I had a hip replacement in Jan 2023. I paid my $226 deductible against my pre-op tests. I went to the surgeon of my choice, was in PT rehab for 12 days, the dr prescribed follow-up meds, and I had in-home PT for four weeks after rehab. I have Part A&B and Supplement G. Aside from my Part B premium and Supp G premium, I had no additional out-of-pocket costs. That’s including all my follow-ups with the surgeon and his PAs. A&B and supp G are more than worth it for me.
@@CeruleanSky1111 Plan G is $170. I do not have a Plan D. I couldn’t find a plan that included all the prescriptions I take. I utilize a Good Rx card at one pharmacy for occasional prescriptions, and for the two I take on a regular basis I get from a mail-order pharmacy affiliated with the health organization my PCP is at. They have their own negotiated contact with drug companies. My two prescriptions cost around $15 each for a 90-day supply. Hope this helps.
71 y/o, I fractured my right hip and wrist. I had surgery 12/23 and was sent to Skilled Nursing Facility. I was released after 60 days. I'm currently doing physical therapy once a week. I know every persons scenario is different. In my case , I have several medical issues. Therefore, I chose a Medicare Supplemental plan G. I'm happy with my plan.
I'm a retired RN Case Manager for a large hospital chain and I can not tell you the frustration, time and energy it was to try to get benefits for MAP plan patients for treatment, disposition and follow up treatment. Another important factor is that MAP may only contract with specific SNF, often not the best. Traditional Medicare can go to any SNF on discharge. This can be a major consideration for proper PT/OT/ wound care and location to family and support. SHOES
Thank you for the information. It was concise and helpful. My favorite sandals are easy spirit leather slip ons. They hug my feet and are easy to slip on and off.
The thing about advantage plans is its like going to the shoe store and being told you can only buy a couple of kinds of shoes. The problem is, instead of shoes we're talking about surgeons. So you want the the best shoes you can get since unlike shoes, you're going to wear your surgery for the rest of your life. And the shoes on offer with the disadvantage system, speaking as a doctor who's seen them all too often, are never the best.
I like the analogy. I’d probably tweak it a little to be shoe stores rather than shoes themselves. Where you live makes a big difference. Some areas only have 1 shoe store and it only offers cowboy boots 👢 if you live there, and you need something besides boots, that gets tough. Other areas have every shoe store and every type you can get in that area. Most are somewhere in between 🙂 Appreciate you watching and adding this!
I remember walking into my doctor’s office, with my Altra comfortable wide toe box shoes, and seeing a sign with a list of all the Advantage plans they were not accepting. That made my Medicare choice much easier! Enjoy these cost breakdowns. Thanks.
Truly appreciate your very balanced and objective approach. Even though I'm a traditional Medicare fan it's really nice to have an objective presentation of Medicare advantage to make sure that I maintain a critical thinking perspective on retiree insurance. I'm a big fan of slip-on shoes 🙂
After my mom’s bypass surgery and rehab stay I will never get an advantage plan. If you have to go to a skilled nursing place it’s a hassle renewing every few days and they will do anything to get you out of there. Supplemental plan all the way for me.
My HOKA sneakers will keep my legs working strong hopefully avoiding any knee surgery. Thanks as always to your concise and informative Medicare videos. Approaching my 65th birthday and impending Medicare signup late summer.
I've heard great things about HOKAs! Need to get me a pair. Thank you so much for your kind words and support! Exciting times ahead for you! Here to help if you need anything!
Dr. Weir suggests Supplemental plan N overall. No referrals, out of network for travelers, etc. You never know what the future has in store for you. Your example was great, but I will stick to my supplement plan.
Thanks for the great video, Erik. It is another outstanding addition to your virtual library of added value for those interested in healthcare and financial topics; you are unique in this space, and over 100,000 subscribers tell the tale.🔥🔥🔥
I wear mostly boots. Thanks for this example. Quick and clear numbers giving an idea of the different plans for 1 major operation and physical therapy.
Thank you for the timely video! I'll be on Medicare early next year and knee replacement is the only foreseeable procedure that I'll need. I've been able to keep the knees semi-happy by maintaining strong quadriceps, plenty of no-impact cardio and of course, good shoes.
I needed hightop shoes to deal with ankles with advanced DJD - Orthofeet delivered the support and zero "break-in" time. Are they beautiful? That is in the eyes of the wearer! I can walk a lot farther in the hightop shoes with less pain and no sprained ankles. Win-win! * I am very grateful that most of the problems I expected and some I didn't expect are happening before there is a big change in the Medicare Advantage Plan that I get through my Employees Retirement System. It has been a real blessing to essentially walk away owning little or nothing. That won't last, but I have two new knees and a big surgery (unexpected) that were totally covered during these more advantageous (pun intended) times. Feeling blessed. Really blessed. * I love how informative your work is, and I promote you to anyone who will listen. Thank you so much.
I have traditional Medicare and an F supplement. My total knee replacement with all the pre-op costs, surgery costs, 12 physical therapy visits and two surgeon follow ups after the initial 90 day period. My total cost was $0. I also had a fair amount of pre-surgical lab work that was billed separately from the surgery. In my case I stayed overnight in the hospital. My total surgery bill was about $56K and everything else came to about $12K. I don't attribute all of my Part B and Plan F premiums to this surgery since I had about $80K in other medical services that year. I don't carry dental or vision since I only pay about $60 per year for vision and dental coverage around here stinks. I do have a drug plan but it is $0.50/mo.
I need new SHOES!! Thank you for your great understandable explanations on your videos!! I’m new to your channel and will be recommending as well as returning to it.
I've been wearing "barefoot" or "minimalist" shoes for 18 months. They are flat, no cushioning and a wide toe box. Lets your feet interact naturally with the ground...Great video, as usual! A big thing that sticks in my mind is that the Supp plans are much more stable year to year, basically the stuff that is covered is covered the same all the time Adv Plans they can change up who what, when, and how changes very often...
The one year contract for MA is a huge headache keeping up with changes from year to year. Add to that the non-standardization of too many MA plans makeschoosing a plan a nightmare. I'd like to give MA (which costs Medicare more $$$) THE BOOT!
Birkenstocks! 30+ pairs in every color collected over a lifetime and all still wearable. Great video! It is worth noting that all the supplement expenses are already budgeted for, so important on a fixed income, whereas the Advantage plan costs could be a nasty, budget-wrecking surprise.
YES!! The surprise “Gotcha Factor” was a serious consideration for me as well. Many of my retired friends have had to shift to network doctors, receive surprise bills and experienced issues traveling. My time and peace of mind are worth way more than any small or perceived cost savings.
I’m a physical therapist and spend a significant amount of time educating people on the importance of shoes that provide proper support. Unfortunately,there are more times than not, that I am telling people they need to give their shoes a Viking funeral.
I worked in the ER for years. I remember with tennis shoes were so big for the elderly but they kept getting them stuck when shuffling over carpets and bam...face-plant. I was a Hospice RN for 17 years (5 years pediatric hospice) WE loved you PT and how you helped our patients.
Doctors will often question people on why they care about some charge if the insurance company is picking up the tab. I'm one of thise people because I know ultimately it will add to premiums. I have a question along those lines. In the end, you stated Medicare gets $1k/month for the advantage plan for "taking on risk". In plan G and N, are the insurance companies footing that $12k . I'm asking because I don't want the government paying for medical expenses. National debt is already out of control.
Advantage plans get funding (the $1,000 per month example from the video) from Medicare to take on all of your covered health expenses for the year. Advantage plans take the place of Parts A and B, and take the risk from Medicare, so Medicare pays them for it. If you have a supplemental plan, Parts A and B provide coverage for you, and your supplemental plan fills in gaps in A and B coverage. So whether you have an Advantage plan or a supplemental plan, the federal government is involved one way or another in paying for your care: with an Advantage plan, the federal government pays the plan a fixed amount each month (the $1,000 example from the video), whether you use health services or not. If you have a supplemental plan, Parts A and B pay as usual, as does your supplemental plan.
I am only 60 but starting my research early. Learning a lot about the different plans thru taking care of my mom after she broke a hip last year and from my friends that are starting to sign up for Medicare. The new shoes that my mom bought seem to help her walk better now. ☺
Great illustration, thanks! Here’s another possible topic for a video (I looked briefly for such a video on your channel, but possibly missed it?): Any Medicare or Social-Security ramifications of having a non-US-citizen (permanent resident) spouse, whether or not they have worked in the USA.
My wife needs to have both knees replaced as well as her hip. Total cost - - her prescription for pain medication. All I pay is a dispensing fee. I.Live. In. CANADA.
Soles of my shoes are a little wore out, so a slippery comment, but as always you take the fear mongering out of equation and give the facts for an accurate comparison. Keep up the great work
EE shoe size here. Always hard to find good fitting shoes. Trying to decide if Supplement plan or advantage plan is best choice for us. We are healthy now and Advantage seems good bet to save money. But the concern over unexpected health issue down the road pushes towards a Supplement plan which protects us from catastrophic medical bills On the fence🤔
It's a tough decision. Where you live and several other circumstances will affect that. Not sure if you've seen this video yet, but it goes into more detail around the differences between the two: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-eOP76hMPiDs.html
First time viewer, liked your analysis, I’m a subscriber now, and I’m wearing On Cloud slip on tennis shoes for walking and they are supportive and well cushioned. Age 63.5 so studying the Medicare scenario in front of me.
Awesome video and awesome explanation. Sketchers are my go to shoes. Thanks for all that you do to inform us about the rabbit hole that is Medicare coverage.
My wife had to have open heart surgery to replace her aortic valve, she was born with a defective valve. The total medical bill, from diagnostic through rehab was just over $250,00, (I forgot what Medicare paid), our cost for her Plan N was $320, which included the Part B deductible. Her Plan N costs $72 a month. During her rehab I walked with her with my Sketcher walkers, very comfortable.
Great video, I would rather pay the higher cost of the supplemental insurance and be able to go to who I want to wearing my Sperry dock shoes, than have to go to in network only... ;)
"These boots are made for walking" sang Nancy (before your time). Thanks for the very interesting cost comparison. My brother had his second knee replacement 5 weeks ago so I am sending him this link. I don't know what plan he has so I will ask him. It helps all of us to see real cost comparisons before we choose what route is best for each of us and I appreciate that you stay very balanced and point out that each plan has some advantages and some disadvantages. As well as how crazy the US medical system is. But we are fortunate to have any medical system at all.
Very true! We are fortunate! Before my time, but I was raised on that generation of music 🙂 just hope one of these days those boots won't walk all over me 👢🙂
I like slip on shoes like sketchers. I love this site - love watching the costs broken down one versus the other. I took original Med and plan G - it just gives me more piece of mind regardless if thats true when the billing starts for whatever injury or sickness. I live in NC and G is a little less expensive then the avg number u used ( just to mention it) and I didn't purchase a dental vision plan. The dentists I pickeed don't take insurance and the plans themselves are pretty skimpy on what they give you. My total cost using your example came to $3878 still ,more than Advantage. But its still a small price to pay either way for such a surgery. Thanks again for your videos - great info.
I had a TKR last month, May 8, 2024. I wore my Hey Dude shoes so I could get them on and off easy. My surgeon requires a one night stay in the hospital for all of his TKR and hip patients. I had four in home PT visits then in office PT. My PT office told me Medicare only covers 20 PT in office visits.
Ok, after watching several of your comparison videos in past couple of years since having to compare G, N, & MA in general I decided to subscribe. The slip-on shoe comparison was the clincher because I don’t like the brand I’ve been wearing this year. Much like this knee surgery comparison to sort out choices for Medicare coverage I used a medical emergency surgery plus 2 relapses back into hospital I had about 2 years before with retirement pre-Medicare private insurance. So I’m using these comparisons to help me keep updated on plan info.
My podiatrist says my feet are a nightmare and I have to agree. I’ve had issues, over the years and now at 67, I have heel spurs, hammer toes, bunions and arthritis in both ankles. Birkenstocks were awesome for heel spur pain, UNTIL my bunions grew to the point my feet were too wide for Birkenstocks and most other normal shoes! I live in Florida and have found very wide sandals to wear and orthopedic shoes in 9W widths!
Another good video, thank you. I am currently 64 so I am trying to do my homework for next year. So many choices! Like going to a shoe store... which pair fits me best? 😉
It is a lot, for sure! Highly recommend using an agent - even if it's not us. They can help you find your shoe size, the style you're looking for (work boot? sandal? roller skate?) and bring solid options to you :)
Thanks! I've got a bum knee but I'm putting off replacement as long as possible. I've wondered what out of pocket costs might cost if I ever have to get it or them replaced. SHOE yep, I watched it all.
Shoes and underwriting. One MUST consider underwriting if choosing an Advantage plan. It's like a banker and a loan. You can't get a loan when you most likely need it most. My dr. and I decide what treatment is in my best interest NOT some white coat in an office high in some billion dollar building looking at the bottom line of an insurance company.
Thanks Erik for your informative videos. I love your shoes. I am still a little confused about the “Part B Excess Charges“ in Supplement N. In this knee surgery example, there is almost no difference between G and N other than the plan premiums. Cheers from San Diego.
Thanks for the informative video. I sat watching it wearing my Brooks Ghost 16’s. My podiatrist insists I wear a supportive shoe most of my waking hours!!!
I am a retired employee from both the federal government and state government. Both plans are PPOs. My State health insurance plan is free into retirement for me and family and the plan will pay Medicare premiums. My FEHB plan is better, but I pay approximately $800 per month. It also covers me and family. The question is, when I am Medicare eligible, should I drop the federal plan where I pay out of pocket and merely keep the state plan?
I like Nike Air but the sole glue doesn't last so the front is flapping after 6 months. After I figure out the FEHB vs Medicare part B, I'll look for a new shoe.
Good Evening. As a 70 year old retired member of the Armed Forces I have TFL (TriCare for Life.) Tricare for Life is "Medicare-wraparound " coverage. Some may find it helpful if you also include and compare TriCare for Life with an Advantage Plan and with Traditional Medicare with a supplemental plan add on. Thank you
To avoid the need for knee replacements, do regular core strength workouts, maintain normal weight, use proper shoes (cushioning doesn't last forever and the new cushioning technology is incredible).
Very good video. I have a supplement, my wife has an advantage plan. My wife is blessed with very goo health. I am not blessed with good health. For us having different plans makes sense. Yes I like comfy shoes too!
We touch on it in this video: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-mK9Ik6Q269E.html But for those with postal benefits, they are making you take Part B now.
No already retired postal workers still have the choice not to take Medicare - they say they will put you in a PSHB plan that is like the FEHB plan you have currently - the only issue is what is that going to look like - and deadlines are approaching and we haven’t seen the PSHB plans
If I were in your shoes I would talk more about the issues with cost of care out of state. That is one thing I worry about because I do travel to visit family.
Speaking of shoes, do any plans cover an orthopedic lift of greater than an inch (not prescribed by a doctor)? Thank you for all your videos. They are all excellent.
