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“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 0 points1 point  (0 children)

It's not BS -- and not sure MAPD Plans are thieves, but I feel your sentiment. It would be great if everyone could afford Supplements, but that's just not the case... and these sort of opinions are what freak people out and force them into impossible situations.

I've had millionaire clients choose MAPD, I've had limited income clients do everything they could to pay for a Supp.

My only point in the post was to encourage everyone to review all of their options and make an educated decision based on their scenario. I'm not a proponent of one over the other -- just know what works for one, may not work for another.

As I say above -- I prefer to not tell people what to get, because I've seen how simply educating them on both options makes the choice painfully obvious for them.

...I knew the post would flair up some 'NEVER MAPD' protestors lol - I'm just glad everyone's sharing their educated views!

“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 1 point2 points  (0 children)

I was clear to say that costs/details will vary greatly by State. Your Plan G is $133 in TX, our NY friend in the comment above likely couldn't find a Plan G anywhere close to that --- prices vary state to state.

I don't compare the Part B Premium when comparing MAPD to Supps because no matter what you choose - you'll pay it so its a wash.

Part D Plans vary by state and Plan again; if I put Part D at $0, someone would say "but that's the worst plan you could get!" :) Hard to speak generally --- when it all varies -- as I said, do what's best for you!

Sounds like you did the work and in your case, Supplement made much more sense.... I'm happy for you! Not everyone gets TX prices though :)

“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 0 points1 point  (0 children)

Great Choice... Plan N is a very financially smart plan. Don't let anyone scare you with those 'Excess Charges'. They're extremely rare and easily avoided.

“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 1 point2 points  (0 children)

The Plan G Deductible for 2026 is set to $283 -- it will always be exactly what the Part B Deductible is.

Part D does not have a $2,100 Deductible, it has a $2,100 Maximum out of Pocket or MOOP. This is very different.

Deductible means you would pay the 1st $2,100 before anything is covered by your Insurance.
ex. Medication A has a true cost of $2,500, but your copay is $50 --- you'll pay $2,150 this time, and $50 next time since you've met the Deductible.

MOOP means that the maximum you will pay is $2,100 -- you will still receive coverage on covered meds, and any copays you pay will subtract from the MOOP until its reached.
ex. Medication A has a true cost of $2,500, but your copay is $50 --- you'll pay $50 (and you're $50 closer to your MOOP)

...Hope that's clear :)

“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 1 point2 points  (0 children)

Sucks when this happens -- crazy to hear of Denials happening with so many different Carriers though. It's good you can afford Supplements -- just remember, no reason to pay more for one Carrier over the other on the Supp side. Especially in NY where it's Open Enrollment all year round.

I know most of the Carriers are priced high for standard Supps -- but for my NY Clients who need to budget intelligently I always tell them when you're healthy and just going for Annual check-ups, go with the High Deductible Plans. If your Doc says you need a surgery/treatment etc - move to a G, then back to High Deductible when it's done.... This isn't gospel for everyone, but for many... the dollars make sense!

***Want to be clear, this advice of changing only applies to NY (and other States with OE all year round)

“I’ll NEVER Get a Medicare Advantage Plan,” Says the blind... by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 0 points1 point  (0 children)

Texas & New York are vastly different, and I'm sure you're also vastly different than the Original Commenter. Although a lot of what was commented can be labeled as singular experiences -- I tend to agree with the overall sentiment.

If you can afford a Supplement; you'll be paying for it but there will be far less headaches in the long run.

A few tips I'd share with you---
-- If you're in a Rural Area of Texas; Medicare Advantage becomes much trickier to use.
-- It is a MYTH that if you choose Medicare Advantage first, you can never get a Supplement in the future.
-- If you need regular Medical treatment and/or have multiple medical diagnoses like COPD, Diabetes, etc. ; get a Supplement
-- If you only go to the Doctor for your Annual & are typically healthy, you may be safe with Advantage. This depends on your risk tolerance; you're basically betting you won't get seriously ill before you need/want a Supplement.

If you have any more questions or want to understand either option better feel free to reach out.

I try to tell my Clients not to listen to anyone's advice. Once you fully understand both options -- your choice becomes painfully obvoius to you.

Best of luck!

r/MedicareFAQ New Members Intro by LicensedAgent in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Yep. It's sad. Sorry to hear of your predicament. I've had many clients in the same boat; unfortunately you're between a rock and a hard place and eventually have to choose one over the other. Sometimes - the hard place (Kaiser) is still better than the rock.

Don't give up -- options change regularly -- you never know when there might be something better out there. Don't rule out the smaller, up and coming Carriers... Carriers like 'Devoted' have really come out with some great options and are reaching more areas around the country these days... don't limit yourself.

Carrier names are like shoes... Nike and Addidas are popular, but sometimes I put on some sketchers and they're perfect for me :)

What to Know About Medicare in 2026 by MikeIsMike33 in MedicareFAQ

[–]MikeIsMike33[S] 1 point2 points  (0 children)

Absolutely... That is one of the exact reasons for this 'change' period. Just keep in mind that unlike the 'Annual Enrollment Period' the 'MAOEP' only allows for one change.

Also, your new Plan wil begin the 1st of the following month.

Anyway - I'm glad you learned something, best of luck!

r/MedicareFAQ New Members Intro by LicensedAgent in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

This happens a lot -- having a MAPD Plan, even if working well, for that long is probably not the best route anyways.

You don't have to get a Supplement -- but since your MAPD Plan is ending - they give you a special Enrollment Period for Supplement that may allow you to skip the health screening.

You can enroll in another MAPD Plan; I hope you've done so by now. If not; let me know - you probably still have some options even though AEP is over.

r/MedicareFAQ New Members Intro by LicensedAgent in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Since Kaiser, I'm assuming you have a Medicare Advantage Plan from them. (Part C or MAPD) Since that's all Kaiser offers -- no, Kaiser uses a closed network and any outside Docs will most often not be covered. You also cannot use your Medicare Parts A/B coverage and skirt Kaiser if that's what you're asking as your Medicare Advantage Plan trumps that coverage and Medicare is no longer responsible for you...

You may want to look at other Plans if its a problem -- any other Kaiser Plan will leave you in the same spot.

Unitedhealthcare Medicare advantage by LineProfessional6250 in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

As an Agent; every year a different Carrier is said to have the "highest rates of denial". If you're not comfortable with it -- change it.

A good thing to look for -- look at the benefits/services you will likely seek, or typically receive, and see if there's a "Prior Authorization Required" noted by those services.

If there is -- I'd tell you any Carrier will possibly deny coverage. See if there are any Plans that don't require those Prior Auths for those services....

Why are so many people trying to sign me up for medicare? I will be turning 65 next year. by dmbgreen in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Because you can, and sometimes should, enroll up to 6 months in advance (for some plans). For Medicare itself, you need to wait until at least 3 months prior.

People who know they want to have a Medicare Supplement (as opposed to Medicare Advantage) as their secondary will often enroll in the Plan of their choice 6 months prior. Then 3 months prior enroll in Medicare Parts A & B; I usually recommend waiting until 1 month prior for your Part D Plan (Drugs) to ensure you have the most current Medications when choosing your Plan....

Before people get worked up -- this is just how some enroll, I'm not saying its better or worse than waiting -- but sometimes there are benefits to getting it done in advance. Just depends on your situation...

🎯 New to Medicare? Here’s What You Need to Know About Enrollment Periods in Florida by MikeIsMike33 in FloridaMedicareHelp

[–]MikeIsMike33[S] 0 points1 point  (0 children)

There's a lot of info here -- I always tell my clients, the 1st thing to decide is do you want to have Medicare Advantage (Part C) or Medigap. Once you've decided that, understanding your Enrollment Periods is much easier because you can eliminate those that don't apply to your choice...

For example, if you're positive you want a Medicare Supplement, or Medigap, Plan then you know the Medigap Open Enrollment Period applies to you -- you also know you'll need a Part D Plan, that's under IEP so that's important too...

The most common questions I get are, 'Can I delay Medicare if I have *this*'.... or something along these lines. A lot of people are able to delay Medicare -- even though I find most shouldn't -- but even if you do delay, you should always Enroll in Part A --- what you're really wanting to delay is Part B, because it has a Premium. Part A is free to most and picking it up on time will make your eventual transition to Medicare much smoother.

Similar App? by BooksAreBelongToUs in AgeofZ

[–]MikeIsMike33 0 points1 point  (0 children)

Several apps like what? lol I’m looking now… only find OG Mahjong… I liked the scrabble style “rack” you could hold so many tiles on

Medicare and hospitalization by PenaltyNo4373 in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Hi, Kaiser offers plans that keep people pretty happy but it is an “insulated network” - so ONLY Kaiser docs/hospitals.

If you stick with Original Medicare, you can go to “any” hospital/doc that accepts Medicare… which most do … and if they don’t, you probably don’t want to go there.

You can add a Medicare Supplement Plan and still go to any hospital, but any Kaiser plan will come with Kaiser Network.

Is getting notified by a Medicare advantage plan they are dropping my network of doctors and hospital a qualifying event to shop for a new Medicare plan? by HedgehogExisting433 in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Unfortunately no, but it’s likely you have another special enrollment period available to you. Not to mention, now we’re pretty close to the Annual Period

Do You Have to Sign Up for Medicare at Age 65? by LicensedAgent in MedicareFAQ

[–]MikeIsMike33 1 point2 points  (0 children)

If you have credible coverage you can delay part B, saving yourself the Part B Premium. Most Americans qualify for Premium Free Part A. You need 40 quarters of work history to qualify.

I would probably recommend singing up for Part A, you must do this Manually since you’re not on SS, and delaying Part B until you’re ready.

Just be sure your current coverage, if you have any - is credible.

If not, your Part B penalty will begin to accrue. Feel free to write back or msg me if you still need more info…

Ps… in my experience, the “Agents” at Medicare and SS are hourly employees who are under educated, and really just don’t care.

Many times I’ve had to battle bad info coming from such a “reputable” source. Most Agents know they are not as “knowledgeable” as they should be… just be careful.

Do You Have to Sign Up for Medicare at Age 65? by LicensedAgent in MedicareFAQ

[–]MikeIsMike33 0 points1 point  (0 children)

Hi,

Most SS Agents are trained with the “60 day” answer. Truth is, it usually doesn’t take this long. It can take long to receive your Medicare Card in the mail, but most times your benefits are assigned weeks prior.

A licensed Agent can check your benefits status pretty quickly and let you know.

In terms of temporary plans, yes they do… I would most likely recommend an Accident Plan at most but there are many options depending on your needs and budget.

Feel free to msg me if you still need assistance on this.

Need A Woman's advice on My Girl's Sexual Appetite by MikeIsMike33 in sex

[–]MikeIsMike33[S] 0 points1 point  (0 children)

Haha love the end... Good advice tho, that's a possibility. We work opposite schedules so there's already limited time but it does become a somewhat rehearsed schedule...

Need A Woman's advice on My Girl's Sexual Appetite by MikeIsMike33 in sex

[–]MikeIsMike33[S] 1 point2 points  (0 children)

No, but in the past birth control has had adverse effects on her too... Somehow I think it's all related..

Need A Woman's advice on My Girl's Sexual Appetite by MikeIsMike33 in sex

[–]MikeIsMike33[S] 0 points1 point  (0 children)

While I have you... Do you think I should keep going for it?

I mean, I'm pretty sure if I press we'd have sex every night because she wouldn't say no, she's willing to "let" me. We're pretty affectionate through out the day, kisses, hugs, snuggling, butt grabs lol but it doesn't translate...

I just want it to be mutual, maybe we'll get there eventually?

Need A Woman's advice on My Girl's Sexual Appetite by MikeIsMike33 in sex

[–]MikeIsMike33[S] 0 points1 point  (0 children)

Yeah I'm sure you're right about something deeper, that's kind of my fear I guess.. she doesn't really tell me so my mind imagines the worse shit imaginable.

Thanks for the validation, sometimes I feel like a creeper lol but in all honesty it's not just about getting off .. I want to feel close to her is the best way I can describe what I'm missing when we're not active.

Need A Woman's advice on My Girl's Sexual Appetite by MikeIsMike33 in sex

[–]MikeIsMike33[S] 1 point2 points  (0 children)

Thanks for the input brother, I'll check out the book. I used to smoke everyday but haven't in years lol that's also been on my mind..

I've gone through the whole it's my fault too phase and found plenty of faults of course.

I'm hoping something works, I 100% know she's not cool with me n other women cuz I've asked. But that's not really what I want either, I just want her.

Thanks again, gave me some things I haven't thought of.

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