Medicare Advantage plans have a secret life. The carrier won’t tell you. Neither will the agent. Click SHOW MORE for time stamps
If you knew these secrets you might change your mind about signing up for one.
Time Stamps
0:30 How can they be free?
1:00 I get calls
1:25 Get back on original Medicare
1:50 When are seniors most likely to LEAVE Advantage plans?
2:20 Advantage plans have thin networks
Consider this. Why does if Medicare Advantage plans are so great, why does Medicare give you an escape clause? Why do some agents that sell you on the idea of an Advantage plan tell you to throw away your red, white and blue Medicare card? Why do agents push Medicare Advantage plans so much? Is there something you need to know that they aren’t telling? Do these Advantage plans really have a secret life? And how can they push these “Free” Medicare Plans? What’s the catch? Why is turning 65 so difficult when it comes to Medicare? Watch our video.
There is no free lunch.
There are no free Medicare plans.
In fact, Medicare prohibits the use of the term “free” when referring to Medicare Advantage plans. Instead, they are called “no premium” or “zero premium” plans.
How can that be? How can you pay no monthly premium (not including other out-of-pocket costs) and be enrolled in a plan that pays your claims and offers additional benefits?
Medicare Advantage plans contract with the Centers for Medicare & Medicaid Services (CMS) to take the financial responsibility for Medicare beneficiaries who enroll in their plans. In other words, you show your Medicare Advantage card when you get services as opposed to your red, white, and blue Medicare card.
Since Medicare is no longer paying for your claims, the federal government pays a monthly amount (flat fee) to the insurance company to cover the costs of providing your health-care coverage. That monthly fee varies based on a member’s risk factors.
Is Medicare Advantage the right choice for you?
That is something you will need to decide once you have all the facts
Both Medigap and Advantage plans cover the same types of medical treatment, but what you pay out of pocket for your care, and where you receive your care, is very different.
Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO.
If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.
Non-emergency out of network care charges may be denied if you have an HMO.
In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.
The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.
Some cancer centers, such as Mayo Clinic and MD Anderson do not participate in Medicare Advantage plans.
Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.
Chemotherapy drugs administered in a doctor's office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.
This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.
We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.
According to the Mayo clinic, "new cancer treatments are routinely priced at over $100,000 per year of treatment."
But not if you have original Medicare and a Medigap insurance plan.
Visit my secure website at Georgia Medicare Plans –
For an online resource center or to apply for Medicare visit
To learn about the history of Medigap visit:
For more information on Medicare Part C visit:
Kaiser Foundation survey found that on average “Medicare Advantage plan networks included 46% of all physicians in a county –
Government report as reported by NPR says seniors are more likely to LEAVE managed care plans when they get sicker –
#GeorgiaMedicarePlans #GAMedigapQuotes #Turning65
Is Medicare Advantage the right choice for you?
