#Medigap insurance

[alvisanders]

Who Needs Medigap Insurance?

Medigap insurance, also known as Medicare Supplement Insurance, is a supplementary coverage designed to fill the gaps in Original Medicare. While Original Medicare (Part A and Part B) provides essential coverage for hospital and medical services, it doesn't cover all healthcare costs. Medigap policies are specifically crafted to help individuals bridge these gaps, offering additional financial protection and peace of mind. Understanding who needs Medigap insurance involves considering various factors related to Medicare coverage and individual healthcare needs.

Individuals Enrolled in Original Medicare: Medigap plans in PA are designed to complement Original Medicare, so individuals who are already enrolled in Medicare Part A and Part B are eligible to purchase a Medigap policy.

Those Seeking More Predictable Healthcare Costs: Medigap provides financial predictability by covering certain out-of-pocket costs, such as deductibles, copayments, and coinsurance. This is particularly valuable for individuals who prefer a more stable and budget-friendly approach to healthcare expenses.

People with High Healthcare Utilization: Individuals who anticipate frequent doctor visits, medical treatments, or hospital stays may find Medigap beneficial. The supplemental coverage can help offset the costs associated with regular healthcare utilization.

Individuals with Chronic Conditions: Chronic health conditions often require ongoing medical care and treatment. Medigap can be advantageous for individuals with chronic conditions by helping manage the out-of-pocket costs associated with regular medical services.

Those Wanting Coverage for Foreign Travel: Some Medigap plans provide coverage for emergency healthcare services during foreign travel. Individuals who frequently travel internationally may find this feature valuable for added peace of mind.

People on a Fixed Income: Medigap plans can provide financial stability for individuals on fixed incomes by helping to cover Medicare's cost-sharing requirements. This ensures that healthcare expenses remain more predictable and manageable.

Individuals Not Eligible for Medicare Advantage: While Medigap supplements Original Medicare, it cannot be used in conjunction with Medicare Advantage plans. Individuals who prefer the flexibility of choosing their healthcare providers and want the added benefits of a Medigap plan may find this coverage more suitable.

Those Concerned About Out-of-Pocket Expenses: Medigap policies are designed to alleviate concerns about unexpected and significant out-of-pocket expenses. This can be particularly important for individuals who want a comprehensive healthcare safety net without the limitations of Original Medicare alone.

Individuals Who Want Guaranteed Renewable Coverage: Medigap policies are guaranteed renewable, meaning insurance companies cannot cancel the coverage as long as premiums are paid. This stability is attractive to individuals who seek long-term, reliable healthcare coverage.

People Turning 65 and Enrolling in Medicare: Many individuals consider purchasing Medigap policies during their initial enrollment period when they turn 65 and first become eligible for Medicare. This period provides guaranteed issue rights, ensuring that individuals can purchase any Medigap policy available in their area without medical underwriting.

In summary, Medigap insurance is suitable for individuals enrolled in Original Medicare who are looking to enhance their coverage and reduce out-of-pocket expenses. It caters to those who want more predictable healthcare costs, have high healthcare utilization, or are concerned about potential gaps in Medicare coverage. By addressing these needs, Medigap offers a valuable supplement to Medicare and provides individuals with greater financial security and flexibility in managing their healthcare expenses.

[albaalexa]

What Is Medigap Coverage Used For?

Medigap, or Medicare Supplement Insurance, is designed to cover some of the out-of-pocket costs that beneficiaries face when enrolled in Original Medicare (Part A and Part B). While Original Medicare provides essential coverage for a wide range of medical services, it does not cover all expenses, which is where Medigap comes into play. Understanding what Medigap coverage is used for can help beneficiaries effectively manage their healthcare costs and make informed decisions about their insurance needs.

Hospitalization Costs

One of the primary uses of the Medigap plans in PA is to help pay for costs associated with hospitalization. Medicare Part A covers inpatient hospital stays, but it comes with certain out-of-pocket expenses that Medigap can help alleviate. For instance:

Deductibles: In 2024, the Medicare Part A deductible is $1,600 per benefit period. A Medigap policy can cover this deductible, so beneficiaries do not have to pay it out of pocket.

Coinsurance: After the first 60 days of hospitalization, Medicare beneficiaries must pay coinsurance, which is $400 per day for days 61 to 90 and $800 per day for lifetime reserve days. Medigap can cover these coinsurance costs, significantly reducing the financial burden of extended hospital stays.

Skilled Nursing Facility Care

If a beneficiary requires skilled nursing facility care after a hospitalization, Medigap can assist with the associated costs. Medicare Part A covers the first 20 days of skilled nursing care at no cost, but from days 21 to 100, there is a daily coinsurance of $200. Medigap policies can cover this coinsurance, making it easier for beneficiaries to access necessary rehabilitative services without incurring substantial expenses.

Outpatient Services

Medigap coverage is also beneficial for outpatient services, which fall under Medicare Part B. This includes doctor visits, outpatient surgeries, and diagnostic tests. Although Medicare Part B covers many outpatient services, it requires beneficiaries to pay a coinsurance amount, typically 20% of the approved amount for most services. Medigap can cover this coinsurance, reducing the amount that beneficiaries have to pay out of pocket each time they receive care.

Preventive Services

While many preventive services are covered by Medicare without any cost to the beneficiary, some additional costs may arise. Medigap can help cover these costs, including coinsurance for certain preventive screenings, vaccinations, and annual wellness visits, ensuring that beneficiaries can access necessary preventive care without financial barriers.

Emergency Care Abroad

For beneficiaries who travel outside the United States, Medigap can provide peace of mind through coverage for emergency medical care abroad. Most Medigap plans offer coverage for emergency services when traveling internationally, typically up to $50,000. This is particularly important for seniors who may travel frequently or live part-time in other countries, as Medicare does not cover healthcare services outside the U.S.

Excess Charges

In some cases, healthcare providers may not accept Medicare's approved amount as full payment for their services. These excess charges can add significant out-of-pocket costs for beneficiaries. Medigap plans, particularly Plans F and G, can cover these excess charges, ensuring that beneficiaries are not caught off guard by unexpected expenses when seeing non-participating providers.

Blood Services

Medigap policies can also cover the first three pints of blood needed for a transfusion, as Medicare Part A only covers blood transfusions after the first three pints. This benefit can help reduce costs for beneficiaries requiring blood transfusions during medical treatments.

Conclusion

Medigap coverage serves as an essential financial tool for Medicare beneficiaries, helping to fill the gaps left by Original Medicare. By understanding the various ways Medigap can be utilized—from hospital stays and skilled nursing care to outpatient services and emergency coverage abroad—beneficiaries can make informed decisions about their healthcare and insurance needs. This coverage not only helps to manage costs but also provides peace of mind, allowing seniors to focus on their health and well-being.

[worldfinancesystemma1]

World Finance System

Website: worldfinancesystem.blogspot.com

Address: 4516 Tenmile Road Needham, MA 02192

Phone: 720-474-9464

Lucy Matoke - HealthMarkets Insurance is located in Fort Worth TX and is dedicated to providing quality services of High Deductible Health Plan Fort Worth TX ,Health Savings Account Fort Worth TX ,Medicare Insurance Fort Worth TX ,Medicaid Insurance Services Fort Worth TX ,Premium Insurance Fort Worth TX ,Copayment Insurance Fort Worth TX . Call us today at (817) 724-7350. We can help! We look forward to hearing from you.

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[eloisemia]

Medigap Plans: Navigating The Options And Finding What Works Best For You

Medigap plans offer supplemental coverage to fill the gaps in Original Medicare, providing peace of mind and financial protection for Medicare beneficiaries. However, navigating the various Medigap options can be overwhelming. In this guide, we'll explore the different Medigap plans available, considerations for choosing the right plan, and strategies for finding the best fit for your healthcare needs.

Understanding Medigap Plans: Medigap plans, also known as Medicare Supplement Insurance, are standardized policies offered by private insurance companies. There are ten standardized plans labeled A, B, C, D, F, G, K, L, M, and N. While coverage is consistent across plans with the same letter, premiums may vary among insurers.

Considerations for Choosing a Medigap Plan:

Assess Your Healthcare Needs:

Evaluate Your Health Status: Consider your current health condition, anticipated medical expenses, and any ongoing treatments or medications.

Anticipate Future Needs: Factor in potential changes in health status, such as the need for specialized care or prescription drugs.

Understand Coverage Options:

Compare Plan Benefits: Each PA Medicare plan offers different coverage levels, ranging from basic benefits to comprehensive coverage. Review the benefits provided by each plan to determine which aligns best with your healthcare needs.

Consider Your Budget: Balance the extent of coverage with your budgetary constraints. While more comprehensive plans may offer greater peace of mind, they typically come with higher premiums.

Research Premiums and Insurers:

Compare Premiums: Obtain quotes from multiple insurance companies to compare premiums for the desired Medigap plan. While coverage is standardized, premiums may vary based on factors such as age, location, and insurer.

Evaluate Insurer Reputation: Research the reputation and financial stability of insurance companies offering Medigap plans. Look for insurers with a strong track record of customer service and timely claims processing.

Finding the Best Medigap Plan for You:

Match Coverage to Needs:

Tailor Coverage to Your Health Profile: Select a Medigap plan that provides coverage for services and treatments you're most likely to use based on your health profile.

Consider Future Needs: Choose a plan that offers flexibility to accommodate potential changes in health status or medical needs over time.

Compare Costs and Benefits:

Evaluate Total Cost of Coverage: Consider both premiums and out-of-pocket costs, including deductibles, copayments, and coinsurance, when assessing the affordability of Medigap plans.

Factor in Cost-Sharing Features: Some plans may have cost-sharing features, such as higher deductibles or copayments, which can affect your overall healthcare expenses.

Review Plan Flexibility and Accessibility:

Verify Provider Acceptance: Confirm that healthcare providers in your area accept the Medigap plan you're considering to avoid unexpected out-of-network charges.

Assess Travel Coverage: If you frequently travel or reside part-time in different locations, ensure that the Medigap plan provides coverage for out-of-area services or emergency care.

Navigating the options and finding the right Medigap plan requires careful consideration of your healthcare needs, budget, and coverage preferences. By assessing your health status, understanding coverage options, researching premiums and insurers, and matching coverage to your needs, you can select a Medigap plan that provides comprehensive coverage and financial protection. With the right plan in place, you can enjoy peace of mind knowing that your healthcare needs are covered, allowing you to focus on what matters most—your health and well-being.

[totalbenefits]

Decisions for someone who is nearing age 65

As you near age 65, you need to learn about Medicare coverage choices and make several important enrollment decisions. This fact sheet will give you a list of the steps you shouldtake and tell you about resources to help you make your Medicare enrollment decisions. There can be penalties if you do not enroll on time, so it is best to complete these tasksat least 3 months BEFORE you turn 65.Please…

[avaa7944]

Medigap Vs. Medicare Advantage

Medigap and Medicare Advantage are two distinct options for enhancing your Medicare coverage, and they have their advantages and disadvantages. Understanding the differences between Medigap and Medicare Advantage can help you make an informed decision based on your specific healthcare needs and preferences.

Medigap:

Supplement to Original Medicare: Medigap plans in PA work alongside Original Medicare (Part A and Part B). It fills in the gaps in Medicare coverage by covering some or all of the out-of-pocket costs, such as deductibles, copayments, and coinsurance.

Standardized Plans: Medigap offers ten standardized plans labeled A through N. Each plan provides a different combination of benefits, allowing you to choose the one that best matches your healthcare needs.

Freedom to Choose Providers: Medigap plans typically do not have provider networks. You can visit any healthcare provider that accepts Medicare, giving you the freedom to see the doctors and specialists you prefer.

Predictable Costs: With a Medigap plan, your healthcare costs become more predictable. You pay a monthly premium for the plan, and out-of-pocket expenses are generally minimal, making budgeting for healthcare more manageable.

No Prescription Drug Coverage: Medigap plans do not include prescription drug coverage. You need to purchase a separate Medicare Part D prescription drug plan if you want this coverage.

No Extra Benefits: Medigap plans do not provide additional benefits like dental, vision, or hearing coverage. They focus on covering Medicare’s cost-sharing expenses.

Guaranteed Issue Rights: During your initial enrollment period, you have guaranteed issue rights, which means insurance companies cannot deny you coverage or charge you higher premiums based on pre-existing conditions.

Medicare Advantage:

All-in-One Coverage: Medicare Advantage (Part C) bundles your Medicare Part A, and Part B, and often includes prescription drug coverage (Medicare Part D). Some plans may also offer extra benefits like dental, vision, and fitness programs.

Network-Based: Most Medicare Advantage plans have provider networks, which means you may need to choose healthcare providers within the plan’s network. Some plans may offer out-of-network coverage but at higher costs.

Lower Premiums: Medicare Advantage plans typically have lower monthly premiums compared to Medigap plans. However, you may incur higher out-of-pocket costs when you receive healthcare services.

Prescription Drug Coverage: Many Medicare Advantage plans include prescription drug coverage, simplifying your healthcare needs. This can be a significant advantage for those who take multiple medications.

Extra Benefits: Medicare Advantage plans often offer additional benefits that are not covered by Original Medicare, such as dental, vision, hearing, and wellness programs. These extras can be appealing to individuals seeking a more comprehensive healthcare package.

Annual Changes: Medicare Advantage plans can change annually, including provider networks, covered medications, and benefits. It’s crucial to review your plan each year during the Annual Enrollment Period to ensure it still meets your needs.

Potential for Higher Out-of-Pocket Costs: While Medicare Advantage plans offer lower premiums, you may face higher out-of-pocket costs when receiving medical care, including copayments and deductibles. These costs can vary based on the specific plan.

In summary, the choice between Medigap and Medicare Advantage depends on your healthcare priorities and preferences. Medigap provides a straightforward approach to filling the gaps in Original Medicare, offering the freedom to choose your healthcare providers and predictable costs. However, it doesn’t include prescription drug coverage or extra benefits.

On the other hand, Medicare Advantage offers an all-in-one solution with the convenience of covering hospital, medical, and prescription drug costs in one plan. It often includes extra benefits, but you may have to use a provider network, and out-of-pocket costs can be less predictable.

Consider your budget, healthcare needs, and preference for provider flexibility when making this decision. It’s advisable to review your options annually and consult with a licensed insurance professional who specializes in Medicare to ensure your chosen plan continues to meet your needs.

[medicare-plans-rochester-ny]

Medicare Made Easy: Navigating Your Path to Health and Financial Security

Navigating the complexities of Medicare can be overwhelming, but you don’t have to face it alone. At assisting you and your Medicare Needs in Rochester NY, Maust and Leone are here to provide you with the information and support you need to make the best decisions regarding your Medicare insurance. With our expertise and commitment to treating you like family, we aim to help you stay healthy and access the medical care you deserve. Here we will break down the different parts of Original Medicare, discuss what they cover, what they don’t cover, and explore additional options available to you.

Part A: Hospital Care and More: Original Medicare Part A is designed to cover essential healthcare services. Here’s what it generally includes:

Hospital care: This encompasses inpatient care, including room charges, nursing services, and meals during your stay.

Skilled nursing facility care: If you require skilled nursing or rehabilitation services after a hospital stay, Part A may cover this.

Hospice care: For individuals with terminal illnesses, hospice care provides comfort and support services.

Home health services: Part A covers medically necessary services received at home, such as skilled nursing care, physical therapy, and medical equipment.

Part B: Medically Necessary and Preventive Services: Original Medicare Part B complements Part A by covering a range of services to diagnose, treat, and prevent medical conditions. Here’s what it includes:

Medically necessary services: This includes doctor visits, outpatient care, medical supplies, and necessary treatments.

Preventive services: Medicare encourages preventive care, covering screenings, vaccinations, and wellness visits to catch potential health issues early.

Exploring Your Options: While Original Medicare provides a solid foundation of coverage, additional options can help fill the gaps and enhance your benefits. These include Medicare Advantage Plans and Medicare Supplement Plans:

Medicare Advantage Plans: Offered by private insurance companies, these plans combine Part A, Part B, and often Part D (prescription drug coverage) into a single package. They may also provide additional benefits such as dental, vision, and hearing coverage.

Medicare Supplement Plans: Also known as Medigap plans, these policies help cover out-of-pocket expenses like deductibles, copayments, and coinsurance that Original Medicare does not pay for. They work alongside your Original Medicare coverage.

We understand that the world of Medicare can be complex, which is why we offer a FREE consultation to help you explore your options and find the plan that best suits your health and financial needs. Remember, we’re here to work for you, just like family, and ensure you receive the care you need. Contact us today at (585) 563–7979 to schedule your consultation and take the first step towards a healthier future.

[andrewkevin018]

How to Compare Medicare Advantage Plans?

Medicare Advantage plans typically have a network of healthcare providers with whom they have contracts. These networks can vary significantly between plans. Check whether your preferred doctors, hospitals, and specialists are included in the plan's network. If you have specific healthcare providers you want to continue seeing, it's crucial to ensure they are within the plan's network.

[alvisanders]

What Is A Medigap Plan?

A Medigap plan in PA is private health insurance designed to complement Original Medicare. It helps cover out-of-pocket costs such as deductibles, copayments, and coinsurance. Medigap plans are standardized and offered by private insurers. Beneficiaries choose from different plan types, each providing specific benefits. These plans work alongside Original Medicare, providing additional financial protection and flexibility in healthcare provider choices.

[theturning65advisor]

Best Supplemental Insurance for Medicare in Peoria & Surprise, AZ

The Medicare Supplement Insurance Brokers at The Turning 65 Advisor can help you navigate the complexity and minimize your out-of-pocket expenses! If you live in or near Peoria or Surprise, Arizona, give us a call today to discuss your choices.

https://www.theturning65advisor.com/medicare-supplement/

[albaalexa]

What Medigap Covers?

Medigap, also known as Medicare Supplement Insurance, is a private health insurance policy designed to supplement Original Medicare (Part A and Part B) by covering certain out-of-pocket costs that Medicare doesn’t pay. This can include copayments, coinsurance, and deductibles, helping to bridge the gap between what Medicare covers and what beneficiaries must pay.

Understanding what Medigap covers is essential for seniors looking to manage their healthcare expenses effectively.

Key Coverage Areas

Hospital Costs: Medigap plans can cover the deductible for Medicare Part A, which is the amount you pay for hospital stays. In 2024, this deductible is $1,600 per benefit period. Medigap plans may also cover the coinsurance costs for hospital stays beyond the 60th day, which can be a significant financial burden for extended hospitalizations.

Skilled Nursing Facility Care: If you need skilled nursing facility care after a hospital stay, Medigap can cover the coinsurance for days 21 to 100, which is typically $200 per day in 2024. After day 100, you will be responsible for all costs.

Doctor Visits and Outpatient Care: Medigap plans can help with the costs of doctor visits and outpatient services not covered by Medicare Part B, including coinsurance and copayments for doctor services. This coverage ensures that beneficiaries are not overwhelmed by medical bills when seeking routine or specialized care.

Preventive Services: While Medicare covers many preventive services at no cost, some additional costs related to screenings and vaccinations may be covered by Medigap. This can include services like flu shots and cancer screenings, providing peace of mind for preventive healthcare.

Emergency Care Abroad: Medigap plans often provide coverage for emergency medical care while traveling outside the United States. This coverage is usually limited to a certain amount (often $50,000), and you may be required to pay a deductible. This benefit is particularly valuable for seniors who travel frequently.

Excess Charges: If a doctor does not accept Medicare assignment (the agreed-upon fee for services), they may charge you more, known as excess charges. Some Medigap plans cover these excess charges, protecting beneficiaries from unexpected costs when seeing non-participating providers.

Blood Services: Medigap policies can cover the first three pints of blood you may need in a year, as Medicare Part A covers blood transfusions only after the first three pints.

Important Considerations

Standardized Plans: Medigap plans are standardized, meaning that the benefits offered by each plan type (A through N) are the same across different insurance companies. However, premiums can vary significantly between insurers, making it crucial to shop around for the best price.

Enrollment Period: The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period, which lasts for six months starting the first month you’re 65 and enrolled in Medicare Part B. During this time, you have guaranteed issue rights, meaning insurers cannot deny you coverage or charge higher premiums due to pre-existing conditions.

Limited to Original Medicare: Medigap policies do not work with Medicare Advantage Plans (Part C). If you are enrolled in a Medicare Advantage Plan, you cannot purchase a Medigap policy.

Medigap plans in PA play a vital role in filling the gaps left by Original Medicare, helping beneficiaries manage healthcare costs more effectively. By understanding what Medigap covers, seniors can make informed decisions about their healthcare options, ensuring they receive the necessary care without incurring overwhelming expenses. As healthcare costs continue to rise, having a Medigap policy can provide financial security and peace of mind for seniors navigating their healthcare journey.

[misfitwashere]

If You Don't Know Medicare Advantage Is a Scam, You're Not Paying Attention

We’re on the edge of the open enrollment period for Medicare, and the Advantage scammers will be carpet-bombing America with advertisements over the next few months. Don't be fooled about what it is—and who is profiting.

Thom Hartmann

Oct 07, 2023

Common Dreams

President George W. Bush and Republicans (and a handful of on-the-take Democrats) in Congress created the Medicare Advantage scam in 2003 as a way of routing hundreds of billions of taxpayer dollars into the pockets of for-profit insurance companies.

Those companies, and their executives, then recycle some of that profit back into politicians’ pockets via the Citizens United legalized bribery loophole created by five corrupt Republicans on the Supreme Court.

Just the overcharges happening right now in that scam are costing Americans over $140 billion a year: more than the entire budget for the Medicare Part B or Part D programs. These ripoffs — that our federal government seems to have no interest in stopping — are draining the Medicare trust fund while ensnaring gullible seniors in private insurance programs where they’re often denied life-saving care.

Real Medicare pays bills when they’re presented. Medicare Advantage insurance companies, on the other hand, get a fixed dollar amount every year for each of the people enrolled in their programs, regardless of how much they spent on each customer.

As a result, Medicare Advantage programs make the greatest profits for their CEOs and shareholders when they actively refuse to pay for care, something that happens frequently. It’s a safe bet that nearly 100 percent of the people who sign up for Advantage programs don’t know this and don’t have any idea how badly screwed they could be if they get seriously ill.

Not only that, when people do figure out they’ve been duped and try to get back on real Medicare, the same insurance companies often punish them by refusing to write Medigap plans (that fill in the 20% hole in real Medicare). They can’t do that when you first sign up when you turn 65, but if you “leave” real Medicare for privatized Medicare Advantage, it can be damn hard to get back on it.

The doctors’ group Physicians for a National Health Program (PNHP) just published a shocking report on the extent of the Medicare Advantage ripoffs — both to individual customers and to Medicare itself — that every American should know about.

The report, titled Our Payments, Their Profits, opens with this shocking exposé:

“By our estimate, and based on 2022 spending, Medicare Advantage overcharges taxpayers by a minimum of 22% or $88 billion per year, and potentially by up to 35% or $140 billion. By comparison, Part B premiums in 2022 totaled approximately $131 billion, and overall federal spending on Part D drug benefits cost approximately $126 billion. Either of these — or other crucial aspects of Medicare and Medicaid — could be funded entirely by eliminating overcharges in the Medicare Advantage program. “Medicare Advantage, also known as MA or Medicare Part C, is a privately administered insurance program that uses a capitated payment structure, as opposed to the fee-for-service (FFS) structure of Traditional Medicare or TM. Instead of paying directly for the health care of beneficiaries, the federal government gives a lump sum of money to a third party (generally a commercial insurer) to ‘manage’ patient care.”

With real Medicare and a Medigap plan, you talk with your physician or hospital and decide on your treatment, they bill Medicare, and you never see or hear about the bill. There is nobody between you and your physician or hospital and Medicare only goes after the payment they’ve made if they sniff out a fraud.

With Medicare Advantage, on the other hand, your insurance company gets a lump-sum payment from Medicare every year and keeps the difference between what they get and what they pay out. They then insert themselves between you and your doctor or hospital to avoid paying for whatever they can.

Whatever you decide on regarding treatment, many Advantage insurance company will regularly second-guess and do everything they can to intimidate you into paying yourself out-of-pocket. Often, they simply refuse payment and wait for you to file a complaint against them; for people seriously ill the cumbersome “appeals” process is often more than they can handle.

As a result, hospitals and doctor groups across the nation are beginning to refuse to take Medicare Advantage patients. California-based Scripps Health, for example, cares for around 30,000 people on Medicare Advantage and recently notified all of them that Scripps will no longer offer medical services to them unless they pay out-of-pocket or revert back to real Medicare.

They made this decision because over $75 million worth of services and procedures their physicians had recommended to their patients were turned down by Medicare Advantage insurance companies. In many cases, Scripps had already provided the care and is now stuck with the bills that the Advantage companies refuse to pay.

Scripps CEO Chris Van Gorder told MedPage Today:

“We are a patient care organization and not a patient denial organization and, in many ways, the model of managed care has always been about denying or delaying care – at least economically. That is why denials, [prior] authorizations and administrative processes have become a very big issue for physicians and hospitals...”

Similarly, the Mayo Clinic has warned its customers in Florida and Arizona that they won’t accept Medicare Advantage any more, either. Increasing numbers of physician groups and hospitals are simply over being ripped off by Advantage insurance companies.

Not only is the Medicare Advantage scam a screw job for healthcare providers and people who are on the programs and are unfortunate enough to get sick, it’s also preventing Americans from getting expanded benefits from real Medicare.

As the PNHP report notes, for real Medicare to provide comprehensive vision, dental, and hearing benefits to all Medicare recipients would cost the system around $84 billion a year, according to the Congressional Budget Office.

Instead, though, the Medicare system is burdened with at least that amount of money in over-payments to Medicare Advantage providers — over-payments that have no health benefit whatsoever and merely inflate the companies’ profits.

A hundred billion dollars in excess profits can be put to a lot of uses, and the health insurance industry is quite good at it. The former CEO of UnitedHealth, “Dollar” Bill McGuire, for example, made off with over $1.5 billion dollars for his efforts.

And, because five corrupt Republicans on the Supreme Court legalized political bribery with their Citizens United decision, some of these companies allocate millions every year (a mere drop in the bucket) to pay off loyal members of Congress and to dangle high-paying future jobs to high-level employees of CMS who have the power to keep the gravy train going and thwart prosecutions.

As PNHP noted:

“Medicare Advantage is just another example of the endless greed of the insurance industry poisoning American health care, siphoning money from vulnerable patients while delaying and denying necessary and often life-saving treatment. While there is obvious reason to fix these issues in MA and to expand Traditional Medicare for the sake of all beneficiaries, the deep structural problems with our health care system will only be fixed when we achieve improved Medicare for All.”

We’re on the edge of the open enrollment period for Medicare, and the Advantage scammers will be carpet-bombing America with advertisements over the next few months. Representatives Pocan, Khanna, and Schakowsky have introduced the “Save Medicare Act” that would ban Advantage companies from using the word Medicare in their advertising.

They made a video about it that’s well worth sharing with friends and family:

As Schakowsky, Khanna, and Pocan note, “Only Medicare is Medicare.” Don’t be fooled by the Medicare Advantage scam.

And now that you know, pass it on and save somebody else’s health!

[squaredawayblog]

Quality, cost, the local healthcare market – there’s a lot to consider when picking the Medicare option that fits your individual circumstance.

[eloisemia]

How Medigap Plans Can Save You Thousands of Dollars in Healthcare Costs?

Medigap plans in PA can save you thousands by covering out-of-pocket expenses like deductibles, copayments, and coinsurance under Original Medicare. With predictable costs, flexibility in choosing providers, and peace of mind, Medigap plans contribute to reduced financial stress during retirement, ensuring that you preserve retirement savings and enjoy comprehensive healthcare coverage without the worry of unexpected medical expenses.

[merisms]

I genuinely do not even understand the point of Medicare Advantage plans. People say it's "cheaper" but by cheaper they mean cheaper than Original Medicare plus Part D plus Medigap. And like? Medigap is not something I ever got? I got quoted $405/mo which doesn't include Original Medicare cost. All Medigap does is cover your copays. I am not spending $405+/mo in copays.

And then Medicare Advantage is paying more (compared to Original Medicare) just to have your pool of doctors restricted and your treatment options restricted???? What's happening. Why would I do that.

And then with ABLE accounts tell me why the investment option is not FDIC insured, at least in my state. Savings is, but not investment. Why would you not have it be insured?

[avaa7944]

A Bit About Medigap Enrollment Periods

Enrollment periods for Medigap plans in PA are crucial for securing supplemental coverage. The initial enrollment period begins when you're 65 or older and enrolled in Medicare Part B, lasting six months. During this time, insurers must accept you without underwriting. Missing this period may result in higher premiums or denial based on health. Open enrollment, annually from October 15 to December 7, allows plan changes. Special enrollment periods exist for specific circumstances, emphasizing the importance of timely Medigap enrollment.