Medicare Advantage Plans Explained

Medicare Advantage Plans Explained

Medicare Advantage Plans Explained What is Medicare Advantage?

If you’re researching Medicare and looking for a video to help you understand Medicare Advantage plans and if they are the right choice for you, this is the video you need to see. Stay tuned.
Hi, I’m Matthew Claassen with Medigap Seminars Insurance Agency. We are an independent insurance broker helping people with their Medicare and retirement needs from Hawaii to Virginia and Alaska down to the Florida Keys. We represent our client’s best interest, not that of an insurance company, and our services are free to you the consumer. All you need to do, is ask.

This video is different than other videos you may have seen on Medicare Advantage Plans. I am not going to simply describe a Medicare Advantage Plan. Rather, the intent of this video is to give you the information you need to decide for yourself if a Medicare Advantage plan is right for you.

If you want to limit you’re your financial risk, you can either purchase additional coverage via a Medicare supplement plan or replace your Original Medicare with a Privatized version of Medicare Part A and Part B managed by a private, for profit insurance company. That is a Medicare Advantage Plan.
Now, there are many different types of Medicare Advantage plans. But literally 98% of all Medicare Advantage plans are constructed as either an HMO or a PPO. In this video we will just be discussing HMOs and PPOs and not other types of Medicare Advantage plans.
To be clear, a Medicare Advantage Plan is not a Medicare supplement. It does not supplement your Original Medicare, it replaces it. You still must pay your Medicare Part B monthly premium to Medicare, but you are no longer using Original Medicare. You don’t use your red, white and blue Medicare card. The insurance company you choose for a Medicare Advantage plan will issue you their own insurance card for the plan you enrolled in.

As you may know Original Medicare has a lot of copays and deductibles. Each Medicare Advantage Plan has its own copays and deductibles and by law must be designed as an Actuarial Equivalent to Original Medicare. Actuarial Equivalent. It’s an interesting term. What exactly does it mean? It means that the average person on any Medicare Advantage plan must have roughly the same annual out-of-pocket expense as they would have if they had simply kept their Original Medicare Part A and Part B and NOT added a Medicare supplement.
Unlike a Medicare supplement, every Medicare Advantage plan is different. Each has different coverage, uses different doctors and hospitals and every Medicare Advantage plan can change its benefits and costs each calendar year. But, by law, they must remain an actuarial equivalent to Original Medicare.
However, as I mentioned earlier, Medicare Advantage plans have maximum limit on a policy holder’s annual financial risk, also called your maximum out-of-pocket expense.

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[debrakettler]

Absolutely great YouTube video. My husband and I just spent an hour and a half with an insurance agent yesterday and all he wanted to talk about was an Aetna Medicare solutions plan at zero cost. I told my husband that there is something wrong with the situation ...if it’s too good to be true, it can’t be true. I have worked in skilled nursing home for the past 12 years in admissions and definitely have seen the outcomes to people having a Medicare replacement policy compared to traditional Medicare. My husband turns 65 this year and we have been trying to find the options for him. This video certainly gave me a better way to explain it to him. I knew that insurance agent yesterday was trying to add some money to his pocket. I’m sure he’s good at what he does, he had tons of awards all over his office. But as you stated, doing your homework is the best thing anyone can do. Thanks for your videos I will watch more.

[ut]

wow, what an eye opener about them denying health care. you are the 1st video that mentioned this, thanks so much. i'd give this 2 thumbs up if possible :)

[nancydelathouwer]

I'm sure glad that I listened to you before my husband and I signed up for medicare. Our plan N supplement saved his life when he needed heart surgery. Mayo Clinic accepted it and we are so grateful.
Thank you for the good advice. I had a feeling Advantage plans weren't a good idea, but they sound even worse than I imagined. How awful to have necessary care denied when it is most needed.

[jerrygreene]

What a great explanation of Medicare Advantage plans. I am so tired of the commercials on this topic. They say what I want to hear instead of what I need to hear. Thanks so much for the information.

[denisd.budnik]

Great video on Medicare Advantage Plan... thank you Matthew. I fall into the poverty level, were the Advantage plan is really my only choice... I'm a Medi Medi. I'm a Multiple Sclerosis patient, at the time I was an undiagnosed MS patient and had Scan a HMO Advantage Plan. SCAN continually denied a referral to see a Neurologist, I was walking with a cane at the time. I can no longer walk, and have to use a powerchair. Had Scan allowed me to see a Neurologist, chances are I'd still be walking as I'd have scene treatment for my MS. I switched Advantage plans and was allowed to see a Neurologist who diagnosed me with MS. I'm now on Anthem Blue Cross an HMO Advantage plan. I cannot say enough good things about Anthem. They have never once denied a referral -- unlike SCAN, I call them "SCAM."

[sheilakelly]

Absolutely excellent information. I worked with the Medicare and Medicare Advantage system as an RN for many years. I was aghast at the unscrupulous behavior of some HMOs particularly in the Southern CA area both in their lack of coverage as well as their marketing practices. I am glad that you are out there providing great clarity to these issues. Sheila, Retired RN

[donnakelley]

Thanks for helping me understand this. I have to admit I'm totally overwhelmed by all of the information out there. Your videos are clear and concise and I am grateful for the information you provided here. I need to watch all of your videos. Please keep them coming.

[shelley]

You have saved me hours of research and decision making trying to understand the medicare advantage plans. I have been overwhelmed with the amount of mail and calls and couldn't understand the FREE premiums. I have a friend in a doctors office who told me, stick with medicare and now I'm sure that is what I'm going to do.

[christinerhiner]

Too bad many Seniors will never learn to use YouTube. So informative! Thank you.

[johngarnergarner]

Excellent stuff. I am a medicare agent in North Carolina and this mirrors exactly what I tell my customers. I've been doing this a long time and, as you can imagine, I've run into about everything you can think of. I remember a situation just a couple of years ago. I was working with a gentleman who was turning 65 and instead of buying a supplement from me he went with medicare advantage. He gets cancer ----and I think he was diagnosed at the end of September--- hits his out of pocket limits and then the clock re-sets in January. He calls me and I have to inform him that he can no longer get a supplement. The most difficult client I have is the person who says to me, " I don't get sick, I never get sick." Well, the answer is simple. You don't get sick until you get sick

[Sparkernp]

I'm turning 65 in 2020 and have been exploring my MC options. Thank you for convincing me that I want a supplemental plan, not an advantage plan! Also, I thought your "Breaking Bad" analogy was a good one. Loved that show!

[almitraprice]

I recommend your channel to all my new Medicare eligible patients. Thank you

[barbaram]

Wow, I had already decided against an Advantage plan because of one of your prior videos I watched but this video reinforces that decision even more. I'll be sharing your videos and information.

[chrissmith]

Thank you for a very clear video on the Medicare Advantage plans. I will stick with my supplementals now that I understand this Medicare situation better.

[shandraloggins]

Fascinating, thank you for speaking so clearly to us.

[richardbrunelle]

Great videos! There is so much detail missing in the promotional material we are given and expected to make an "informed" decision. Thank you for making these details available.

[reedsawyer]

Matthew, thank you for these videos. I am studying for my insurance certification, and these videos are invaluable. Great job!

[debrafollmer]

Definitely worth the time to watch this video! With the benefit my husband has had with his supplemental insurance, watching this video scared me right out of the idea of considering a Medicare advantage policy! I’ve seen the “advantage” of choosing a supplemental insurance policy! Thank you for making it perfectly clear!

[crochetnut]

While my state is under a “Stay at Home” order due to COVID-19, I have had plenty of time to do my homework and devour any information I can find between original Medicare and Medicare advantage plans. My cousin found one of your videos and sent it to me. I have watched three or four in a row and I am continuing to watch more. Thank you for speaking so clearly and making everything understandable. At this point I think I know which Choice to make. Although it is pleasant not to be interrupted by commercials while watching your YouTube videos, you might consider monetization because you definitely deserve it!

[davidelliott]

I've been watching other videos on this subject, I have found things none of the others have even mentioned. Thank you!