Medicare Advantage or Dis Advantage

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Medicare Advantage or Disadvantage

Hello, It's Jon Kelderman, your Medicare tutor with Kelderman Insurance. I want to just give you some thoughts on one of the things that I've run into a few times. These issues are relatively new for me, it's not new in the Medicare industry but there's a couple things where Medicare Advantage doesn't probably do the job that a supplement does. It's not to say that these challenges are insurmountable or I don't think it's necessarily the reason to not do a Medicare Advantage but I think it's something to consider. The areas are Part B prescription drugs and skilled nursing. Typically, prescription drugs are handled through part d as in dog. What can happen is that if a drug is administered in a doctor's office or in a clinical environment, then it's covered by Part B. Part B drugs on a lot of Medicare Advantage plans are only covered at 80 percent, so you would be responsible for 20 percent. A good example of this is chemotherapy. Chemotherapy drugs are very expensive, into the hundreds of thousands or tens of thousands of dollars and if you're paying 20% of that that can get you to your max out of pocket very quickly. One of the things that I often do is I'll set somebody up with an Indemnity plan that covers for up to five thousand dollars for cancer so they at least have a one-time way of eliminating that expense. Let's talk about interim care when you go into skilled nursing. So most the time when people go to the hospital, especially as as we age, what will happen is is there will be a a skilled nursing portion of that care, You will go to the hospital, you'll spend you know several days there you'll have something done and what they'll do is rehab you and the way they do that is they bring you into a skilled nursing or maybe there's some some things that don't require full hospitalization but that would require a skilled nurse. Medicare Advantage on Medicare supplement both cover skilled nursing. The challenge becomes is that Medicare Advantage plans will often require, and this is throughout the whole Medicare process ,will often require more what I want to say what they call them progress notes but just basically more information from the doctors to make sure that somebody is not just receiving custodial care in a Skilled Nursing Facility. What I mean by custodial care is a traditional care that you get when you're no longer able to live by yourself and you need help with just basic daily activities whether it's bathing or eating, etc. Those are not covered by Medicare so interestingly the challenge becomes Medicare Advantage plans and the they will actually have a little bit more rigor that they'll put towards making sure the people aren't that are getting the right care and that they're covering the right things, not to say that that can't happen with a Medicare supplement just Medicare supplements being the federal government they're they're quite frankly they're just not as good at it, that's my that's my read on it. Anyway, just something to think about.Again, not saying that Medicare advantages is not the way to go but it can be a challenge. I had never ran into this issue until I just had a few clients that have brought it up and one that I actually is a client had an issue with skilled nursing. We were able to get through it. Anyway, Jon Kelderman American Republic, Kelderman Insurance, your Medicare tutor. Have a great rest of the week.