Another great video Dr Bricker - THANK YOU SO MUCH for explaining the difference between traditional medicare and medicare advantage - this information is so important - hard to learn when you are an employee in a corp!!
Thank you for this video. As a CM, I find the coverage under the ACA, a challenge to access and coverage is minimal. Often times, individuals need to drive over 25 miles one way, to locate a provider that would accept the insurance.
I would love to create a Medicare supplement plan that covers the totality of the added costs of a wound episode like nutrition, DME, and advanced dressings and skin substitutes.
Small correction: MEC does not necessarily require any of the ten essential health benefits (e.g. inpatient, etc), but ACA marketplace plans are required to cover all ten EHBs with no lifetime limits, so it's a very minor distinction. MEC by itself is basically just preventative care and the commercial market has very lean "MEC-only plans" since self-funded employer-sponsored plans have the option to not cover EHBs (unlike marketplace plans) and effectively provide a preventative-only plan. Great video though!
Medicine is already socialized. Always found it funny how everyone is asking for the free market to resolve the healthcare issues when the biggest payer is the government...
@@ahealthcarez Thank you for doing this series. It's great to hear the perspective of a Doctor that's experienced the impact that the bean-counters have on both the practice of medicine AND the resulting treatment of patients. It's infuriatingly interesting to read the comments from those that want to exclusively blame the government while giving the modern day profiteers and Robber Barrons a blind pass.
Wait so traditional Medicare isn’t run by managed care companies? They have separate lines on their balance sheet for Medicare vs Medicare advantage vs part D vs supplemental
Correct. Traditional Medicare is not Managed Care at all. Paid directly by Feds to healthcare providers via a Medicare Administrative Contractor (MAC) that just processes the claims and takes NO risk.
Lowest blue cross blue shield HMO plan in my area is $350 but with $8000+ deductible. Everything is no charge (after deductible)… didn’t pick that plan
I see this type of thing every day over at my hospital job. People coming in with oscar with a front loaded deductible of 7200 and they're basically homeless. They get paid 40 dollars by agents recruiting them on the streets. It's just sad that this type of predatory practice happens in my big city, guessing it's also elsewhere.
This video seems to be describing Managed Medicaid (capitated model) rather than just Medicaid (FFS). Are they analogous to Medicaid being like traditional Medicare and Managed Medicaid as like Medicare Advantage?
Words can NOT express how grateful i am for finding this channel
Super! Thank you for watching!
Thank you, Dr. Bricker, for dummying down all of these GHIPs to make them easier to understand.
Thank you for watching and for your comment!!
Another great video Dr Bricker - THANK YOU SO MUCH for explaining the difference between traditional medicare and medicare advantage - this information is so important - hard to learn when you are an employee in a corp!!
Thank you for watching and for your comment. Appreciate the encouragement.
I I 😊😊😅
@@ahealthcarez
@@ahealthcarez
Thank you! Very clearly explained
Thank you for watching and for your comment.
Thx a lot Dr🙏 Luving all your podcast !
Thank you for watching.
Thank you for this video. As a CM, I find the coverage under the ACA, a challenge to access and coverage is minimal. Often times, individuals need to drive over 25 miles one way, to locate a provider that would accept the insurance.
#True. Health Insurance is NOT de facto Access to Healthcare.
I would love to create a Medicare supplement plan that covers the totality of the added costs of a wound episode like nutrition, DME, and advanced dressings and skin substitutes.
Great idea! Thank you for sharing it.
Small correction: MEC does not necessarily require any of the ten essential health benefits (e.g. inpatient, etc), but ACA marketplace plans are required to cover all ten EHBs with no lifetime limits, so it's a very minor distinction. MEC by itself is basically just preventative care and the commercial market has very lean "MEC-only plans" since self-funded employer-sponsored plans have the option to not cover EHBs (unlike marketplace plans) and effectively provide a preventative-only plan.
Great video though!
Appreciate the information. Thank you for watching.
Medicine is already socialized. Always found it funny how everyone is asking for the free market to resolve the healthcare issues when the biggest payer is the government...
#True. Just socialized enough for corporate control of government to limit competition and increase profits.
@@ahealthcarez Thank you for doing this series. It's great to hear the perspective of a Doctor that's experienced the impact that the bean-counters have on both the practice of medicine AND the resulting treatment of patients. It's infuriatingly interesting to read the comments from those that want to exclusively blame the government while giving the modern day profiteers and Robber Barrons a blind pass.
Amazing video!!
Thank you for watching and for your comment.
Wait so traditional Medicare isn’t run by managed care companies? They have separate lines on their balance sheet for Medicare vs Medicare advantage vs part D vs supplemental
Correct. Traditional Medicare is not Managed Care at all. Paid directly by Feds to healthcare providers via a Medicare Administrative Contractor (MAC) that just processes the claims and takes NO risk.
@@ahealthcarez did not know that - thank you for clarifying!
Marketplace / ACA / Obamacare starts at 18:00
Lowest blue cross blue shield HMO plan in my area is $350 but with $8000+ deductible. Everything is no charge (after deductible)… didn’t pick that plan
Yup.
I see this type of thing every day over at my hospital job. People coming in with oscar with a front loaded deductible of 7200 and they're basically homeless. They get paid 40 dollars by agents recruiting them on the streets. It's just sad that this type of predatory practice happens in my big city, guessing it's also elsewhere.
Thank you for watching and sharing your experience.
This video seems to be describing Managed Medicaid (capitated model) rather than just Medicaid (FFS). Are they analogous to Medicaid being like traditional Medicare and Managed Medicaid as like Medicare Advantage?
Hi Doctor, do you mind doing a video on ACO Reach? What it is and how it will affect health plans / employers?
Thank you for your suggestion.
Need to discuss IRMAA
Can you do a quality and value based care training?
Thank you for your suggestion.