there are two ways that you can make a permanent mistake when you're new to Medicare and the first is by choosing the wrong option out of the choices you have and the second way is by choosing the right option but the wrong plan within that option and we're going to go over all of that next Medicare explained Medicare Made Easy Medicare made clear no matter how we word it in the title of all these videos that you're watching understanding Medicare is not always easy I know I have helped over ten thousand people with their Medicare in just the past five years by the end of this video you will understand Medicare and be confident in the choices that you must make that's my promise for most people this video will answer almost all of your Medicare questions enough so that you'll know with certainty which direction you're going to go next with your Medicare research you'll have all the information you need to know to make a decision to make an informed decision about both Medicare Advantage plans and Medicare supplement plans we're going to start by helping you understand your Medicare part A and Part B and then we're going to review the three options from which you must choose one you must choose one of these three options and this will be the most important decision that you have to make with your Medicare it will set you on a course that will impact the quality of health care that you receive over your lifetime and can be potentially irreversible in this discussion I'm going to compare and contrast Medicare Advantage plans versus Medicare supplement plans in a way likely you've not seen before most importantly I'll show you how to avoid making a permanent mistake with your Medicare if you stay until the end I have some great bonus material that I know you're going to love to see now I have a clickable table of contents in the video descriptions below if you wish to navigate to a specific topic within this video just click on that subject in the table of contents below now I'm also going to be showing the table of contents here so that if you are watching your YouTube on TV you can navigate as well if we haven't met yet I'm Matthew Claussen CEO of medigapseminars.org my company is one of the Premier Medicare insurance brokers in the United States we're an independent insurance broker specializing in your Medicare and retirement needs and our services are free to you the consumer if you like these videos you're not alone my medicare explained videos are among YouTube's most popular educational videos on Medicare check out our five star reviews and call us you'll be glad you did to keep this video brief I will leave out the details of how and when to enroll in Medicare I have those details in a separate video cleverly tied it and cleverly titled how to sign up for Medicare and when and the link above my left shoulder and in the video summary below you should watch that video after this one it also covers Medicare enrollment periods and when you may stay with your employer coverage if you so choose signing up for Medicare is the easy part you sign up for Medicare through the Social Security office either online or in person when you do you're signing up to receive your Medicare part A and your Medicare Part B once you sign up for Medicare part A and B you must make one of three choices with your Medicare and that's the most important part of this video but before I go over those choices let's take a close look at Medicare part A and Medicare Part B Medicare part A is that portion of your health insurance that covers you when you're an inpatient as soon as you are registered as an inpatient in a hospital a nursing facility or hospice Medicare part A takes over so think of Medicare part A as insurance for inpatient Services if you've not been an inpatient in a hospital before you may not know that everything Medicare related that's involved with your stay is covered under part A and this includes any medications you can't bring into the hospital medications that you're taking at home the hospital will provide them for you so that they control what medications you're taking it also covers durable equipment like a walker or crutchers and or crutches it also covers durable equipment like a walker or crutches and maybe even one of those funny socks that they give you with the little grip stuff on the bottom if you take this home with you anyway everything that is provided for you at the hospital while you're an inpatient is covered under Medicare part A if you're going in for surgery as an inpatient and your doctor has ordered you know a necessary or required pre-op test those two are covered under part a if you've been an inpatient for at least three midnights and are being discharged to a Skilled Nursing Facility Medicare part A coverage will include most or all of the skilled nursing care part A also covers hospice care for most of us we've paid for our Medicare part A with a payroll tax so we've paid during our working years that's the tax out of your paycheck it's marked Medicare it comes out of course every paycheck that paid for your Medicare part A if you or your spouse have paid that tax for at least 10 years then your Medicare part A has no additional cost for you your part A is paid for if neither you nor your spouse paid that tax for at least 10 years then you can still get Medicare part A but it will cost you a monthly premium for most of us Medicare part A is already paid for so what about Medicare Part B Medicare Part B is your outpatient and Physician Services insurance if you're not an inpatient you must be an outpatient and that's covered under your Medicare Part B Medicare Part B is the it's the insurance that you use when you see a doctor or when you have lab tests or Wellness Services it also covers outpatient durable equipment like insulin pumps Wheelchairs and so on Medicare Part B is that part of your health care insurance that people do use most often it's whenever you see a doctor often outside of a hospital but even many of the hospital services and the surgeries are now done on an outpatient basis which would then mean they're covered under Medicare Part B so Medicare Part B has a monthly premium and everyone must pay for Medicare Part B everyone's 65 and older and needs Medicare Part B unless you're actively employed and continuing with employer health insurance coverage and your employer has 20 or more employees absent that you'll need to get Medicare Part B and you must pay for it as an aside if you're considering to staying with your employer coverage please don't get your Medicare once you start your Medicare you set off some clocks that are really important to your guarantee issue of certain things so don't start Medicare part A and B until Medicare is going to be your primary insurance so how much you pay for your Medicare Part B depends on your income specifically your modified adjusted gross income from your tax returns as of two years ago in 2023 the base monthly premium for Medicare Part B is 164.96 a month people with higher individual incomes ninety seven thousand dollars or more or twice that if you're filing your taxes jointly will pay a higher monthly premium so that higher monthly premium is called your income related monthly adjustment amount or Irma for short if you are subject to Irma the premiums for both Medicare Part B and Part D your prescription drug coverage are increased now I have a video and an article that details Irma how you can appeal and how you can avoid the Irma surcharge and that too is linked you know Below in the video description and above in my left shoulder or use the search tool on my website if you go to medigapseminars.org and type in the irmaa that'll bring you to the article in the video that I've produced for you so to recap Medicare part A is your inpatient coverage it's going to cover you if you're admitted as an inpatient on a hospital or a nursing facility or a hospice Medicare Part B is outpatient services and Physician Services that's the part of Medicare that you will expect to use the most often and it covers you when you see your doctor it covers you for your lab tests and all of the other outpatient services together Medicare part A and Medicare Part B are called original Medicare or traditional Medicare that's an important term that you should remember we will refer to it several times during this video original Medicare is Medicare part A and Part B combined it's the foundation of Medicare so next is one of the most important pieces of information in this entire video If you get nothing else out of this video please remember the two greatest benefits of original Medicare that I'll cover next after that I'm going to talk about your three options from which you must choose one and how to avoid making a permanent mistake now I've seen my competitors attempt to compare Medicare Advantage to Medicare supplement by detailing benefits and costs and hypothetical situation it's enough to make your eyes gloss over in my humble opinion they're missing the big picture so here's how I look at it and the many thousands of people that we've helped with our Medicare I started seeing years ago a theme develop so over and over when people voice why they chose original Medicare as their primary coverage it was consistently because of these two benefits the two greatest benefits of having original Medicare as your primary health care are one that you can see any doctor in the United States or its territories as long as they accept original Medicare now that's over 98 percent of all doctors you have no network limitations you don't need to seek approval to seek out a specialist or a second opinion you have the freedom to see the medical professionals that you want to see if there's a doctor halfway around the country that can save your life you can see them and Medicare will pay their portions of the bill second is that no insurance company can interfere with your care all other health insurance options allow the insurance company to demand that your doctor seek their prior approval before any treatment can be recommended the intent of Medicare is to cover everything that's medically necessary it's a government program not for profit and they lean on your doctor to determine medical necessity as a result your health care decisions are made by you and your doctor not an insurance company that's important you have the freedom of choice over the doctor that you choose and control over your health care remember this as you review your options now let's look at your options once you sign up for Medicare Part B you must choose between one of three options your four your first choice would be to do nothing just keep your original Medicare part A and B and hopefully add a prescription drug coverage through part D unfortunately Medicare was never intended to be a standalone Health Care policy with just Medicare Parts A and B alone you're you not only must pay the deductibles and a co-insurance associated with Medicare but you also have no maximum out-of-pocket limit on your Financial Risk you have an unlimited Financial Risk in the worst case scenario so one of the purposes of insurance is to protect you from personal financial catastrophe having just original Medicare doesn't do that still it's a choice some people make and it's a choice that you can make if you wish now to see the deductibles and co-pays and coinsurance of Medicare you can click on the link above my left shoulder in the description below and you can also find that information again on my website medigapseminars.org under the resources tab along with a lot of other stuff so understanding these deductibles and coinsurance as Etc is important if you're going with just original Medicare but both of your next two options render those details moot so you don't have to memorize them see First Option staying with just original Medicare has no maximum out of pocket your other two options do if you wish to have health insurance with a maximum out of pocket limit to protect your finances there are only two ways that you can do this with your Medicare and those two are your other two options either a Medicare Advantage plan or Medicare supplement so your second option is to trade in your original Medicare for a Medicare Advantage plan Medicare Advantage plans are also referred to as Medicare Part C the nomenclature is a bit misleading and some organizations are trying to work through Congress to prevent Medicare Advantage plans from using the term Medicare because part C replaces Medicare and they're regulated and regulated means that Medicare has rules the advantage plan must follow and as long as they stay within the guidelines they can roam free Medicare Advantage plans were originally called Medicare replacement policies because that is what they do they replace your Medicare Parts A and B advantage plans are designed and operated by a private for-profit insurance companies but again are regulated by Medicare so many people assume that if you have an advantage plan and it's replaced your Medicare you no longer must pay your Medicare Part B premium that's not true that money goes you pay that premium and it ends up at the Medicare Advantage insurance company so if you have an advantage plan you must still pay your Medicare Part B monthly premium and any Irma surcharge due to your income you also still have deductibles and co-pays and coinsurance but they're defined each year by the insurance company not Medicare one of the benefits of a Medicare Advantage plan is that they provide a maximum out-of-pocket limit on your health care bills for 2023 the maximum limit that's allowed for an advantage plan is eight thousand three hundred dollars for in-network services and twelve thousand four hundred and fifty dollars if you use out of network Services an advantage plan may choose to have a lower limit and many do but they cannot have a higher limit the maximum limit resets to zero every January one so if you find one December you've gotten halfway there well you have to start all over again in January 1.
keep in mind the maximum limit is only for Approved Services your doctor is required to seek prior authorization from the insurance company before treating you and expecting the insurance company to pay except of course for emergency services or minor procedures so I was speaking with a prospective client a few weeks back who has a Medicare Advantage PPO and they're totally shocked that they had over thirty thousand dollars in medical bills that they had to pay and they didn't understand how that could be it was more than three times their supposed maximum out-of-pocket limit so how did that happen they were battling cancer and they went ahead with treatment the insurance company had not authorized it saved their life but it made it a hundred percent the beneficiary's financial obligation with no maximum out of pocket you will pay a hundred percent for any treatment not approved by the insurance company and there's no maximum out-of-pocket limit for treatment not approved by the insurance company each Medicare Advantage plan is different has different benefits different costs and a different network and the benefits and costs of each plan change every year that can be overwhelming but wait until you hear how many different Medicare Advantage plans there are in this country wait did you press the like button yet below and maybe subscribe according to the Kaiser Family Foundation the majority of Medicare Advantage plans are either an HMO or a PPO approximately 46 percent of the Medicare Advantage plan enrollees choose a PPO and 16 percent choose an HMO so 62 percent choose either an HMO or a PPO among the advantage plans that are available PPO stands for a preferred provider Network it's a network of medical providers that are local but usually cover a county or multiple counties the two features that make a PPO stand out are that you don't need a primary care physician to direct your coverage you don't need a referral from a primary care physician in order to see a specialist in addition you typically have the ability to ask an out-of-network provider if they will accept your insurance if accepted it will be on a separate out of network fee schedule so let's look at HMO HMO stands for health maintenance organization and HMO typically they they typically have a smaller Network than a PPO are there even more local in coverage and with most hmos you must get permission from your primary care physician in order to see any other doctor without permission your specialist visit or other doctor visit is not covered by the HMO also hmos typically do not have an out of network option you're not insured if you see a provider who's not networked now lately there have been more hybrid hmos coming up that have been some of those features a bit and are better than this the standard HMO but those are still few and far between for both hmos and ppos when you're outside of their service area the only health insurance coverage you have is emergency and Urgent Care coverage that's it you don't have standard coverage outside of that area also according to the Kaiser Family Foundation the average person on Medicare can choose from 43 different Medicare Advantage plans the the parts of the country with the least availability may only have one plan available the most have over 80 on average it's 43.
Now get this there are 3998 Medicare Advantage plans Nationwide and that sounds to me like a saturated Market especially when you consider that only 46 percent of Physicians that accept Medicare accept any Medicare Advantage plan now metropolitan areas the number of doctors accepting Medicare Advantage plans is typically pretty robust but less so in rural areas but think about this even if there are a hundred doctors within driving distance that accept Medicare on average only 46 of them would accept any advantage plan and even a smaller number who would accept your advantage plan now the most attractive feature of an advantage plan is that many have no or very low monthly premium you know zero premium Medicare Advantage plans are rather common it's it's not entirely accurate to say no premium because you still must pay your Medicare Part B but again according to Kaiser 70 percent of the people in an advantage plan pay no monthly premium in addition to that Part B premium the average Medicare Advantage plan premium across the country is only eighteen dollars a month so they're not all zero premium so how does the insurance company make money when you have no premium well for one the U.S government subsidizes them according to CMS the center for Medicare Medicaid services on average the government pays the advantage plan approximately twelve thousand dollars a year per person that's a thousand dollars per month for every person they have on an Advantage plan on average if the person has a and active health history they may actually get up to eighteen hundred dollars a month in addition the insurance company gets to control your care and do so with the intent of controlling their expenses to think about that for a moment so this brings us to what I consider the biggest drawback of having a Medicare Advantage plan the drawback is that you lose the two most important benefits of original Medicare with a Medicare Advantage plan you'll need to stay within their insurance plan Network when seeing a medical provider you must make certain they accept your specific insurance and just because a physician accepts Medicare Advantage plans does not mean that they accept your advantage plan so you can no longer see any doctor that accepts Medicare because you replaced your Medicare with the advantage plan also with an advantage plan the insurance company has the right to delay or deny any procedure your doctor recommends the insurance company controls your health care decisions I have linked below and on my website two separate reports from studies done by the inspector generals for Health and Human Services these two studies were done by two separate inspector generals and about four years apart 2018 and 2022.
They both point to the common problem of denial of service decisions made by the advantage plan insurance companies the inspector generals found as mentioned earlier that insurance companies control your health care to control their expenses over the years I've seen and heard more stories of denial of care than I can count in each case the Medicare beneficiary is forced to fight for the health care that they should have had without question and that's not what we should expect from our health insurance next there's a lot of confusion about certain benefits of a Medicare Advantage plan so much so that even many insurance agents misunderstand so next are a few bullet points on the benefits of any advantage plan and once you've heard these bullet points I have for you I believe that you'll know more about the nuances of Medicare Advantage plans than most of the insurance agents who are trying to sell them so let's start with my favorite you'll hear that Advantage Plans have all the benefits of Medicare Parts A and B that's not true or it's not entirely accurate they have benefits from all the same categories as Medicare part A and B but not the same benefits for example if you're on original Medicare and if you need a physical therapy you get the physical therapy sessions that your doctor recommends with an advantage plan the insurance company will tell you how many physical therapy sessions they allow it's often significantly less same benefit category Physical Therapy not the same benefits and that's true amongst all the the benefit categories not just physical therapy you'll also hear that with a Medicare Advantage plan PPO you can see any doctor that accepts original Medicare even if they're not in network and again that's not accurate a more accurate statement is that you can ask any doctor that accepts original Medicare if they will accept your advantage plan Insurance the rates and terms and conditions doctors can and usually do say no I say almost always they're under no obligation to accept your insurance and if you get for example cancer and you want to go see the top Specialists for your particular type of cancer with an advantage plan all you can do is ask if they will accept your insurance if they don't have a previous relationship with you they will typically say no the Mayo Clinic in Florida and I believe in Arizona for example send out a letter every year making it clear that they will not accept any Medicare Advantage plan Insurance all Advantage plans are out of network and they don't want any part of it next bullet point when evaluating a Medicare Advantage plan look at the summary of benefits now the first page coverage should list your annual maximum out-of-pocket liability for 2023 it can be no more than eight thousand three hundred dollars for in-network care it can be much less but not more then look at near the last page of the health coverage just before the section on your part D prescription drug coverage and that is where you will find your benefits if diagnosed with cancer and every Advantage plan I've seen you're liable for 20 percent of the cost to treat your cancer up to the maximum out of pocket understand your annual maximum out of pocket resets each year on January 1.
If you get sick near the end of the year and your treatment persists into the next year you may pay that maximum twice next bullet point Part B drugs versus Part D drugs on a Medicare Advantage plan so if your doctor writes a prescription and you receive the drug from a pharmacy and you self-administer it for example swallow a pill that's typically covered under Medicare Part D prescription drug plans if your advantage plan has a Part D plan bundled with it then what you spend on Part D drugs does not count towards your annual maximum out-of-pocket limit that's very important it's entirely separate if you have a specialty Cancer drugs even pills most any drug or infusion where it's administered by a professional usually in a medical setting then that drug is likely covered under Medicare Part B outpatient services when you have original Medicare with a Medicare Advantage plan you will pay 20 percent of your we call them Part B drugs because that's where they belong you're going to pay 20 percent of your part B drugs up to your maximum annual out-of-pocket limit last point the benefits and cost of your Medicare Advantage plan change every calendar year sometimes a little sometimes a lot it's your responsibility to shop your plan every year or you can get stuck with the costs and benefit changes that are not to your liking and that's what the annual enrollment period is for it's from October 15 through December 7th and during that time you can see next year's plans and choose the one that best fits your needs if you have an advantage plan you must commit to reshopping your insurance every year so when do you get a Medicare Advantage plan well if you're going to choose a Medicare Advantage plan you must do so either during your initial enrollment period or when you first enroll in Medicare Part B during an annual enrollment period your initial enrollment period is that seven month window starting three months before the month you turn 65.
if you're beyond your initial enrollment period and have not yet signed up for Part B then you can get a special enrollment period when your part B starts if you had them if you had employer coverage that was creditable so those details are in the how and when to sign up for Medicare video they're never any medical questions or pre-existing conditions for an advantage plan but you must have your Medicare Parts A and B to get an advantage plan so let's summarize then we're going to look at Choice number three and how you can avoid making a permanent mistake your first option is to do nothing just use your original Medicare and add a Part D plan for your prescriptions you can see any doctor in the U.S or its territories that accepts original Medicare and your health care is directed by you and your doctor unfortunately original Medicare has no maximum out of pocket which means that you have potentially unlimited Financial Risk your second option is to trade in your original Medicare for a privatized replacement called Medicare Advantage plans Advantage Plans offer a maximum out-of-pocket limit if you play by the insurance company's rules however you must give up the best benefits of original Medicare you're limited to a network of medical providers and the insurance company has a final say in what is or is not covered and by the way if it seems like I'm bashing Medicare Advantage plans I am not there are people with whom the advantage plan is the right choice but what I am doing however is making sure that you know what you're getting into it is not the same as original Medicare with just a few extra bells and whistles thrown in and this is your health care I want you to make an informed decision so after the third option that I'm going to cover next I'll cover who typically chooses a Medicare Advantage plan and if you're unsure what you should do first because making the wrong choice first can lead to a permanent mistake there are two ways that you can make a permanent mistake when you're new to Medicare and the first is by choosing the wrong option out of the choices you have and the second way is by choosing the right option but the wrong plan within that option and we're going to go over all of that next before I do I would like to ask a brief favor please like this video comment and share it on social media doing so helps me and it helps others that are just like you who are looking for this information so please like share comment it will help me and it will help others thank you in advance so what is your third choice I mean if you haven't guessed already your third choice is to keep your original Medicare keep your Medicare part A and B with all the benefits of seeing any doctor that accepts Medicare and keeping your health care decisions between you and your doctor and then build on it add a Medicare Supplement Plan that pays the co-pays co-insurance the deductibles that Medicare leaves is your responsibility a supplement increases your insurance coverage and brings your maximum annual out-of-pocket Financial Risk for Medicare bills down to as low as just a few hundred dollars so what exactly is a Medicare Supplement Plan a Medicare Supplement Plan is private insurance designed to work as secondary insurance to your Medicare medicare's primary that means Medicare sets the rules for the supplement to follow the supplement is secondary insurance it's like a dummy insurance policy it has no say in your coverage when Medicare pays its portion of the bill it instructs the supplement company on what to pay and to whom all of this is done electronically through most of the major insurance companies which is why about according to the major insurance companies 85 percent of the bills sent to the supplement are paid within 48 hours without human intervention to be clear a supplement does not increase the types of procedures covered by Medicare it pays the deductibles and co-pays that Medicare does not pay it pays the financial gaps in Medicare so that you have very limited exposure to medical bills that is why they're also called Medigap plans so how many supplement plans are there well I'll give you a hint there are not 3998 plans like in Advantage Plans well actually there are 10 Medicare supplement plans two of the plans have high deductible options each plant is referred to by a letter for example the two most popular plans available today are a plan at G as in golf at a plan n as in November I've linked a table of Medicare Supplement Plan benefits and should be here above my left shoulder and it's of course below now this is important Medicare supplement benefits are standardized by the government not just regulated now that's important there are they are defined and written into Social Security Law and that means the benefits are identical from one insurance company to another for example the benefits of all plan G's are the same all plan ends are the same and so on and the benefits never change once you have a Supplement Plan no one can take your plan away from you or change the benefits not even an act of Congress they can change it for the people starting Medicare in the future but not you if Medicare covers a procedure your supplement will pay their portion of the bill no questions asked and usually automatically often with no human intervention for example if you have just original Medicare and you end up an inpatient in the hospital so you have have no supplement then you must pay the deductible before Medicare pays a benefit in 2023 that deductible is a per benefit period deductible of a thousand six hundred dollars your benefit period resets when you're out of the hospital for 60 days if you're in the hospital for an extended period you'll start paying a daily coinsurance as of day 61.
with a Medicare Supplement Plan any Supplement Plan except the high deductible versions you'll have a hundred percent inpatient coverage you can spend a year in the hospital and between Medicare and your supplement you will not pay a dime for a second example consider your outpatient coverage with original Medicare you must pay 20 percent of your outpatient medical bills with any of the most popular supplement plans the supplement will pay that twenty percent for you now I'm not going to go into the details of each Supplement Plan in this video I have a benefit table linked above my left shoulder and below I recommend you see my Medicare supplement plans explain video or my comparison between Plan G and plan n or any of my other videos specifically on Medicare supplement plans for more details but there are a few bullet points about supplement plans that you should learn from this video first the only difference in plans from one insurance company to the other is what you pay for your insurance today and what you will pay in the years ahead same benefits different prices next the cheapest plan today is not necessarily the lowest cost over your lifetime some insurance companies know that you get comfortable with your supplement very quickly they offer it at a very low price with the intent to raise prices later so we try to work with the companies that are most price stable over your lifetime the biggest drawback of having a Medicare supplement well Medicare supplement Plans cost money they all have monthly premiums the average Medicare supplement premium in the United States is around 125 dollars a month but that premium varies greatly by where you live your age your gender and more importantly the insurance company that you choose to work with there are some states where the premiums are under a hundred dollars a month there are other states where they're 300 a month well you pay more in premiums for a supplement versus an advantage plan you pay much less for your medical care and have significantly lower almost inconsequential maximum out of pocket so if you want specifics on prices and plans for you please use the quote request form again linked above and below and you know use this and let us know what your situation is and we will get back to you typically first by email with what we think are your best options for your area so this is very important it's about the Medicare Supplement Plan initial enrollment period there's an airplane that's been flying around above there so I don't know if you can hear that on the mic or not but it's been persistent for a while so we have to move on so when can you get a Medicare supplement first understand that you have a hundred and eighty days a six-month window to get a Medicare supplement when you are new to Medicare Part B your Medicare supplement initial enrollment period is the first six months of being on Medicare Part B it can be your Medicare initial enrollment period or a special enrollment period of the general enrollment period it doesn't matter the first six months on Part B is your Medicare supplement initial enrollment period and most insurance companies don't use six calendar months they use 180 calendar days after that 180 day window you can still apply for a supplement any day of the year every day of the year you can switch Supplement Plan fans or insurance companies all you wish there is no annual enrollment window that you're stuck Within however you will have to medically qualify for the new Supplement Plan if the insurance company is uncomfortable with your medical history they can say no and deny your application now some states have special rules on supplement enrollment that benefit the consumer that provides you with a window of time where you can do some changes without medical underwriting so check with us and we'll let you know what your state rules are but this is how and why you can make a permanent mistake when starting Medicare if you're unsure of Which choice that you want to make I suggest that you start with a supplement plan because you can always move to a Medicare Advantage Plan and there's never medical underwriting they must accept you without asking about your health but if you start with a Medicare Advantage plan and then you get sick or injured you may not qualify for a Medicare supplement you can be stuck within the Medicare supplement plans choose today the insurance that you will want to have when you are sick or injured regardless of your health today don't assume that you can get lower coverage today because you're healthy and upgrade later you can't and boy do we see people do that a lot well I got this low coverage because I'm healthy now I'm not healthy and I want to change and we say well you can't get today the insurance that you're going to want to have when you are sick or injured from every year during annual enrollment we feel literally what seems like hundreds of calls from people wanting to improve their coverage usually they want to move to a supplement from an advantage plan because of the expense of their care or their denial of denial of coverage or the the network changes or any Myriad of reasons that they're unhappy with their health care but they can't because of their health so you know there's a saying in the industry Medicare Advantage plans are great until you need them once you need them and you realize some of the drawbacks of the plan it can be too late to change to a supplement with most people that have called us in that case they they've lost that choice permanently so just yesterday as an example I talked with a woman who was on an Advantage plan she actually sent me an email and says well I'm 75 now and it's time for me to get serious about my health insurance and I want to change to a supplement well that train left years ago when she developed rheumatoid arthritis the time to get serious about your insurance is the day you start your Medicare you know you can do a lot to avoid the mistakes that we see almost every day simply by choosing a Medicare Supplement Plan first and then if you decide you can't afford a supplement plan we'll help you switch to a Medicare Advantage plan during the next annual enrollment and when you do choose a plan choose the plan that you're going to want to have when you are sick or injured now I've got a couple bonus things that I wanted to add to this that you're not going to find in any of my other videos or any of the videos actually that will also help you and first off understand people who are right for Medicare Advantage plan are typically people who are shopping by budget they're shopping you know where budget is their primary filter for what they can or cannot get and oftentimes the Medicare Advantage plan is great coverage for them plus we have added and they do have a video on this a Medicare Advocate who is a professional experienced in Medicare billing and in helping people you know appeals with their advantage plans Etc so we can't act as an attorney for you but if you're our client and you're in an advantage plan we've got your back if something goes wrong we can walk you through what to do so you're not fight that battle alone a great way to describe the difference in consumer experience between an advantage plan and a supplement is simply this with a Medicare Advantage plan people are more likely to complain or have displeasure about the benefits than their premium I've listened to a lot of people then about Medicare Advantage plans over the years and I've I've never once heard an advantage plan client complain about their premiums now don't get me wrong many people have a great experience with their advantage plan it's just that a lot of people don't and we contrast that to a Supplement Plan with a Medicare Supplement Plan I've never heard a person complain about their benefits not once now there are many who complain about the premiums but never about the benefits so think about this as you make your decision another video You may wish to see is the Sister video to this one is called Medicare explained that the secrets of who and why in that video I review the demographics of who typically chooses a Medicare Advantage plan and who typically chooses a Supplement Plan as well as who tends to go with just original Medicare not only is that video very interesting it's often useful to see what decisions that your peers make and why and that is what the Medicare explained secrets of who and why video explores so next important point that will help you with your decision is by answering the questions about how these plans adjust for inflation it's simple but important because inflation is very likely to be with us for years to come a Medicare Advantage plan reduces benefits over time to adjust for inflation they have higher deductibles a higher maximum out of pocket as I produce this video in late 2022 we're looking at the 2023 Medicare Advantage plans maximum out of pocket and and and I've noticed that the out-of-pocket maximum for Advantage plants has increased by 24 in just the last three years a Medicare Supplement Plan adjusts for inflation by increasing premiums benefits remain the same but the premiums will increase over time and that can be of concern for those who are barely affording the supplement as they begin to retire because prices will go up and they can compound for another 2 20-25 years of your life so this has been a long video but we haven't touched on Part D I have a separate website and video that details what you need to know about Part D that website even helps you shop for a plan so that you can see exactly what your prescriptions will cost the website is called the partdshopper.com I encourage you to visit that site to learn about Part D and research your options you can find that site by typing in part D shopper.com into your url or if you go to medigapseminars.org right in the middle of the upper menu there is Part D plans you click on that and it'll take you to the part D shopper.com and at partdshopper.com you can not only research Part D and learn about Part D but you can put in your own prescriptions and shop for a Part D plan and see exactly what you know your prescriptions will cost you for the year ahead please use the contact us or quote request form if you'd like us to provide details on plans available in your area our services are free to the consumer it's the insurance company that pays us we would when we help you with your application and of course we work with all Medicare supplement plans and all major advantage plans and most of all we represent your best interest I'm Matthew Claussen from medigapseminars.org thank you for watching
