Stephanie - Another well done video from you and your staff. Many people on Advantage plans are denied services. Since only 11% appeal it indicates that many people on Medicare Advantage do not have the educational background or cognitive skills to process an appeal. The fact that 82% of the appeals are overturned should be a RED FLAG that the Medicare Advantage system is seriously broken. The important thing to remember about Medicare Advantage is that it is not Medicare and it is not an Advantage

Once upon a time, I naively believed that American citizens who were taxed for Medicare their entire working lives, received free Medicare benefits at age 65. What a shocker when I learned Medicare is not free, and it is very expensive.

Thank you for your updates. When you see ads on TV run every second about MA plans, you gotta wonder. I am beginning to understand that our seniors in this country are not well regarded. Turning 65 this year.

I worked in healthcare my entire career, including during the heyday of managed care. I would never get on a Medicare Advantage plan. If you've ever worked in a hospital, you KNOW. you want to be able to choose your own doctor. There are some incompetent physicians out there, and you don't want to be stuck with a bad one. You also don't want to wait for treatment while they drag their feet in giving a prior authorization! I could rant on and on. I recommend traditional Medicare without reservation.

It's frightening that there are large volumes of people, who are rapidly approaching 65, that know nothing as to the complexities of Medicare.

The Advantage is for the Insurance Company and that is why they spend big money on celebrities and TV Advertising.

This is an Awesome job explaining most important highlights of managed care plans. I admire your work❗️

Great advice Stephanie. I plan on giving your Agency a call soon, in preparation for a change from my current plan. I hope I can improve my situation and am not locked in as you mentioned towards the end of your video. OY VEY!! I think our healthcare system needs a huge overhaul!

Thank you for the free information. You look stunning ❤

i'm glad to find you. there are other channels pushing the advantage plans so hard to expats and do not put in the crucial bit about the medical underwriting if they move back to the USA and are expecting to "just make the switch" to regular. i will eat the cost of regular B medicare because i want the freedom to choose my providers anywhere in the nation without having to beg an HMO to approve anything. and reaching that 20% - that could be the difference between a stable retirement and poverty.

If you compare MA that includes prescription and dental allowance costs with comparable coverage MG costs you spend around #3K a year in premiums for MG and nothing in premiums for the MA plan. There would have to be a major health issue to hit anywhere near the $3K costs. And the MA networks are excellent, yeah I can't go to the mayo clinic, big deal. And keep in mind MG premiums go up every year. Over a 10 year period if your average spend is $500/yr in an MA plan vs paying premiums for MG, you end up paying at least $25K more in MG over the time period and the care is not any better if you live in an area with a decent network.

Thanks…, Great info! I’m trying to figure this all out and you’re really helping me a lot!

The Feds should NEVER allow a provider to “leave the network” in mid year. This should be illegal.

We have a newer thing called ESA extended service area. An advantage plan can offer a member to have this and see any Medicare provider. Best for rpatient if doctor will send the bill and get paid the in network amount they are already getting from traditional plans.

Hi beautiful 😍❤️ thanks for the update another good 👍 good video have a great day Hi from Cleveland Ohio

Have you run into a Medicare nightmare? Share your advice below!

Stephanie!! Every time I think "I got it. I understand." I see another video and realize: No. I don't got it!! hahaha. My sister is a nurse and far smarter than me: She is on 5 star Advantage Plan. She thinks I am "nuts" for wanting Medigap plan. - sigh -

Another tip when you enroll that you mentioned at the end was you said you can add supplement plans only when you get approved for Part B , that is true but people should also be aware that during SEP(special enrollment) is always an option to sign up for an MA or Supp plan. Your agent can let you know if you have a SEP. generally if it’s a move, or loosing employer coverage, or a new Medicaid recipient etc. there are quite a few “special” circumstances.

Prior authorizations are "bad" if there is an alternative, so as original Medicare (+ medigap) but don't many of us already have PA on o ur pre-retirement insurance from work (for example)? I just had to go through it for various procedures and medications. But, yes, if you don't have to have it, then probably better not to! One other point, the fact that most appeals were successful isn't necessarily as meaningful as it may seem. As you said, a small percentage (11?) did appeal, and these can easily be those where the case was strong and the doctor/medical staff were motivated to appeal. The other 89% might have been more correctly denied originally.

My brother has schizophrenia and was admitted many times in the psychiatrist hospital before. They wanted to keep him longer so he can get well, but the humana said they would not approve it unless he's a threat to himself or others. Is that another disadvantage of medicare advantage plan? If he switch back to original medicare and medicaid, will they keep him as long as they want?

I am turning 65 in April 2024. Will I be able to apply for Medex? Or is it no longer available?

I be 65 in 2024 No advantage plan for me, alot of out of pocket expenses (co-insurance bills), etc, Best to get plan G or N. I'm going with plan N,.

Hi Stephanie, I have a Blue Cross & Blue Shield of R.I. . I do pay an extra $132.00 per month to be covered in other states and to set appointments for myself, I'm 67 years old and my urologist is in Massachusetts and I only pay for my copay as I have always done in years past. Thank you David. I think your a very knowledgeable woman in your field and I enjoy your videos on KZfaq.

I’ve been hearing how brokers will guide consumers to the correct plan for them. How do the brokers get paid. How do they do it for free? I assume that the insurance companies pay the brokers? Not turning 65 for another year, but doing lots of research.

Are you licensed in WI?

Most people on medicare/Medicaid don't have the money for co-pays of any kind. There are people forced to live on the streets or in cars, the cost is eating their ability to make decision do to their income.

Most individuals who had group insurance through an employer. Had managed care insurance. Your assessment of pre-authorization is suggesting those that were denied or partially denied were treated unfairly. Not accurate. Managed care can actually help a person avoid unnecessary procedures some doctor is recommending. This is the big flaw in Original Medicare. The doctor isn't always right. Doctors perform many thousands of unnecessary surgeries every year. Most come through Original Medicare. All insurance is based on risk tolerance. Medicare Advantage plans work and so does Original Medicare and a supplement. I've had a UHC PPO advantage plan for 10 years. All these KZfaq insurance agent videos never mention that if a person starts with Original Medicare and a supplement. They can at anytime try an Advantage plan for 12 months. Don't like it or have problems. You're able to switch back to your supplement without any underwriting requirements. In other words. Zero risk.

I write on average 300 MAPD plans every month 12 months a year. And on average 5 plan G supplements. As everything in life it comes down to affordability. The average monthly income I’m seeing is about $1100. Per month. Across 48 states I’m licensed in. Not many people can afford to spend around 30-50% of monthly income to stay in original Medicare with a a plan G supplement and then purchase separate vision and dental insurance. *most states especially now with income redetermination is still not easy to qualify for Medicaid even with a $1100/month benefit. And if a client still eligible for Medicaid a D-SNP plan is incredible. With most counties across the county now giving $200-$305. In OTC benefits every month .. and as you should know most counties in Florida MAPD plans have a part B give back of $164.90/month with very low MOOP. Financially a no brainer of a decision.

Seems a little biased against MA plans based on the stats. I've got a great MA plan that works for me. PPO network and reasonable co-pays with no preauthorizations. Lots of other benefits. Things can change but right now, everything is good.

Can you help someone that has been on an advantage plan for 5 or more years get a better plan?

If Medicare pays 80% and your copay is 20%. Do provides write off any unpaid balance?

I don't know how post was deleted last night, I Iwas asking about cost of both plans as we age and none of you want to confront this issue. I would really like to go with supplemental but need to make an educated choice. Without the cost as we age, this is difficult. Besides cost as a factor, a report came out today by Medscape physicians compensation report 2023, that there is a clear reduction of physicians accepting Medicare patients. 5 years ago 71 percent of physicians they would continue treating current Medicaid patients, and the number dropped in 2023 to 65 percent, this is an alarming trend that should be considered.

Then Advatage plans would have a lower yearly out of pocket charge than regular Medicare would?

I have United Healthcare, I am 61 and disabled..I get many perks. including 180.00 a month for food, utilities, products. They have been good to me. Forget these morons.

The mao did not make clear which stars you are not licensed in

Ok, so what are the alternatives to Medicare Advantage plans? Because Medicare doesn't provide all the paid coverage that seniors will need.

There are some employer Medicare Advantage plans that are significantly better than the plans that are generally available. Many of these videos fail to acknowledge these and give all Medicare Advantage plans a bad review. We were originally reluctant to sign up for one of these plans because of the negative review of Advantage plans. Now we have been on this employer provided plan our only regret is we didn't sign up for it earlier. This plan let's us see ANY Midicare provider. Our annual out of pocket is $150 and even though we have medical issues we have never reached it. Not all Medicare Advantage plans are the same. Our employer provided plan offers both Medicare Supplements or Medicare Advantage. The Medicare Advantage is by far the better plan.

Sorry I can’t because I work for the company. Will send info I can. Kaiser is a different animal altogether.

Where are the “pro tips”?

You do not understand advantage as well as you believe you do. Continuity of care. Look it up. HMO and PPO are not the only choices. Providers come and go anytime from choosing to being dropped for not keeping up credentials. Your authorizations info is wrong. Most denials happen from doctors not submitting all they need to and that is 95% of the time. The other 5% is due to Medicare guidelines that must be obeyed by Medicare. Most DME has no deductible either and most of the time 0 cost. Wow. You need to learn a lot. You got supplemental correct. Study before you teach. Salesperson.

I wouldn't touch a Medicare advantage plan with your fingers