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Medicare Advantage

Yes, we can help with Medicare Advantage, but we want you to know both sides of the story that you are not getting on the TV commercials.
Our number is: 1-800-729-9590

Click for Flyer Comparing Advantage vs. Supplement

There are some things you should know before joining a Medicare Advantage Plan.

These are things that most sales agents will NOT tell you that you are giving up, if you join a Medicare Advantage plan.

May 5, 2023 – Prior Authorization Problem is Growing with Medicare Advantage – See story here

Brokers Earn More to Steer New Beneficiaries to Medicare Advantage – See the Story where Chris was interviewed.

November 3, 2022 – Senate Finance Committee Report: DECEPTIVE MARKETING PRACTICES FLOURISH IN MEDICARE ADVANTAGE – see report here.

October 19, 2022 – CMS sends urgent warning to Medicare Advantage companies to stop their deceptive TV commercials immediately. Action pending. See the memo here.

Update from October 1, 2022 – Mayo Clinic warns patients that they will NOT be on any Medicare Advantage Network. See the letter they wrote to their patients about the difference between specialty care of Medicare Supplement vs. Medicare Advantage. Click here.

See Fortune Article: Nursing home surprise: Advantage plans may shorten stays to less time than Medicare covers.

NY Times Article: “The Cash Monster Was Insatiable”: How Insurers Exploited Medicare for Billions 

Update from September 2022 – Rep. Greg Murphy, M.D. (R-NC) spoke on the House floor in support of the “Improving Seniors’ Timely Access to Care Act” which might finally improve Medicare Advantage access to care. Watch his passionate speech with examples of Medicare Advantage patient experiences:

Update from April, 2022 –  See details here of the latest Inspector General report about routine denials of care within Medicare Advantage.

Please read this article from MedPage Today about Medicare Advantage vs. Medicare. It is quite eye-opening and includes information from the American Medical Association, California’s Health Insurance Counseling & Advocacy Program, and Ralph Nader.

Also, see this 2018 report from the Office of Inspector General for Health and Human Service, who found that 75% of those having to file Appeals with Medicare Advantage plans to get their care were ultimately overturned (appeal granted). 

See the whole report, but one of the best quotes from the study says, “The high number of overturned denials raises concerns that some Medicare Advantage beneficiaries and providers were initially denied services and payments that should have been provided. This is especially concerning because beneficiaries and providers rarely used the appeals process, which is designed to ensure access to care and payment. During 2014-16, beneficiaries and providers appealed only 1 percent of denials to the first level of appeal.”

The following videos offer insight into “Advantage” plans not found anywhere else:

 Considering a Medicare Advantage Plan to save money?
 

Consider This: Most retirees are on a fixed income.

This means that our senior clients like a health care plan with no hidden fees or surprises – like the consistent, monthly premiums that occur with a Medicare Supplement policy. 

But, with a Medicare Advantage Plan you could have a big surprise when you need hospital services: increased out-of-pocket payments.
 Take a look at the comparison chart below. The blue line represents a consistent monthly Medicare Supplement (Medigap) plan premium, compared to the unexpected and sudden costs associated with using a typical Medicare Advantage program.

Some agents use the “Max out of Pocket” with Medicare Advantage as a good thing.

Well, that Max out of Pocket limit allowed by Medicare for 2023 for HMO is $7,550 and $11,000 for PPO plans.
Some plans may vary, depending on the insurance carrier in your area.

This chart shows one client’s payments after a 4-day hospital stay and outpatient procedures with the Medicare Advantage plan.
 Avoid the red line that’s possible with Medicare Advantage.

Life can be uncertain, your coverage doesn’t have to be.

Medicare Supplements vs. Most Medicare Advantage Plans:

Concerns of Seniors: Medicare
Supplement		 Medicare
Advantage
Restrictive Network of doctors and hospitals NO YES
Co-Payments to Providers NO on Plan F or G.
Up to $20 on Plan N at Doctor		 YES – Varying
Usually hundreds per day for
Surgeries or Admissions
Up to $8,300 yearly
Out of Pocket Costs (in 2023)		 NO
YES
*Unless procedure is not approved. Then you pay 100% of all costs without a limit.
Health Plan Decides What Test and Procedures
Are Approved For You		 NO YES
See OIG Investigation
Can Your Plan
Be Cancelled?		 NO

Cannot be cancelled as long as premiums
are paid

YES

Plans are approved yearly and can be dropped.
Ability to Travel the Country and Use Any Doctor or Hospital YES NO
Is Pre-Certification Required for some Treatments? NO YES

Penalties apply if pre-cert not done.

MD Anderson Cancer
Treatment Center Included?
MAYO Clinic Included?

 YES NO

    Let us help you find the best plan for YOUR situation.

Call us for FREE to discuss the best options at
 1-800-729-9590.

 

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Please look for this on your CALLER ID.

 

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