Why Medicare Supplement Plan G Might Not Be Your Best Choice

So in 2025 and 2026 there is going to be major changes when it comes to Medicare. We've already seen it a lot of these changes have come out but they're going to come out slowly as time goes on. So in this video I want to explain to you the differences between the Medicare Advantage plans and the Medigap also known as the Medicare Supplement plans. And the way that I'm going to do this is by showing you charts and data that gives you numbers so that you can make a decision on what the best plan is for you. Now if we take a look on the screen the first thing that I want to start with the beginning when you're turning 65 or when you want to go on to Medicare for the first time this could be after the age of 65 if you're still working and you're getting benefits from your company or something like that. But when you want to go on to Medicare for the first time you're going to contact the social security office it could be your local social security office and you're going to sign up to get this red white and blue card that's on the screen. Now this card is original Medicare this is going to cover about 80% of your costs. This card is going to cost the average person meaning the person that's making an average amount of money per year $185 a month. Now if you're a higher income earner and you're making $750,000 a year you're going to pay a lot more than $185,000. If you're making $4,000 a year and you're on Medicaid you could pay a lot lower than $185,000 a month. But for the majority of people that's what you're going to pay to get 80% of your coverage. Now I always say to people 80% of the coverage sounds great but if you had a million dollar bill and you had to pay $200,000 that would not be so great. So here are the categories that I'm going to talk to excuse me talk about in this video and I'm going to compare Medicare Advantage and the Medigap plans. The first one is going to be the so premiums can be all over the place but what you want to see is an average of what this will cost and also what you get for these premiums just because something's cheaper than the next thing doesn't mean it's better. So after I do premiums I'm going to talk about the hospital coverage and the costs doctors and specialists and how much that's going to cost. Let's scroll down here. CAT scans, MRIs, PET scans, how much they cost, networks, all those different things. Then I'm going to talk about skilled nursing. This is extremely important because as people age skilled nursing becomes a huge factor with their Medicare plan and people don't see it coming. I get it I mean we all think we're going to remain the same age or years are going to go by very slowly but when you hit 65 all of a sudden 80 becomes it comes rather quickly for a lot of people. Then I'm going to talk about ambulance coverage and the costs and then I'm going to go into the maximum out-of-pocket. Now this is very important because when I talk about maximum out-of-pocket I also have to talk about networks and so forth because some people think well I have a 2,000 maximum out-of-pocket. Yeah but the catch might be how many doctors can you go see you know how many hospitals will actually accept you. Then of course I'm going to go into the drug plans, the dental vision and hearing, and a little bit of the over-the-counter cards that Medicare advanced plans give you and the gym membership. Those are just a little extra. I'm not going to spend a lot of time on them but I will discuss them. So let's talk about the first column which is the premiums. Now Medicare advanced plans will definitely for the most part have lower premiums. The reason being for this is because you are going to pay deductibles and co-pays as you go to the Now with Medigap plan G and plan N the premium is going to be much higher than Medicare advanced plans but the coverage is going to be much better and that's just a fact. For me personally as a broker probably 95% of my clients are on plan G and plan N and I always tell people this because I want them to know look I'm going to explain to you what the best plans are and why and then I'm going to explain all the other different plans that your neighbor might have talked to you about or you looked on the internet and it sounded pretty good. So on an average plan G this is an average it's not for everyone it will be about $140 a month for somebody who's 65 years old. Now if you're 75 you might want to tack on you know another $40 a month $180 or something like that. If you live in certain areas like New York City this plan G is going to be over $300 a month. So I'm just giving an average throughout the entire country it's based basically off of how expensive it is where you live for the most part. Plan N is going to be around $106 a month and I'm going to explain why. So what happens when you go to the hospital with these three different plans? Now I know I just said Medicare Advantage there's different companies with all of these plans UnitedHealthcare, Aetna, Cigna, Humana for both Medicare Advantage and Medigap plan G and N. Here's the difference Medicare Advantage plans have all separate companies but those companies also have separate plans so you really have to dive into what the benefits are. When it comes to plan G and plan N every single company out there is going to have the same benefits. So if a plan G as you can see on the screen and the plan N cover 100% of your hospital coverage it doesn't matter if you go with Aetna or UnitedHealthcare or Cigna or whatever it may be it's going to cost nothing. Now the difference some people might say and I'll just hover over this the difference between a plan G from one company to the next is going to be the service that you get and it's going to be the price and a lot of times people want to see well the cost is low when they're 65 but it really jumps up when I turn 68. Hey these companies sometimes try to get people in early when they're 65 and then raise the premiums people don't want to change there's all sorts of things that go on like that but the benefits will never change from a plan G from Aetna to a plan G from Cigna or to a plan G from UnitedHealthcare and so on same thing with the plan N. So let's talk about hospital coverage so Medicare Advantage plans yes they have a zero premium but the hospital stay per day could be $250 $350 it could be $500 a day it could be $600 a day when it comes to the medic and here's another thing about Medicare Advantage not only can the hospital stay be as high as $600 or whatever it may be you might not be able to go to that hospital you have to check not only with the company like the company that you have so let's say you have UnitedHealthcare Medicare Advantage such and such you have to ask the hospital hey I have UnitedHealthcare and they might say oh we accept that but you can't stop there you have to say well it is plan such and such do you accept that because UnitedHealthcare has a ton of Medicare Advantage plans they're not all accepted everywhere the difference between plan G and plan N from the Medicare Advantage is if they accept original Medicare they have to accept every plan G and every plan N at that hospital so when I say the coverage is perfect when it comes to traveling and these type of things it is way better than the Medicare Advantage plan I couldn't think of a better word than perfect but it is the best coverage that you can get in the country in my opinion and I'm not on Medicare now plan G and plan N will cost you nothing in the hospital I have over 17 years experience in this in Medicare and the one thing I can tell you is I have clients of mine that have had strokes heart attacks everything that you could pretty cancer everything and I've gotten phone calls from them from their children from their siblings and they said I can't believe this I didn't pay anything or my husband didn't pay anything he got the best coverage we were able to go to the hospital we wanted to so this is a fantastic feature and I know I've spent you know a couple minutes on this but you have to know that that is the difference between these plans let's talk about doctor and specialists when it comes to Medicare Advantage plans a lot of them do you pick a primary care physician they don't charge anything the government pays for it or the plan pays for it specialists might be 35 or 45 maybe 50 to go to so that's something you have to look out for when it comes to the plan G and the plan N you will have a part B deductible for the entire year now in 2024 it was 240 for the entire year what that is is part B covers doctors specialists and outpatient centers so you pay that first 240 with plan G then you don't pay anything going to the doctor specialist MRIs CAT scans skilled nursing you pay nothing I'll just put the hover over this in blue but all the way down you'll pay nothing after the 240 with plan N you will pay that same 240 deductible for the entire year but you will also have a copay and that will be up to 20 each time you see the doctor or the specialist now I said up to $20 a lot of times they will charge you nothing for this they won't bother it's like they don't want the billing department to get into it they'll just take the money that they get from Medicare and the plan and leave it at that this is one of the reasons why plan N is becoming so popular but even if they charge you up to $20 after that deductible that's all you're going to pay you're not going to get a copay of $100 or whatever it is let's move on to CAT scans and MRIs same thing I've seen it you know I have 300 up here I'm putting this on the low end I've seen it at 250 I've seen it at 400 but Medicare Advantage plans are going to charge you when you go and get a CAT scan or a PET scan or MRI you will not get charged with the plan N or plan G for these items starting to see how they plan G and plan N pretty much cover everything it's fantastic skilled nursing I can't tell you how many phone calls I get Medicare Advantage plans give you 20 days of skilled nursing plan G and plan N give you 100 days of skilled nursing I have had people that have especially strokes and things like that nature where they've been in skilled nursing for 100 days and they have paid zero and they get the best care they get to go wherever they want once again when you have Medicare Advantage you go to get a CAT scan they have to accept your plan you go to skilled nursing you have to look at the networks can I go to where I want and a lot of times they'll say no you have to go over here this is the biggest complaint so not only do you get 20 days instead of 100 they'll pick the place where they want you to go when you have a plan G and plan N you go to the best place as long as they accept Medicare and you pay nothing for 100 days I've had people they rave about the coverage when it comes to skilled nursing ambulance is zero for plan G and plan N around 250 to something I mean it depends on where you live but 450 for Medicare Advantage and then maximum out-of-pocket per year now Medicare Advantage is going to give you all sorts of numbers for different plans $2,000 for this plan 5,000 for this plan it could be 7,500 like I have on the screen but they say that's the maximum out-of-pocket but do they actually accept the plan people tell me all the time well my maximum out-of-pocket is $2,000 I see it in the comments number one if your maximum out-of-pocket is $2,000 you are very limited to what where you can go that there's just no way you can go wherever you want and your max out-of-pocket is $2,000 here's another thing about Medicare Advantage plans they'll they will fight with their clients about procedures getting done now me personally I have over a thousand clients personally I also have agents that work with me and they have their own separate clients and I do not get phone calls that say my doctor didn't accept this or they I needed to get this surgery done and they wouldn't allow me I I mean I wouldn't be able to have that many clients and by the way I have staff that works with me and everything and so we have a nice little thing going that we you know we're able to help a lot of people out but with the Medicare Advantage plan if I had 30 clients I mean if I had let's say a hundred or 300 clients on this plan I guarantee you my phone will be ringing off the hook my doctor doesn't accept this anymore they didn't approve this but you know I needed to get surgery and they told me well go to physical therapy first I hear all of these things that's why I do not do Medicare Advantage except for in extreme cases let's let's take a look at the drug plans now there are zero premium drug plans for both Medicare Advantage it's not if it's attached let me go back a little bit Medicare Advantage all of these things are combined into one now let me throw up this chart you sign up for Medicare A&B through the Social Security office and all you have to do is pick up the phone and call them or make an appointment or whatever it is but that's your first thing that you need to do after you sign up for Medicare and you get that red white blue card or while you're waiting you're gonna be making the decision do I want to go with a Medicare Advantage plan as you see the blue side on the right if you choose that side that's it it will come with a drug plan it will come with dental vision and hearing it will come with an over-the-counter card most likely these things it will come with a gym membership maybe but it's all through that plan but like I said you have to decide do you want these little extras or do you want the best coverage in the country if you choose to go to the red side as I have on the screen Medigap or GAP plan or MedSup or Medicare supplement these are these words are interchangeable they all mean the same thing you're gonna have to get the MedSup then you're gonna attach a drug plan to it and then you're gonna attach a separate vision dental and hearing plan Medicare Advantage all-in-one Medicare supplement plan you attach everything to it might sound complicated but when it comes to getting the best coverage in the country in my opinion that's what you're gonna want to do both of these have zero premium plans both some of them cost more and it really depends on the drug that you take the the copays and so forth you're gonna have to look that up dental vision hearing like I said Medicare Advantage is going to attach that it's not attached when it comes to plan G and plan N you'll get a separate plan it can cost you anywhere from $10 to $50 a month or something like that it just depends you'll have to take a look at your area what they have the next thing is the over-the-counter card and the gym membership these two things are just something that Medicare Advantage plans try to give you to entice you into the plan and I feel like it's going to go bad at very very soon where they're gonna take away these extras and they're gonna raise these premiums from zero going up they've already dropped a lot of people in the country from the plan they send you a letter and say hey we're not offering this plan anymore if that happens pick up the phone and call an agent so let's go over as you can see I'm more into the plan G and the plan N than the Medicare Advantage plans please leave your comments because some people I love the comments once again people learn from the comments sometimes more than the video that I do at least that's what some people in the comments say hey I love the comments I learned so much so leave your comment or ask your question in the comments below so if you look at a plan G let's just go over this real quick the premium plus the deductible on the copays you're going to pay on average 65 year old $140 a month multiply that by 12 12 months you get $1,680 that's what you're gonna pay for the year in premiums so what else do you pay for well when it comes to the hospital the doctor the specialist the ambulance the MRIs the skilled nursing all of those things the only other thing you're gonna pay is $240 in deductible in 2024 2025 they're gonna raise it most likely but you take that $1,680 add that small deductible for the entire year and you're going to spend $1,920 on all of those things hospital doctor MRIs CAT scans ambulance skilled nursing it's you know chemotherapy whatever it may be you cannot get a better plan than that but the plan N rivals this plan because it has the benefits and the same coverage except they charge you a lower premium so instead of 140 being the average it'll be $106 on average times that by 12 $1,272 add that $240 deductible just like you did for the plan G you see it's $1,512 then add up to $20 going to the doctors so what I did is I said okay the average person let's say goes to the doctor six times a year that's $120 if the doctor charges the max amount add that now we have $1,632 one thing I think about the plan N is they have a emergency room fee of $50 it's waived if you get admitted so I put one time people go to the emergency room per year and then you have your total of $1,682 so this number let me scroll down here maximum out-of-pocket I tell this to everyone I talked to on the phone out of the people I speak with and people that are my clients it's split 50-50 plan G and plan M reason being is some people save a lot of money on plan N if you're going to the doctors a hundred times a year you know specialists and some people do do this they go to the doctor and specialist you know six times a month I mean and they might be spending about equal or more than the plan G and they don't want to pay the copay so they like the plan G a lot of people will save money on plan N and you get a lot of these same benefits hospital doctor skilled nursing all these same benefits and you can save some money but that's something I discuss over the phone because it's individualized I don't have a favorite plan G or N now plan N does have a possibility of an excess charge less than 3% of the doctors in the country charge this this means they do not accept Medicare's payment I can't stand this because it's less than 3% of the doctors I have never had anyone of my clients or people I've heard of say that they got an excess charge I had one person the last video I did one the last video well the last two videos got about 400,000 people that watched them and one person that's in the last I don't know how many years said I got an excess charge from such and such and who knows if he was even telling the truth I mean I don't know but I personally have never gotten an email from any of my clients and I haven't heard any agents that I know that said oh my client got charged an excess charge and keep in mind the excess charges the part B excess charge so people say well I don't want to go to the hospital and I have $100,000 bill because they didn't accept Medicare's payment now when you go to the doctors especially the specialist or whatever you would most of the time nobody on planet asks do you accept Medicare's payment they just say do you accept Medicare doctor says yes and then they go but I'll get off of that that topic that's another thing that I talked to people over the phone about for their individual oh the reason why I had these states I'm sorry these states do not have an excess charge but that's why I have them up on the screen but be honest with you I I do not worry about any of my clients getting an excess charge it is extremely rare it's never happened to one of my clients so one of the things is this chart and many other things are on my website so this I'm gonna scroll this is actually a book that I wrote so if I scroll I'll try to scroll a little bit closer so I the book is on the website and let me scroll up to the top it's called Medicare without confusion it is free you don't put your email or your phone number nothing you just go to my website and I'll show you medicare-365.com and I'll put the link in the description box you go to my website it's pretty easy to see you got these nice looking people on the screen but you go to resources and you'll see ebook right here you just click on ebook it takes you right there and then you just read it I mean you know it talks about you know I have a little something about myself and then I have chapters and you can just click on the chapters and it will go right to the chapter you know or you can just read through the whole book four parts of Medicare just explain and I have a lot of videos that you can just click on and and do it there so I hope this video wasn't too long but I wanted to describe you know what's going on some of the changes in Medicare look premiums are going up the drug plans are exploding in price I know they said that there's a $2,000 maximum I've been reading like crazy talking to people and you know there's an asterisk to that there's a $2,000 maximum if they cover the drug you know if they don't cover your drug then they're just not going to cover the drug and that's it you have to go find out so some people think well I'll get on the cheapest plan there's only a $2,000 maximum hey you have to look if you're on these expensive drugs what plan actually covers them but once again when it comes to choosing where's the I have to go to my little chart here when it comes to choosing a plan oh there it is go to the Social Security office get your a and B you choose Medicare Advantage or your MedSupp if you choose Medicare Advantage you've done you choose MedSupp you choose a separate prescription drug plan separate vision dental and then you're done hope this video helped thanks so much for watching leave a comment and I'll see you at the next video