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08/27/2024

MEDICARE SUPPLEMENTS VS ADVANTAGE

Just got off the phone with someone who is considering an Medicare supplement. There are some good ones out there yet, but plans C & F are no longer available unless you already have them and/or were grandfathered in. If you just now are turning 65 you can't get them.

Plan C (not to be confused with Medicare part C - which is what Advantage plans fall under), paid for just about everything. Pan F paid for all except your Part B Deductible (which is $240 in 24).

Doctors and hospitals see dollar signs when you come in with one of these plans. They know they will get paid no matter how many tests or procedures they perform on you! That is why congress did away with C & F.

With a supplement you will always have an additional premium, in addition to what you pay out of your SS check for part B. They have no Max out of pocket, and in some cases your Medigap plan (which is another name for supplement cause they fill in the GAPs of Medicare) will not pay for what they consider "Overages". With Supplements your premium will go up every year. At some point you may not be able to afford it anymore and will need to drop it or get a Zero Premium Advantage plan. I've helped several seniors in that situation.

Still Supplements can be good for the right folks that want them. With Medigap, you can go to any doctor or hospital that takes Medicare. There are a few that won't these days.

While no single pan is right for every person or situation, Medigap does have it's place. Personally I would not get one if I were a Multi-Millionaire, but that is just me. I tend to think that the less you have to do with doctors the better off you are. So, as long as I have something to cover me in case something catastrophic happens, I'm fine.

With an Advantage plan there are several benefits you can use even if you never get sick. Like glasses, gym membership, and dental coverage. Over-the-counter benefits you can use at Wal-Mart, DG, and other stores. I also like having coverage should I go out of the country. I also know what my Max out of pocket will be should something catastrophic happen. The plan I like is $3500 MAX. There are no premiums (there are many good ones in OK and TX - I'm licensed in both states) on many plans.

It would be impossible for me to list all the differences here between Medigap and Advantage plans. I will say that Supplement sales folks bad-mouth Advantage, cause they are losing a LOT of business to them! I've been in classes with them where they are saying things to the sales team that are just NOT TRUE.

If you were selling balloons, and someone opened up next door and were giving them away, what would you think of them? Just saying. If you need to talk about your situation, please let me know. Both types of plans have their place, and no single plan is right for everyone or situation.

08/26/2024

With an Advantage plan this client paid the hospital 48 bucks for a 4-day stay. Heart stint installed and is doing fine. Thanks again my friend for sharing this with me. If she had original Medicare I can assure you she would have paid more - Much MORE! The hospital would have received more too - but I'm protecting individuals - NOT hospitals!

08/26/2024

Advantage Plans and Home Health

I have recently had to help a couple of people get their Full Benefits for Home Health with their PPO Advantage plan. Humana, United Health and Aetna the Big 3 around here, all have Home Health agencies that work with them.

Typically the BIG home health agencies won't work with Advantage plans cause they know it is easier to rip off the government than it is insurance companies who all have Fraud departments. Fraud in Medicare is the number one reason we have Advantage plans!

In one case the PCA was a close friend that she wanted to keep. Many PCA's and Therapists work with several home-health agencies. We were able to get her PCA hired with the agency that works with United in her area. The other benefits for home health were the same, plus she got the $180 per month benefit that she can use for food, utilities and more. A real LIFE-CHANGER for her. She also loved the fact that she would no longer have to pay her money for glasses and dental! The right plan can change someone's life!

08/26/2024

More Untruths about Medicare Advantage.

If there is an Emergency you can go to Any hospital. If you are on original Medicare you have about a $1600 deductible for hospital stays. That can be Per Hospital stay, that is NOT an annual deductible. If you are destitute, most of the hospitals around here will work with you to find aid. They know where the Deep pockets of money are.

The average hospital stay in the US is 2 to 3 days. Some are longer some are shorter, but that is the average. Advantage plans normally have a $200 to $400 per day hospital co-pay for the first 3 to 5 days. My experience has been that many times they don't charge you that co-pay at all. But, if you have a 2 or 3 day stay (and they do charge the co-pay) it will be less than $1600. Normally MUCH less - if anything!

Advantage plans may charge you about a $90 ER fee if you are NOT admitted to the hospital. This is to keep folks from going to the ER room each time their nose is running. That is what your doctor is for.

If you understand your plan and have a good agent who puts you on the right one for your situation, you will LOVE it. I have over 100 clients who do. The added benefits of Glasses, Dental, Over-The-Counter, Gym membership and more, have folks using a LOT of benefits even if they never get sick. If you are one who takes a lot of meds, those benefits can be in your plan eliminating the need for a Part D drug plan, and in my experience cover you MUCH better than stand alone Part D plans do!

If you also have Medicaid, the Dual Plan Benefits are hard to beat!

08/26/2024

It's that time of year again and here we go with the attacks on Medicare advantage plans! Here is an example below. Now Some of these Might be true of Advantage IF you have an HMO plan. Something I Never put anyone on unless they demand it.

With Advantage PPO you DO NOT have to get referrals to see a specialist. YOU choose your care and doctor, NOT the plan. If you work with a good advisor they will check to see if your current doctors are in the plan or will accept a PPO. Many will, some won't. But, then again there are a few doctors that won't accept original Medicare.

A good PPO Advantage plan will have low to No Fees on labs.

On original Medicare there is a deductible of about $200 before it pays Anything on doctor visits. A good PPO Advantage plan will be zero to see your doctor. You may have to pay $20 or $30 to see a specialist, but again, with a PPO plan you can choose to see a specialist at any time. Read more above to uncloud the untruths you are hearing.

03/21/2022

If you don't like your current Advantage plan, you have till March 31st to drop it or change to a better plan. I can help. Set an appointment on my FB page link.

11/05/2021

Set up a time to talk. Watch this PM video, one of the great companies we work with:
https://fb.watch/94hohylxTy/

09/20/2021

Oct 15th is almost here. Let me help you find the best Medicare Plan for you and/or Final Expense. There are several No Premim plans in OK, TX and LA. Contact me today

08/05/2021

Get Report Here:
https://m.me/stressfreemedicare?ref=w15667786
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07/29/2021

My article on Steet Insider:

For unbiased reviews of Medicare Options, watch our video before you make Any Medicare decisions at: MedicareWithoutStress.com Make an appointment with Doug @...