Medicare Advantage Plans Explained (2020)

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Medicare Advantage Plans Explained
Check out our video on Medicare supplement plans and insurance companies:
Medicare Supplement Plan G
Medicare Supplement Plan N

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 an 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.

#MedicareAdvantagePlansExplained #MedicareHMO #MedicarePPO

Medicare Advantage Plans Explained (2020)


31 thoughts on “Medicare Advantage Plans Explained (2020)

  1. This video has information on Medicare Advantage plans you will not find elsewhere on YouTube. All of what I have to say is backed up by links in the description. Just click “show more” above.
    What do you think? Is this information that is important to your research?

  2. What you Say Is The Problem I Have For The Last 5 Years Been Watching Your Videos So Far I Like The Supplementen G Will Be Calling Your Company Soon P.S

  3. I liked this video. Glad I subscribe so I’m notified right away when you post a new one.
    Didn’t watch Breaking Bad but I can understand his quandary. The guy in the body cast really shocked me. I hope he appealed the companys decision. I understand a large percentage of appeals in the MA world are found FOR the client, so learn the appeal process of you’re stuck in an MA plan.
    Great video Matthew 😉

  4. My husband got his insurance through your agency last year, and you’ve been great. Got the plan F-HD and an annuity. I would definitely recommend that combination to anybody looking to save money on their insurance plan.

    • Hi Karen. I am so glad you like your coverage. The FHD with annuity savings account are a great combination. The Plan F-HD is a great value in states that mandate all policies be issued as either Community Rated or Issue Age, like Florida, CT, NY, Washington State and others.

  5. Might want to mention the “goodies” medicare advantage plans dangle to try to sucker you in: dental, health clubs, hearing aids, travel to treatment assistance, or vision. Many somewhat meager in their actual benefits. I was in a Medicare Advantage plan my first three years of eligibility. It worked well for me only because I never really needed much other than regular checkups and drug coverage. I realized I did a poor job with my homework and obtained a supplemental policy, switching back to regular Medicare using the opportunity provided by moving to a location outside my Advantage plan’s area of coverage. You helped me switch to a different insurance company’s supplemental plan two years ago saving me premium $. Thank you.

    • Hi Larry, It’s good to hear from you. You are right, I should have mentioned the “goody’s”. They are getting more extreme too. Now some offer free Uber rides to physical therapy or free grocery delivery. There are some people who’s health has deteriorated to the point where these could be useful. But for most people it’s just a distraction. Focus on health benefits. I try to advise people to get the healthcare you will want when you are sick or injured. Don’t be distracted by all this other stuff. It is intended to distract you so you don’t focus on the lower health benefits.

  6. Thanks for this educational video. There is one other big problem with both Medicare Adv HMO and PPO plans, If you are ever in a hospital even for a day, you get several bills from different service providers. While the hospital may be in your HMO or PPO plan, many of those service providers are not. Obviously, the insurance company will insist that you pay their bills in full. This actually had happened to me. I live in Texas and wrote to the Texas Department of Insurance and their advise was that I should try to negotiate with service providers. When I was in the hospital, I had no way to know or control who operated on me. But I was stuck with thousands dollars worth of bills.

    • Thank you for sharing this. You’re right, of course, and I should have mentioned it. This cannot happen with Original Medicare and a supplement

  7. I watched Breaking Bad since it started and I remember your analogy, it’s perfect. Ironically, I was going through cancer treatments at that same time too! My insurance covered some of the outrageous costs. Unfortunately, both my wife and my jobs relocated and we both had to go on unemployment at the same time. 2008 was a very bad year for us. As luck would have it, things worked out much better in the end than they were back then. Two years ago I retired on Social Security early (at 62) and I believe I’ll get my Medicare paperwork in a few months. That’s why I’m trying to educate myself on this stuff now. My wife, who is younger than me, will go on working for probably 10 more years since we both are fully covered (with Blue Cross/Blue Shield) at her work. I plan on rejecting Medicare Part B because of her insurance covering us. Do you have any more tips for me? Also, President Trump just signed an Executive Order supposedly making the Medicare Advantage Plan better. Any thoughts on that yet? By the way, your videos are the best on the web about Medicare, and I’ve watched several.

  8. i learned more on this one video than all the years since I’ve retired, thank you, I now have all my medical in the VA system, that do you think about the VA system?

    • Hi OldMachinist, If you had enough service to qualify for TrciCareforLife, that would be ideal. With the VA there can be some issues. Many Veterans will get a high deductible Medigap plan so that if they want to seek care outside of the VA they can with limited financial risk. I have a video on F-HD. The premiums are very, very minimal.

  9. This is the best video on choices for medicare and advantage plans. Hes right on about Advantage plans just think about how many times your regular ins denied a request for DME or medication when u were working!

  10. I watched Breaking Bad and felt for the guy and his family. I have a Medicare Advantage Plan and at 90 years old, my cost is $0

  11. I would like to hear what you have to say about the other 2% or Medicare Advantage Plans. Specifically the new MSA plan offered by Lasso Healthcare.

  12. Great video. Thanks for the info we’ll never get from the insurance companies pushing Medicare Advantage Plans saying along with drug coverage dental, eye glasses and hearing aids may be partially covered by their plan. People only hear what they want to hear “no charge”. I have Original Medicare with a supplemental Plan G. I see any doctor I want and get the care recommended by the doctor and it’s fully covered after $180 annual copay. No insurance company decides who I see nor what procedures I can have.

  13. Great info. I’m going to be 65 in about 12 months and I’m just starting my research. From what I have read,and you confirmed, Advantage plans are not that good. I’ll be watching more of your videos. Thanks

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