr not say that it was free. $300 extra, on top my Medicare premiums I would consider a heavy charge for such little work. They get the Medicare reimbursement plus my$300. I’d call it a rip.
Just tell them you will not be doing an annual Wellness visit, just schedule a regular appointment for a med check or blood work- tell them you are overly tired - oh let's check your blood work LOL
@@marywiggins7411 👍👍
if they accept medicare at all report them. they cant do that up front.
I will return and make note of your tips. Thank you! I got a surprise just this week when I picked up my "bowel prep" prescription for my upcoming colonoscopy. It was not covered by Medicare or my supplemental insurance. It was $116.
Yes, this often is subject to your Part D drug deductible, so most people will have to pay in full if they haven't met that.
I am new to the Medicare system and picked up my bowel prep meds for my upcoming colonoscopy but I only had to pay $7.00. I have BC/BS Advantage and I have the drug supplement. Not sure why mine was so cheap.
Many doctors don’t even have you use that anymore. They give an instruction list with over-the-counter products.
My last time the doctor just had me dump a whole bottle of Miralax into Gatorade, and that was it. Less liquid to drink, and better tasting. Still same miserable results though!!
Tell your physician that this is cost prohibitive. Quite often they will give you the prep stuff.