The short answer: If you can't predict exactly what drugs you are likely to need, picking a better plan will be a shot in the dark. Switch to a more expensive Medicare supplement? That would likely be counterproductive: HDG premium savings offset the out-of-pocket costs and save big bucks during healthier times. Medicare Advantage Minute: hundreds …

Those who don't know about Medicare for the Lazy Man can be duped. If the agent is new or not trained, he won't know how to properly search for the best drug plan for you. Medicare Advantage Minute: One plan in Missouri has been ordered by the government to stop enrolling new clients. Their infraction? Showing too much profit. Welcome to America! "…

This might explain why Medicare Advantage plans are losing their support. More former supporters from each side of the aisle are wavering. The Wikipedia entry for Medicare makes the point that the public expresses more support for government programs that are universal than those that are means tested. MD Anderson, in Houston, has failed to come to…

In the Medicare Advantage Minute segment, we learn that 23 health systems (as of the publishing date) are refusing to accept MA plans for reimbursement in 2025. The Wikipedia page about Medicare discusses the possibility and ramifications of reforming care for "Dual Eligibles", those who are eligible for both Medicare and Medicaid. Finally, choosin…

More recently, CVS fired another CEO who they just finished paying $21,000,000. What's wrong with this picture? The Medicare page of Wikipedia describes the Federal government negotiating the prices of prescription drugs. In my opinion the government doesn't negotiate; they dictate! Toni (with an "i") advises a heart patient to dump COBRA ASAP and …

Many new, naive agents have not been taught the scientific way to save clients a great deal of money by choosing the best Part D drug plan! Medicare Advantage Minute: "Where health systems are going wrong with MA" turns out to be a promotion of the basic, very silly theories behind HMO plans. Wikipedia's Medicare page explores the projected savings…

A recent survey of health system CFOs revealed that it is becoming even more difficult to collect reimbursement payments due from patients insured by Medicare Advantage plans. Wikipedia page "Medicare" explores several ideas for procedures that might reduce the burden Medicare places on the US treasury. One of the theories is called the "Premium Su…

Jones family trips had plenty of room for improvement! Headline encountered in the Medicare Advantage Minute: MA Plans Propose Cuts While Continuing to Maximize Overpayments! The Wikipedia page for Medicare details some of the changes in the program wrought by Obamacare. Tom wrote to ask if there would be an MLM 2025 edition. When he was assured th…

After a short time in MA, almost all of those desiring to escape to Medicare with a supplement must show evidence of good health. If they cannot satisfy the underwriters, they cannot enjoy the freedom of traditional Medicare with a supplement. An esteemed client in Colorado insisted on purchasing Plan G when I advised him to opt for HDG. His Plan G…

If your agent doesn't perform a scientific search for the best Part D drug plan for you, don't believe his recommendations! Wellcare plan cost $0 while a Humana plan cost $1,760! Same guy, same generic drug, same little town in Missouri produced dramatically different results: In the Medicare Advantage Minute, some insurance companies say they are …

In the Medicare Advantage Minute we learn about a survey: 50% do not know the difference between original Medicare and MA plans. Wikipedia page on "Medicare" addresses legislation and reforms. Next we present a couple of sad stories illustrating the fact that, while the VA can be a valuable health resource, veterans should not avoid enrolling in Me…

Medicare Advantage Minute article: Changing to a Medicate Advantage plan can be stressful! Medicare Wikipedia page: Hospital accreditation and where the cost of residency training comes from. Finally, enjoy some interesting correspondence and questions submitted by prospects and actual clients. Contact me at: DBJ@MLMMailbag.com (Most severe critic:…

The entire episode is a discussion of the process for selecting the best Part D prescription drug plan (PDP) for you. Master this skill without any annoying insurance agents pestering you. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to…

Medicare Advantage Minute consists of an article decrying the increase in prior authorization denials. Of 46 million prior authorization requests, over 3 million (7+%) were denied in 2022. "Medicare" on the Wikipedia page discusses criticisms of Medicare and the principles behind having participants of various ages contribute to the cost of the pro…

Medicare Advantage Minute: Prior authorization denials have been more numerous in recent years. Only 10% of those denials are formally appealed but of that number, 83% are reversed. According to Wikipedia, only 5% of Medicare claims are audited so there is plenty of opportunity for fraud, waste and abuse. Finally, Bob from Arizona will be turning 6…

Medicare Advantage Minute: Prior authorization requests are increasing and so are denials. For those with the moxie to file official appeals, the success rate approaches 83%! Wikipedia "Medicare" page: More on funding projections. Actuaries find it impossible to predict future solvency without the assumption that current laws will be followed. How …

We begin this episode with advice about staying safe while planting a lip lock on the Blarney Stone. In the Medicare Advantage Minute article, we learn that giant MA purveyor Aetna has had three downward earnings projection adjustments lately. This has cost the CEO his job. In the Medicare Wikipedia page, the Feds spend a lot of time projecting the…

Our Medicare Advantage Minute article details the split between Health Partners and United Healthcare. This will affect 30,000patients of Health Partners. For even more excitement, listen to our entry on the Wikipedia page about Medicare: Indicators, Long Term Financial Status of Medicare! There is a list of the new stages in Part D drug plans. The…

The Medicare Advantage Minute: Two MA behemoths are cutting back in 2025; which insurers will benefit? Communist government health programs like Medicare can only deal with increasing cost of care in two ways: increasing taxes and rationing care. MLM podcast guest Clarence Cramer was smart enough to hang up on fraudsters: Medicare will never call y…

Medicare Advantage Minute announces: Seven insurers are exiting MA markets in 2025. Wikipedia page on Medicare: a comparison with private insurance. Health systems get ready: here comes the Silver Tsunami! Many of the most popular Part D drug plans have stopped paying commissions to sales agents. Consult "Medicare for the Lazy Man" for simple DIY i…

Medicare Advantage Minute: Star ratings will be recalculated, resulting in payment adjustments of hundreds of millions of dollars. Wikipedia page on Medicare: comparison with private insurance. Finally, Joan writes in asking how to remove herself from the hated Medicaid welfare plan she has become mired in. She wants to re-enroll in original Medica…

Limp wristed pantywaists horrified at summer heat in the desert southwest! Also, fatal heart attacks are more likely in cold weather. Politicos are trying to reform the prior authorization process in order to ease the strain on providers and reduce complaints about Medicare Advantage plans. Did your parent(s) have Alzheimer's disease? Does that mea…

Medicare Advantage Minute article for today: Millions on Humana MA plans could see benefits cut. They are ending plans in some areas while cutting benefits in others. The Medicare page on Wikipedia describes some enrollment processes. Finally, correspondence from a prospective client carries questions about Medicare supplement characteristics, part…

Our Medicare Advantage Minute illustrates a trend responsible for much of the dramatic growth of Advantage plans: Large companies refusing promised retiree benefits if the retiree elects original Medicare rather than a Medicare Advantage plan. Florida: Let's do the Medicare supplement math: Illustrating the potential savings and very limited additi…

A contract dispute has caused the removal of MD Anderson from BC/BS TX Medicare Advantage networks. This will be a problem for their member patients who relied on Anderson for their treatment. This sad upheaval couldn't happen with Medicare and a Medicare supplement! The Medicare Advantage Minute quotes an article illustrating the areas of the US w…

The article addressed in our Medicare Minute is entitled, "Need a Medicare Advantage Plan?" It goes on to describe the results of a study illustrating the fact that residents of poor counties have difficulty getting highly rated MA plans. The Medicare Wikipedia page describes how medical doctors are reimbursed for their services depending on their …

The initial segment contains our Medicare Advantage Minute. Here, the government brings a premature end to their experimental MA hospice benefit. On the Wikipedia page regarding Medicare, we wallow in the actuarial magic of reimbursement calculations. This episode culminates with the official position statement of Medicare for the Lazy Man when it …

The episode starts of with the Medicare Advantage Minute segment, an article entitled: A Majority of Medicare Advantage Enrollees Don't Fully Understand Their Plans! Afterword, my friend Randy Norris describes the trials and tribulations of enduring a course of treatment for what has been described as an "off the charts" problem with sleep apnea. C…

We kick off this episode with our favorite segment: The Medicare Advantage Minute. Today's article is entitled: The Medicare Advantage Paradox; How Advantage Plans Cost Taxpayers Billions! After that, close personal friend and avid MLM podcast listener Kirk "Fish" Fisher takes the stand for an intense interrogation about his career, his life and hi…

In the Medicare Advantage minute, we learn that Centene in 2025 will exit a handful of markets where they currently have MA plans. Wikipedia page on "Medicare" explains the reimbursement for Part A services. Finally, in what is looking like a year of turmoil and change, what you should expect to learn from your Annual Notice Of Change (ANOC). Conta…

Once again, Medicare supplements explained in 3 short minutes: https://youtu.be/fJhZt5RHiMs The Medicare Advantage Minute - comes in like a lion, goes out like a little sissy. Sorry folks! The Wikipedia page on Medicare is an exciting lesson on payment for services and drug plans, according to my notes. Finally, a dire prediction for Part D drug pl…

How do they know? Because the insurance company reporting the diagnosis (like diabetic cataracts) rarely ever treats that disease. Walgreen's is apparently preparing to say "good-bye" to Village MD. Are you an MD? Learn the 15 best and 15 worst states in which to practice medicine. Finally, learn how Medicare is treating GLP-1 drugs for those with …

Medicare Advantage may be radically altered if a proposed new law passes. Prior Authorization will be required for Prior Authorizations! Gee, what genius came up with this plan? New business rates are creeping higher in these inflationary times. Rate increases for the rich plan are hitting insureds harder than those for the High Deductible plans th…

They think the problem involving prior authorizations can be fixed with legislation. So the evil MA trolls won't find another way to use their enslaved members to extract more cash from the US Treasury? On the Wikipedia page about Medicare, we learn about out-of-pocket costs: deductibles, co-pays, co-insurance and IRMAA. Correspondence with clients…

The Association of Mature American Citizens (AMAC) takes exactly the wrong position when it comes to supporting freedoms for Medicare participants. C'mon guys, wise up! "Managed care" is not what freedom-loving men and women long for in their health insurance! In the MA Minute, one hour nurse visits to members' homes result in a $15 billion windfal…

Medicare payment options allow some flexibility in meeting this "must do" financial obligation. The only way to dodge it is Medicaid: welfare. Thomas, accident victim in his late 50s, is able to purchase a Medicare supplement plan because his state mandates that right. We list all the states with similar regulations. Finally, One big MA carrier is …

Not a new story but one that bears repeating. This is one of many warnings that responsible insurance pros should share with clients. From the "Medicare" page on Wikipedia we learn about how the hospital and nursing facility benefits are renewed after a period without the need for treatment. Medicare supplement rate increases follow the pattern: in…

Additionally, providers are having to write off 8.5% of patient revenue from MA members as uncollectible. From the Medicare Wikipedia page: how you qualify for free-of-charge Part A of Medicare. What happens to hospitals with high readmission rates? Ouch! Finally, the sad story of a patient in Bullhead City, AZ who was hauled off to the hospital an…

When a hospital and Medicare advantage plan part ways, insurance plan members have to look for new docs elsewhere. One woman was forced to scramble to find four new docs and specialists. Are insurance companies keeping secrets? An actuarial reporting firm is asking subscribers to rat out MA plans who intend to exit or reduce their "footprint" in a …

It can diagnose like no previous test. Can it cure? Nope, no cure yet. Your Federal Government is auditing, setting stiff penalties for fraudulent MA charges...but tells the thieves they can just keep the cash! More exciting prose from the Wikipedia page on "Medicare". Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICAR…

Every so often a client 'fesses up and says they should have listened more carefully to my advice. Today we hear from Michael.....! Also, we enjoy correspondence with a couple of other clients, including Marvin who was helping his 88 year-old-neighbor get away from his Medicare Advantage plan. Also, a woman who is working to become a Medicare agent…

Also, on our Medicare Advantage minute: Anthem Blue Cross is engaged in a dispute that could penalize hundreds of thousands! We revisit the Medicare Wikipedia page with a description of the historical development of this massive government program. Finally, a survey: What do people on Medicare think about Medicare? Contact me at: DBJ@MLMMailbag.com…

Pharmacists warn of big trouble in the prescription drug supply process if the Administration's plans are instituted. Article for our Medicare Advantage minute shows that enemies of MA plans are worlds apart when it comes to supporting freedom! "Demystifying Medicare" drastically understates the critical importance of Medicare supplements! Finally,…

A large insurance firm says their agents are performing unauthorized enrollments and plan switches to enrich themselves to the detriment of their unsuspecting clientele. In our Medicare Advantage Minute we hear the majority of providers say that frustrations caused by prior authorization demands are growing. How about a new problem to watch out for…

That is our selection for today's Medicare Advantage Minute. Also, I plug my friend's new book of non-woke wisdom and witticisms: "How It Used to Be"! Finally, a person under age 65 in Virginia with Medicare is only able to purchase Medicare Supplement Plan A. Since I have a client in that position, and he asked for details, we list the differences…

In every episode we celebrate a "Medicare Advantage Minute" by sharing a short article or parts of a longer article. Today's selection: Health Providers Irked at the Behavior of Medicare Advantage Plans; Some Refuse to Take Them! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easi…

Medicare Advantage Minute: members find "challenges" with their MA plans all too frequently. A long-time client worries that her new annual HDF premium is out of line; I was able to reassure her. Another client needed a reminder about how his HDG plan works with claims that he incurs. His response: "Good information"! Finally, a tutorial on hospice…

Not just the denials but also the deliberate foot dragging and payment delays are causing cash flow problems for those who can least afford them! Surprise, surprise! Sales commissions on Advantage plans are being increased again! ...almost 20%.... Finally, the cost of medications is causing patients to face difficult decisions. Will the government'…

Early in the episode is a report on the evil doings of Medicare Advantage plans, straight from the Inspector General of the Department of Health & Human Services. Then we have some correspondence with clients, friends and others. Finally, we peruse a list of the best hospitals plus the best cancer treatment centers in America. Contact me at: DBJ@ML…

If the government has it's way, doctors will lose 2.9% of their current reimbursements. Also, Medicare drug plans are planning to slash coverage. This will affect EVERYBODY. Finally, prepare to hear more and more about how evil it is to make people work in the heat. What are they going to whine and cry about when winter returns? Contact me at: DBJ@…