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Should I Choose A Medicare Advantage or Medicare Supplement?

November 8, 2016 | By | No Comments

In today’s episode, Peggy asks, “Should I Choose A Medicare Advantage or Medicare Supplement Plan? Watch to find out the answer…

Here’s the rest of the transcription continued from YouTube:

Tripp: With a Medicare Advantage, if it is an HMO or PPO, they’re what we call “Network providers”. And if your doctor or specialist, maybe it’s and oncologist or a gynecologist, whatever it may be is not in that network, maybe you can go to somebody outside of the network, but that is not your doctor.  You are not too familiar with that doctor, he has known you twenty, thirty, forty years, what have you.

So it can be very restrictive on those HMO and PPO plans which are technically Medicare Advantage plans. So,very restrictive.

Medicare Supplement as long as the physician or the hospital accepts original Medicare, which they all do, you can go to any of them in the country any of them it doesn’t matter. No restrictions.

Wendy: And that is important and especially to ladies relationship is important to us and if you have a doctor that you love it really is important that you are able to stay with them. So something to definitely think about.

Co- payments to providers, you mentioned that, Medicare Advantage yes Medicare Supplement no.

Tripp: Yeah, real quick on that, with a Medicare Advantage plan maybe your  primary Doctor co-pays ten or twenty dollars every time you go, so when you leave you are paying that to the Office Manager.

With a Medicare Supplement, there is a flat premium to have that product. And so, when you walk out of the hospital or the doctor it is already taken care of.

I can’t tell you how many clients I have, ladies specifically, that would say “I am so glad I don’t have co-pays anymore. I don’t like them going ‘Hey do you have a co-pay?’”. No I have got a Medicare Supplement, it is taken care of.

Wendy: It is just not feeling of what ladies want, to be taken care of.

Tripp: Peace of mind, yeah.

Wendy: So that is what the supplement provides for you.

The next one, up to sixty seven hundred dollars yearly in out of pocket cost.  That is huge.

Tripp: It is huge. Well here is a great example. Let’s say Medicare Supplement, maybe that level premium for example is say a hundred and fifty dollars a month, so that is eighteen hundred dollars a year that you are paying to have a that supplement plan.

Wendy: And it varies based on location and age…

Tripp: Yeah, that’s right, zip code, age, tobacco, sex those are all the variables there. But with the Medicare Advantage plan especially during the annual enrollment period the warm when you are getting crushed with commercials about zero premiums, free HMO and all those things, it sounds like a zero premium, and it is a zero premium.

What happens is you might have a maximum out of pocket of sixty seven hundred.  So you tell me if you paid eighteen hundred dollars flat, guaranteed on the Medicare Supplement, but you pay sixty seven hundred dollars on all your maximum out of pocket for a Medicare Advantage plan, who is winning?

I mean you are paying what is that, almost another five thousand dollars out of pocket and less peace of mind because you have got those network restrictions.

I am not a fan of the Advantage plans; in fact, as you know, I don’t even write those anymore I am focused on the Supplements.

Wendy: Well they are a huge gamble; from what I’m hearing from you, what you just said it just now it is whether or not you like risky business, because it is.

Tripp: And ninety percent of my clients are on fixed incomes, they don’t like surprises; most mature women do not want a surprise a, they want a guarantee. I know what I know, it is a set thing it is being deducted automatically, I can go to any doctor in the United States, any specialist, any hospital as long as I just pay my monthly premium, it is level and it is guaranteed renewal. Nobody can ever take that from me.

Wendy: And you live busy lives, so it is one less thing on your plate that you have to worry about, which is always a good thing.

So we touched on a lot of these, but just feel free to interject as I run through. Health Plan decides which tests and procedures are approved for you: Medicare Advantage yes, Medicare Supplement no. Is that true?

Tripp: It is true and again with a Supplement it gives you more peace of mind, more flexibility no limitations, no networks.

The Advantage plans, depending on the Doctor or the Specialist or the hospital, they dictate what is approved and what is not approved within the particular Medicare Advantage plan.

So again, a lot of times when you are dealing with an issue or a health illness, your primary objective is just to get better or get well and all of a sudden you’re a thrown into this “Oh my god, I didn’t know that wasn’t covered! I thought that was covered! I thought they told me that was covered!”

And it is confusing and frustrating, it just kind of takes you away from the goal of getting healthier.

Wendy: Right and when you were talking about that it just jogged my memory. This video right here, this is a screenshot of the video and I will link it beneath this video.; it is to an ABC News video and it is all about the high risk of Medicare Advantage plans and it goes pacifically into this lady’s particular situation where she just had a rough time getting things approved and procedures and what she needed she wasn’t able to get and it was petty eye-opening.  So definitely watch that, it is about seven minutes; it will kind of sum up what we were talking about.

Next one, can you wrap plan be cancelled?

I was just going to say real quick, I was out at a family dinner just a few weeks ago and my aunt was asking me about Tripp, obviously she knew what he did and she was like “My Advantage plan is just cancelled so I don’t know why or what is happening, We are going to have to figure something out.”

Now I didn’t even realize that that was a possibility until she said that. That is not cool.

Tripp: There is a lot of the carriers that are pulling out of the Medicare Advantage world. Financially there is reasons that they think this didn’t worth us being in, so we are going to retract that plan.

Well if you’re one of the “lucky” individuals on that plan, that is not good, because then you have got caught to scramble and figure out you are going to do.

Having said that, what you can do if your plan is leaving your area or your zip code or your county, then that gives you a special enrollment period where we can help you and put you on a safe predictable Medicare Supplement.

But that is one of the very few times you can do that if your plan leaves. But yes they are very, especially at this time in our economy and our economic climate, what’s going on with the election and all this stuff, people are pulling out of the plan pretty often now. It is scary.

Wendy: Yeah definitely. Alright, just a few more; ability to travel the country and use any Doctor or hospital: Medicare Advantage, no, Medicare Supplement, yes.

Tripp: Right, we touched on that. Yes a lot of my clients have been blessed and fortunate enough financially where they do get to travel and a lot of snowboards go down to Florida, a lot of people go to Arizona. A lot of people like to go to the opposite of a snowboard, they like to go up to Maine and enjoy lobster and all that kind of stuff.

Guess what? If they have an issue, they can get coverage anywhere, it doesn’t matter the hospital or the Doctor. If they accept original Medicare that means Medicare Supplement will be accepted. It doesn’t matter if it is a plan G, a plan F, a B or an N, any of those Medicare plans are going to be accepted nationwide.

Wendy: That is nice. Very nice.

Tripp: No worries.

Wendy: Is pre certification required for some treatments? Medicare Advantage, yes it’s required, Medicare Supplement, no.

Tripp: Again it just depends on the Physician and the hospital, how they code it  and how they are to determine the billing and all that.

Wendy: Yes. And then these last two is just M.D. Anderson Cancer Treatment Center included, a male clinic included, that sort of thing; no for Medicare Advantage, yes for Medicare Supplement.

Just basically reinforcing the fact that, like you said, if God forbid something happens, when you get a terrible disease or cancer, you want to go to the best.

Tripp: That’s right. I had a lady probably six months ago, she ended up getting diagnosed with cancer. She had a Medicare Plan G which is a huge plan we write a lot of and she didn’t want to go her local oncology center. It was a good one but she, again when your life is on the line you want to go to the best one.

So she was able to go to because they accept original Medicare and therefore they accept that Medicare Plan G Supplement and so she is able to get the care of that she needs. In fact, she is going through   her treatments as we speak.

Again, she knows she is getting the very best care that she possibly can find and it is taken care of through that supplement.

Wendy: Yeah.  We will be praying for her for sure.

So hopefully this kind of sums up everything. But I remember you saying something when I was kind of asking you about the differences and I remember you saying, “Put it this way Wendy if my mom were still alive she would be on Medicare Supplement.”

And that really says it all.

Tripp: If I was sixty five, and I really want to say it, I am not taking any chances; I want the predictability just like many of my clients do, and the peace of mind of knowing everything is covered on that Supplement.

Just pay that monthly premium, it is always going to be there for you there is no hidden surprises, there is no big maximum out of pockets, there is no limited restrictions.

It is just, again I can’t say it just a better plan; maybe somebody thinks differently, but that is my opinion, I think it is a superior plan and peace of mind is big with my mature women clients.

Wendy: Absolutely. So hopefully this helped you guys.  If you want to get into a little bit more, the more meat and potatoes of it, we host a workshop a couple of times a week; there should be a link somewhere below where you can click and register for that and learn a little bit more and hopefully that helps you.

So we will see you next time on the next video.

Tripp: See you soon.





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