Medicare Advantage vs Medicare Supplement Plans

Medicare Advantage vs Medicare Supplement Plans
Which has more insurance?
Call us today 800-847-9680 to help you

00:00 MAPD vs Medigap
04:20 Summary of Benefits
06:25 PPO Misconceptions
08:40 Maximum Out-of-Pocket for Medicare Supplement Plans
09:20 Medicare Supplement Plan G
09:40 Medicare Supplement Plan N
10:39 High Deductible Medicare Supplement
15:30 Medicare Advantage Plans Cons
16:30 IG Report
22:55 AHA Letter to CMS

Every year CMS sets maximum out-of-pocket limits for in-network and out-of-network expenses paid by the consumer. For 2022 the maximum out-of-pocket an insurance company can set for their Medicare Advantage Plan is $7,550 annually for in-network services and $11,300 for out-of-network services.
Insurance companies can choose to have a lower limit. But they cannot have higher out-of-pocket limits.

The maximum out-of-pocket only refers to inpatient and outpatient services. Medical Bills. Not premiums or anything to do with Part D.
Two other details we need to point out before we move on.
1. Note that these out-of-pocket limits only refer to “covered” services. If the service is not covered by the plan, the costs of that service is in addition to any maximum out-of-pocket limits. More on that later.
2. Also, I mentioned at the start I would reveal the most common misunderstanding about Medicare PPO’s. Here it is. You will hear agents tell you that with a Medicare Advantage PPO you “Can” see any doctor or go to any medical facility. If the provider is out-of-network it will simply cost you more and have a higher maximum out-of-pocket. In reality, if you want to see a medical provider that is out-of-network you can ask them if they will accept your insurance. They can and usually do say no.
To put it simply, you can see any out-of-network medical provider and be covered by your Medicare Advantage PPO, but only with the medical provider's approval. An out-of-network provider does not have to accept your insurance.
You cannot simply go into a medical facility and demand to be covered as out-of-network.
I will give you the cliff notes version here using the three most popular plans; a Medicare supplement Plan G, Medicare supplement Plan N and the Medicare supplement Plan G-HD high deductible plan.
With the Medicare supplement Plan G your only expense for inpatient and outpatient services is the annual Medicare Part B deductible. That annual deductible is just over $200. That’s it. That is the maximum annual out-of-pocket limit you are at risk for with a Medicare supplement Plan G, just over $200.
With a Medicare supplement Plan N you will also have the annual Medicare Part B deductible. Plus, you will pay up to a $20 copay whenever you see a doctor for diagnosis or evaluation. There is no copay for chemotherapy or physical therapy or preventive care. Just diagnosis or evaluations. There is a $50 copay for emergency room visits. None of us typically know how often we will see a doctor during a calendar year, but it would be unlikely that we would see a doctor once every month. Thus, it is very reasonable to expect a maximum out-of-pocket exposure with the Plan N to be no more than $500. That would be the Part B deductible plus a monthly office visit to the doctor. A $500 annual limit is more than reasonable.
The high deductible plan is also simple to evaluate. Your maximum annual out-of-pocket limit is equal to the deducible. That deductible increases each year with inflation and is currently approximately $2,490.

#MedicareAdvantagePlans #MedicareSupplementPlans #MedicareAdvantagePlansExplained #MedigapSeminars #MedicareExplained #Medicare2022 #MedicareSupplementPlanG #MedicaresupplementplanN #Medicare #HighDeductibleMedicare

[jessicaclark]

I actually work for Medicare and NONE of us are trained properly before they throw us onto the production floor. I'm two months in and half the time even with scripting, I have no damn idea what I'm doing and beg for help and don't recieve it. I'm looking for other options now. If they would just better educate their workers, so much could be prevented.

[bobjohnson]

Matthew: I have a Medigap Plan N with you and Original Medicare. I am so thankful I followed your advise and made this decision. About 4 months after being enrolled, I was diagnosed with Colorectal Cancer. Treatments included a surgery (3 days in the hospital) and 12 Chemo treatments with my Oncologist over 8 months. I am currently in surveillance, with CT scans and annual Colonoscopies. If I had no insurance, I estimate the cost of treatment at over $250, 000. To date, my out-of-pocket expense has been about $750 plus the cost of premiums. At NO time has anything my doctors have prescribed been evaluated or denied by someone else. And I didn't have to wait on any treatments. I am alive today (and hope to be for years in the future) because of the Medicare coverage I have been given. Thank you, thank you for all your efforts.

[Susan-melk]

Thank you, Matthew. Until I watched this podcast, I had no idea that my Aetna Medicare Premier Advantra PPO was actually provided by a privately owned company. Now it makes sense why I was suddenly being encouraged to change my pharmacy to CVS. My local CVS employees are great, but I was a happy, dedicated Walgreens customer for decades. Of more significance is the frightening information about the proven interference in health care delivery from doctors to patients based on the Inspector General's published three-year study. I realize that you earn a living as an insurance agent, but you are earning an honorable living by spreading truth and educating consumers like me. Thank you.

[debradeininger]

i have been researching Medicare supplement plans versus Advantage plans and discovered so many negatives with Advantage plans. Your video confirms for me that supplemental plans are the way to go. I hope more people will educate themselves and not be suckered in by the has-been celebrities who are touting Advantage plans in non-stop commercials. Thanks for the very informative video.

[camgirl]

Hi Matthew! I am on the cusp (literally, I have 2 weeks left to decide about plans) of getting on Medicare. I have been tortured with this for months now, not understanding any of it totally, even with extensive researching on my own. I do not have anyone with whom I could speak to about a decision, so I am very grateful that you just explained the critical differences between an Advantage plan and a Supplement plan. I can now make an informed decision without ending up as one of the medical system casualties you spoke of! I was actually in tears (of relief) watching this video.
My 24 year old son has already had 2 Cancer surgeries, and I really do not want to add to my family's future medical worries any more than necessary. Thank you SO much again! God Bless people like you.

[joseramonramos]

Thank you Mr Glassen for your very articulate description of the description and benefits of the supplemental plans instead of having one of the PPO or HMO disAdvantage plans. I am a retired surgeon and I thought that dealing with patients on Medicare as well as Insurance Companies, I thought I knew something about Medicare. Now I find I knew nothing about the coverage or lack of it that my patients were going thru when dealing with Medicare. I knew nothing about Supplements to Medicare until I heard about your blog. I like to subscribe to your Page and thank you for your information.

[nonadepaul]

Excellent information. My suggestion, respectfully, when comparing prices, you did not clearly explain that Supplements “Do Not” include prescriptions and will require an additional PD plan. Which is not a big premium but it is additional monthly dollars. Supplemental plans are Superior if the Senior can handle the monthly premiums. I’ve worked with some seniors who live social security “paycheck to paycheck” and while there are government programs that help assist, they have to decide premiums or food/medication.

I love Medicare. I love our country. I love our Seniors. I pray for affordable, excellent medical care plans for ALL.

In the meantime, explaining the Medicare plans as you do, is exemplar!!!! You are my hero 👏👏👏

[mngshastry]

For the first time after being on Medicare and supplement plans, I fully understood these plans. THANKS A MILLION. This helped me a lot. I am going to continue keeping my current plan.

[carolknapik]

With cost of living going up I was thinking of changing to an advantage plan....but no way now after listening to you. Thanks so much

[jscott]

I can say your Prior authorization critique is spot on. Radiation oncology staff member.

[rightpath]

I’ve been up listening to your videos! They were a God send. God bless you sir! Thank you…..

[mbg]

Extremely informative! I was just pushed, over the phone, for an Advantage plan. I”m glad I did more research.

[jimc.]

I am so grateful for your instruction on these videos. Your coverage and detail is so important to those who are entering into the Medicare phase of life. Much appreciation!

[qualityreviewer]

Great! I've had traditional Medicare with supplement N for over ten years and was considering an Advantage plan. . . . until I viewed your video. There are many YouTube sites on Medicare but your's is the only one I've found that provides real detail about what is best and why. Most are just overviews of programs. Your insight saved me from a major mistake, thank you.

[bstupes]

Thank you so much for your great explanation of Supp vs Advantage. Although I’ve watched many very good vids by others, you did the best job at providing the reasons and examples. Thank you!!!!

[daor]

Thank you for this video spelling out in detail the pros and cons of each. I am better educated now that I have watched your video!

[scronx]

Thank you very very much for this info! First time all this stuff has started to feel comprehensible.

[mariannehuston]

Thank you so much for this comparison!!! About 5 yrs ago I had to make a decision which way to go when my husband became disabled and became eligible for S.S. Disability. I researched Medicare extensively and decided to go with Original Medicare with a Plan C because of all his health problems and doctor visits, before it was eventually phased out. When he turned 65, I changed over to Plan G as well as for myself and so glad I did. Thanks sgain

[karonvass]

Thank you SO MUCH for this thorough video! You're the first person who's been able to crystallize for me the difference between Supplemental and Advantage plans and wow is it huge and important! THANK YOU and God bless you.

[heavenbound]

Thank you very much for this information, I sure understand now the difference between Supplement vs Advantage plans; you made it so simple. I need to call you.