Medicare Advantage | Pros, Cons and Myths 

I appreciate your feedback - lately Advantage plans do seem to be more heavily advertised and even the Medicare and You guide seems to be skewed in that direction.

@@AbtInsuranceAgency - Yes. Sadly my friend had awful experience getting treatment with his advantage plan. Too much red tape and "approval" hassles ... Regular Medicare he would very likely be fine. Thanks for your videos 👌

CMS actually hates Advantage plans because healthier people tend to sign up for them and this increases the cost sharing for those who remain on traditional Medicare who are usually in poorer health. CMS has no choice in this matter though because the Balanced Budget Act of 1998 that was passed by Congress is what created Advantage plans.

There has to be a cost savings and/or risk reduction for the government to push advantage plans. Considering the restrictions involved with advantage (approvals for services, staying within networks, potential high deductible), I don't see the benefit for a relatively slight increase in cost contrasted with traditional Medicare and Medigap policy. Anyway I want to travel and if I need medical services on a trip I can't be worrying about staying within network and getting approval for services. -- Ms. Abt does a great job explaining this stuff.

It's is not the government that's pushing medicare advantage it's private insurance companies because they are making mega bucks from it.

Seniors retired with a 401k plan and/or pension plan and other financial streams (that take care of Part A and Part B) are very happy with traditional Medicare. No networks, no worries about coverage in other areas of the country, no referrals for specialists. Simple, worry-free, uncluttered; which is the way it should be for EVERY American, senior or not. Especially if you're recovering from a serious illness or accident. You shouldn't have to be stressed out and worried about bills and coverage... Stress and health recovery don't mix. So yeah, these seniors have been very happy with traditional Medicare.

@@8sun52 Agree completely. Prior to reaching 65 I was paying ~$1000/month (no ongoing health concerns) for BC/BS. At 65 went on Medicare A, B and medigap N. My total premiums (part B and N) were ~$320/month for as good and likely better coverage. My medigap N premiums have increased by a total of ~$10/month over five years. You won't catch me whinging about Medicare.

@@MikeNaples Thanks for your feedback. Yes. Medicare has about 3% administrative costs. Health insurance companies can typically have around 10% to 20% administrative costs, not including criminal-in-nature CEO salaries, which is unconscionable; people having to choose high deductible plans (underinsured), people with stripped down health insurance (underinsured), people who have to organize GoFundMe campaigns when they max out their health insurance due to a serious accident or illness. Medical bankruptcies. On and on it goes... People should check out the CEO salaries. It's public record. Then think about that. Really let that sink in. Really, really let that sink in. Very unpatriotic and ethically and morally perverted. Everybody's feeding at the trough selling Medigap Plans, Medicare Advantage Plans etc. This is part of the problem. They don't want to see this gravy train end. But they can find other business opportunities that do not contribute to the very fragmented, expensive, inefficient unpredictable, unstable healthcare non-system that it is...AARP, too, feeding at the trough. I will never, ever have anything to do with AARP. Medicare has been in place for decades. The structure is already there to easily build upon and modify a little bit...contrary to what "special interests" (that have a lot to lose), would have us believe. Everybody In, Nobody Out! Improved and enhanced Medicare For All WEBSITE: Physicians for a National Health Program

Speaking of AARP, can't find their info on AARP's stance re: GOP plans to sunset Medicare and Social Security. I thought AARP was the advocacy group for seniors (?)

Many thanks for watching!

jose martinez thank you so much for the kind words!

Steve Boose 🤓

Kevin Brinkman thanks for watching Kevin!

Stephanie, isn't another advantage with Advantage plans is that they pay the 20% that traditional Medicare does not cover?

@@CarlosGarcia-ls4hn Not always. Many of them are similar to coverage from work and have deductibles and copays. Especially on some big ticket items like cancer treatments and prescriptions. Remember there's no free lunch.

This is a very good point to consider - thank you for sharing!

Thank you!

Thanks for your feedback!

Thank you!

Best of luck to you!

@@AbtInsuranceAgency Thank you!

yES.

Thank you!

I’m so happy to hear that!

Glad it was helpful!

They are the correct answer for 75% or more of the population.

My 90-year-old mom has had and advantage plan for many years and they have covered all her cancer treatments, her doctors and her preferred hospital or in network so I’m very happy that she went that route

@@lenalsheffield Yes, my mother and father are in their 90's. They have no problems with their Advantage plans.

Thank you so much for this feedback!

Thank you Alex!

Excellent points. Speaking with an independent broker is always best. 😉

@@AbtInsuranceAgency which gives better advices, broker or an agent? What’s the difference between these two? Thank you.

@@fatimagross1956 Typically a broker works for YOU and represents many different carriers, while a agent represents one insurance carrier.

Thank you for adding this feedback!

Hilarious! Thanks for the laugh!

A lot simpler, eh?

Yep. The US healthcare non-system is extremely wasteful, expensive, bureaucratic, inefficient and fragmented. Healthcare spending in the US is nearly twice as much as some industrialized European countries and we still leave millions uninsured and underinsured; one serious disease or accident away from bankruptcy and GoFundMe campaigns. And search what these health insurance CEOs are making annually and then think about that the next time you're stuck with a huge deductible or you max out your health insurance. Just let that sink in, let that really sink in. The health insurance CEOs are not there for your benefit but are only there to maximize returns for investment shareholders. Those are our healthcare dollars in one form or another being siphoned away from our healthcare. The US healthcare non-system is ethically and morally perverted.

I find it weird you're even watching these videos

Thinking about immigrating to Canada. I know prosthetic eyebrows are included in the Canadian plan but what about toupées?

Bold &beautifuk

Joe Namath says you may get your $148 a month back from your advantage plan. And why different rules in different Zip codes in the same state. Remember to talk to an agent licensed to practice in your home state.

Thank you so much for helping me to understand the real difference between supplemental insurance and the advantage choice. There is a difference and really did not understand the difference. You really are excellent at explaining the medical choices!!! Again, thank you so very much!!!

Is this true? Please explain further. Thank you.

Thank you Michael, that means a lot!

Can I sell you some cheap twin towers' stock too?

Chris thank you SO much! I truly appreciate you watching and commenting :-)

You're a PAID troll, aren't you

That's the best MA plan I've ever seen. You won't find a better one in the country.

I hear you. I am totally screwed. I am 70 and my husband left, with all of our money, kicked me off his health insurance and refuses to give me my share of our savings. I am trying to get on Part B but they are going to charge me $80 a month as a punishment for not selecting Part B when I was 65. No kidding. I have no money, went back to work and I am working with an agency to help me sort this out.

How'd you qualify for medicaid? What are the qualifications...$$??

New York has different rules regarding Medigap and guaranteed issue rights. I don’t have a video specific to NY yet, but I hope to soon!

How soon on NYS video?

Exactly. Health First is excellent and accepted by most doctors here.

Networks change every year. The doctors you like and trust with your care will leave the plan when they can no longer stand the insurance co.'s pressure to scrimp on your health by no longer approving the better treatments. Medicare Advantage is like sausage - once you see how it is made you will lose your appetite for it. But it will be too late.

@@utuber1000 yep, my doctor just left and no available doctor available accepting Medicare. I have expensive advantage plan, but did find a new provider elsewhere. I rather pay than lose out.

Do not use Advantage. Fewer doctors with less coverage.

The question is can you afford the deductibles on an advantage plan

Very true. Let’s hope the lawmakers can get this legislation passed to amend the big issue with prior authorizations on Medicare Advantage.

If you move out of your Medicare Advantage Plan's service area you will have a "special enrollment period" to choose a new plan in your new area.

This is often the case!

D Lee typically Part D Plans and Medicare Advantage plans have network pharmacies, and then among those there are Preferred and Standard network pharmacies. Rx costs are lowest at Preferred network pharmacies. The plan can tell you which pharmacies are Preferred network pharmacies, and you can always reach out to us with questions too. I hope this helps!

Hello Carlos, How are you doing today?

a dental plan is a plus/.

Please keep in mind most dentists do not take MA plans dental, most do accept Delta in some form.

Medicare Advantage Plans are calendar year plans, so your plan benefits may change each year. You'll receive a renewal packet outlining plan changes in the Fall, and you can either do nothing to continue with your plan's renewal, or you can shop Medicare Advantage Plans during the Annual Election Period from Oct. 15th - Dec. 7th.

Technically, I believe the terminology is "Medicare *_WITH_* Supplement Plan" as Original Medicare remains in effect. You have a Medicare Advantage Plan *_FROM_* KP. Medicare Advantage Plans REPLACE Original Medicare as Original Medicare is NO longer in effect.

No

No again

In most states you will have to pass through underwriting to switch your Plan Letter, or to switch from one insurance company to another.

I am an independent insurance broker, and represent many various insurance companies.

@@AbtInsuranceAgency Thanks A lot for your response...by the way can you please write down medicare script for part c and d??

It depends on several factors. If you have any major pre existing conditions, you may be better off keeping your existing Plan F rather than trying to switch to another lower cost plan. Medical underwriting could potentially disqualify you. I hope this helps!

Original Medicare A and B doesn't offer 100% coverage at the doctor/hospital. You have deductibles and coinsurance that you're responsible for. The Medicare Supplement Plans (like Plan N) help to pay for the deductibles and coinsurance so that you have much lower potential out of pocket exposure. Click Here for more info --> ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-tIEF7dC9e3o.html

drp5 * without a supplement , I believe the biggest risk lies in part B coinsurance being 20%. There is no limit or out-of-pocket maximum. So think about how much outpatient surgery/procedure/treatments could run.

Ron Brown Thank you , starting to make sense now.

That depends on many factor. Please give us a call at 888-465-9728 if you would like to review!

You are on SSDI

In most cases, no. And many Medicare Supplement companies won't sell you have a plan if you have full Medicaid benefits.

Medicare Advantage plans could deny certain services, in which case you could be responsible for the costs of these services.

@@AbtInsuranceAgency that was NOT giving an example...😕

@@druannpellegrini5661 let’s say for example that your doctor advised you to have 5 injections per year to help your arthritis. Your insurance carrier may only deem that up to 4 injections are necessary and could deny the 5th injection. Then you are responsible for the cost of the 5th injection if you receive it. This is not extremely common but could happen. I hope this helps.

In most situations, you are locked into your Medicare Advantage Plan for the calendar year. You can make changes from Oct. 15th - Dec 7th for changes to go into effect Jan. 1st of the following year. If you have a life changing event you may qualify for a special enrollment period to change mid-year. I hope this helps!

You cannot have both a Medicare Supplement and a Medicare Advantage Plan.

No, not at all, since Medicare Advantage Plans are not medically underwritten. You can always change plans between Oct. 15th - Dec. 7th for the coming year.

Yes! I cover the Part B giveback in more depth here - ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-dMy1JJvQwTs.html

Isnt that dependent on your income?

We would be happy to help you review your situation! Please call us at 888-465-9728

I did the part D before it enrolled me in Aetna Medicare advantage, so does that kick my part D separate plan processing from Humana out, and leave the advantage plan alone? Typically also how long Would it take for a plan to enroll? I want to make sure that I’m ok with my advantage plan? I did the separate part D last Saturday and Aetna with me being suddenly approved took effect 7/1 but it never showed up until this Monday. So should I be ok with the advantage plan, or will it kick me off for that separate part D plan that was processed last Saturday?

Stephen, if you call my office at 888-465-9728 we can definitely help. Typically enrolling in an Advantage plan will cancel out your Part D coverage, and vice versa. The coverage that is going to “stick” will depend upon your enrollment dates, approval dates, and election period. I’d be happy to help you sort it out if you’d like.

They never kick anyone off just X 10 your premium, but You weren't kicked off! Haha😛

I review that in more depth here - ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-dMy1JJvQwTs.html

You have one year to try it out from when you initially get it.

I heard that once you go off Medicare Advantage that when you re-apply for a medigap plan they now look into your past medical records to make a decision on cost ect.

@@DavidReo yes, thsts what underwriters do. If you have medical issues You WILL be denied. Each yr you are reviewed by your own plan...they may be able to 'dump' you if you cost too much. Its a risk! 😦

Are you referring to calling my office? If so that doesn’t track. We are real people, here to answer the phone and help seniors. 888-465-9728.