Best Douglas B Jones Clu Rhu With Randy Carson Of C2c Consulting Podcasts (2025)

1
Ep. 840 - SSA Medicare application processing is apparently being performed by turtles! 35:38

Play Pause

6h ago35:38

35:38

In the Medicare Advantage Minute we hear even more detail about the difficulties United Healthcare seems to be mired in. The Department of Justice is investigating charges of Medicare fraud & anti-trust violations. So what else is new? Your Medicare Benefits 2025: Obesity Behavioral Therapy and how Medicare might cover that if you needed it. Soon-t…

1
Ep. 839 - Mad Magazine joked about Maalox-popping advertising men. No joke now! 33:17

1d ago33:17

33:17

In the Medicare Advantage Minute segment We address the dangers of the "Medicare Advantage Trap" and learn how one should avoid it. The government publication "Your Medicare Benefits 2025" reveals the extent to which Medicare will (or will not) cover nursing home care. Is there an overhaul in the works for prior authorization regulations? According…

1
Ep. 838 - Part D Prescription Drug Plans: fun & games or deadly serious business? 33:31

3d ago33:31

33:31

In the Medicare Advantage Minute segment, United Healthcare cites the murder of their CEO in a move to stifle criticism from the press. Gee, that should make them a lot of friends! In a selection from "Your Medicare Benefits 2025" we learn how Medicare would cover Nebulizers and Nebulizer medications. A couple of valued clients inform me about trou…

1
Ep. 837 - AOC & other Lefties are outraged about United HealthGroup. Finally we agree! 31:18

6d ago31:18

31:18

In the "Medicare Advantage Minute" we hear more detail regarding the accusations about alleged misdeeds committed by America's largest Medicare Advantage insurance company. If the accusations are anywhere close to accurate, this behemoth may be following Arthur Anderson down the drain! In the "Your Medicare Benefits 2025" segment we discuss poop, s…

1
Ep.836 - Would-be client wonders if High Deductible supplement will burden his family! 39:09

8d ago39:09

39:09

Medicare Advantage Minute announces 2019 statistics: 17% of MA claims were denied in that year but of those claims that were appealed, 57% were ultimately paid. In the "Your Medicare Benefits 2025" segment we learn how Medicare is likely to cover Monoclonal Antibodies when they are used for the treatment of early onset Alzheimer's disease. "Early o…

1
Ep. 835 - Medicare Advantage sales agents going hungry? 34:48

10d ago34:48

34:48

In the "Medicare Advantage Minute" we learn that many Medicare Advantage insurance companies have stopped paying sales commissions to agents that sell some of their Medicare Advantage and Part D prescription drug plans. Later in the episode we receive the same interesting news from Blue Shield of California. How does a company expect to sell produc…

1
Ep. 834 - HR3467: nightmare in the making? Freedom of choice would be the first victim! 31:16

13d ago31:16

31:16

Our "Medicare Advantage Minute" reveals a plot to force all Medicare enrollees into the gulag of Medicare Advantage plans for a 3-year stretch. Our new favorite listener, Stalker Susie, has been offered an assignment to evaluate the efficacy of the Kindle version of "Medicare Drug Plans; A Simple D-I-Y Guide!" I sure hope she accepts the offer! Fin…

1
Ep. 833 - UnitedHealth under incredible assault - much like Germans at Omaha Beach! 35:36

17d ago35:36

35:36

Randy Carson returns to share the stories of his Grand Tour of Europe! In the "Your Medicare Benefits 2025" segment we learn how Medicare will handle my eventual need for Mental Health Care (outpatient) after I go nuts one day. In UnitedHealth Group news, the company has announced the cessation of commission payments to insurance brokers for some M…

1
Ep. 832 - Love 'em all but the best 5-star review so far is from a SHIP pro: Cleaning Fairy! 33:44

20d ago33:44

33:44

The Cleaning Fairy, who claims to be a "trained & certified" SHIP advisor, gifted "Medicare for the Lazy Man" with substantial praise, calling it: Comprehensive and clear! In the "Your Medicare Benefits 2025" segment we learn how Medicare would be likely to cover Mental Health Care - Inpatient. How about a list of 13 things one can get free from Me…

1
Ep. 831 - Expensive drugs like Jardiance on your list? Let Medicare for the Lazy Man help! 36:17

27d ago36:17

36:17

In the "Medicare Advantage Minute" we learn that some politicians have opined that MA plans might be overdue for an overhaul! Welcome to the party! The "Your Medicare Benefits 2025" segment teaches us how Medicare is likely to cover Mental Health & Substance Use Disorders. Are you worried about having a medical emergency while you are on vacation? …

1
Ep. 830 - Ignore the speculation about Mr. Reich; he has been invited to the Lazy Zone! 33:07

1M ago33:07

33:07

In the "Your Medicare Benefits 2025" segment we learn how Medicare would cover the Medicare Diabetes Prevention Program. "Stalker Susie" checked in to defend Massachusetts and to join me in lamenting the departure of Durgin-Park restaurant. Having changed directions slightly, Neil Reich and I have come to a meeting of the minds. Since we are sort o…

1
Ep. 829 - Who has 500,000 thumbs and hates Medicare Advantage plans? 250,000 angry, lawyered-up NYC retirees, that's who!! 34:22

1M ago34:22

34:22

In our "Medicare Advantage Minute" we learn about Humana's "cautious defense" of Medicare advantage plans. In a refreshing change of pace, Humana seems to be willing to admit that MA plans have room for improvement. In a related conversation we touched on the ongoing legal action of the 250,000 retirees from New York City who have been engaged in a…

1
Ep. 828 - Each 5 years 50% leave their Medicare Advantage plans; Here are reasons why: 33:32

1M ago33:32

33:32

In the "Medicare Advantage Minute" we examine the four major reasons that members of MA plans tend to move on to different plans after a period of time. Hint: it isn't because they are happy where they are! "Your Medicare Benefits 2025": Mammograms. Enough said. Our favorite Medicare Maven Toni King takes a letter from a reader about a claim that M…

1
Ep. 827 - MEDICARE DRUG PLANS; SIMPLE D-I-Y GUIDE: New tool for everyone to use! 32:34

1M ago32:34

32:34

In the Medicare Advantage Minute: it might be a big fat lie but MA plans are pretending to support some reform efforts. Some have predicted that MA plans could receive as much as $43 billion in overpayments per year for diagnoses not supported by medical records. In the "Your Medicare Benefits" segment we look at how Medicare covers age-related Mac…

1
Ep. 826 - Declaring war on Prior Authorization rules in Medicare Advantage! To arms... 31:05

1M ago31:05

31:05

In the Medicare Advantage Minute we learn how MA plans use prior authorization requirements to help balance the books. This at the expense of patients who are in need of medical treatment for the best opportunity to regain health! Nebraska is taking the lead in the war to make MA plans better for their members. In the Your Medicare Benefits segment…

1
Ep. 825 - Special Edition: PAIN! Fifteen things (two from the hosts) you do not want! 37:51

1M ago37:51

37:51

In the "Medicare Advantage Minute" we enjoy an article entitled: Should you ditch your MA plan? Most people do! If you are tempted to ditch your MA plan, you are not alone! Reported problems include difficulty accessing care, receiving quality care and accessing quality care from specialists. In the "Your Medicare Benefits 2025" segment we learn un…

1
Ep, 824 - Do you like Medicaid fraud schemes? Arizona wins the trophy at $2.7 billion! 33:11

2M ago33:11

33:11

Medicare Advantage Minute was the source of an interesting and welcome news report of the likely agenda items to be pushed by Dr, Oz. As the new Administrator of the CMS he has some ambitious goals, including intensive auditing and collection efforts aimed at each Medicare Advantage plan. In the "Your Medicare Benefits 2025" segment we learned how …

1
Ep. 823 - Missouri genius builds a $54 million dollar fortune in Medicare! Coulda been me! 38:30

2M ago38:30

38:30

In the "Medicare Advantage Minute" we learn about an enterprising gentleman who built a Medicare empire. He provided services for which he was able to bill the government over $174 million. Then the police came calling. On to "Your Medicare Benefits 2025" where we learned how Medicare is likely to cover Long Term Care. How might the "Big Beautiful …

1
Ep. 822 - A turbulent month for...the largest health insurance company in the USA 36:23

2M ago36:23

36:23

Accused of several despicable acts of malpractice, May has been a rough month for UnitedHealth Group. It is suffering a drop in stock value, reduced earnings projections and a loss of confidence. One of the many accusations includes pressuring or bribing 2200 nursing homes to refuse the transfer of patients to hospitals, thereby saving the company …

1
Ep. 821 - Healthy woman drops Medicare to save $250/month; now has deadly condition! 33:50

2M ago33:50

33:50

My client had the best Medicare insurance available at a very small cost, but decided to drop Part B and her Medicare supplement for over a year while waiting for Social Security enrollment. Bad move! She has been diagnosed with atrial fibrillation. She now must wait until next year to re-enroll in Part B and she may never qualify to get her great …

1
Ep. 820 - TRIBUTE TO MASSACHUSETTS (with a single-fingered salute to BC/BS MASS)! 38:29

2M ago38:29

38:29

We started out with the Medicare Advantage Minute during which we learned that the "Final Rule" for MA and Part D drug plans for 2026 has been published. Learn 14 (or fewer) exciting things about what the future holds for those plans. In the "Your Medicare Benefits 2025" segment we learn exactly how Medicare would cover Kidney Disease Education. Th…

1
Ep. 819 - What is 6% of 50 million? Recent Medicare Advantage prior authorization refusals! 36:06

2M ago36:06

36:06

The Medicare Advantage Minute segment once again illustrates the fact that very few appeals were filed by MA victims of prior authorization refusals. However, the majority of those appeals resulted in reversals of the denials! In "Your Medicare Benefits 2025" we learn how Medicare covers insulin, including the newly created $35 monthly out-of-pocke…

1
Ep. 818 - A potential client asks ,"Doug, what is your fee?" Who knew I could charge a fee? 32:01

2M ago32:01

32:01

In the Medicare Advantage Minute we (again) read that Dr. Oz plans to scrutinize Medicare Advantage plans to make sure they don't continue to pursue the underhanded tactics, like "upcoding" that have allowed some of them to loot the US Treasury for year after year. In "Your Medicare Benefits 2025" the topic of the day is Inpatient Rehabilitation Ca…

1
Ep. 817 - $260,000 bill but only $39 out-of-pocket? The power of Medicare supplement! 35:21

2M ago35:21

35:21

In the Medicare Advantage Minute, "Another Health System Scales Back Its MA Plan" which will leave Vermont and surrounding New England states with fewer MA plan options. In "Your Medicare Benefits 2025 we learn how Medicare covers inpatient hospital expenses. Finally, we have a look at the Big Beautiful Bill. In particular we review four elements t…

1
Ep. 816 - Dr. Oz has lots of freedom-loving people worried. What will he "scrutinize" first? 32:14

2M ago32:14

32:14

In the "Medicare Advantage Minute" segment we learn a little about what Dr. Oz may prioritize when he assumes command of his little corner of the bureaucracy. How about some oxygen? Hyperbaric Oxygen Therapy is the subject of "Your Medicare Benefits 2025". Finally, have you ever needed to visit a hospital emergency room? Did you wind up leaving in …

1
Ep. 815 - News story starts: REVEALED: UNITED HEALTHCARE... You'd better strap in! 33:34

2M ago33:34

33:34

In the "Medicare Advantage Minute" we have an item detailing a series of accusations about UHC having planted "operatives" in nursing homes. The goal was to dodge big medical claims by manipulating treatment and stopping hospital transfers. Yet to be determined whether there was any collateral damage. On a lighter note, we visit "Your Medicare Bene…

1
Ep. 814 - Want to become my most favorite client in the whole wide world? Just listen... 32:14

2M ago32:14

32:14

In the Medicare Advantage Minute we hit the high points in an article entitled "Medicare Advantage So Far: Five Things To Know!" The bottom line was a bunch of MA plan representatives whining about what they think was a niggardly increase in their payment schedule from the Treasury. In the "Your Medicare Benefits 2025" segment we have a very short …

1
Ep. 813 - Medicare or MA: Which is best? Answer: Medicare + a Medicare supplement! 32:50

2M ago32:50

32:50

In the "Medicare Advantage Minute" we go through news article reporting that the majority of MA members are confused. It had some other negatives to report about Medicare Advantage as well In "Your Medicare Benefits 2024 (or maybe 2025)" we learn exactly how Medicare covers in-home hospice care. Contact me at: [email protected] (Most severe critic…

1
Ep. 812 - Weight loss drugs: Medicare limits and market demand on a collision course! 31:12

2M ago31:12

31:12

Patients with Medicare Advantage insurance coverage: rural hospitals are asking themselves whether they can afford to keep accepting them! This is the subject of our "Medicare Advantage Minute" today. In "Your Medicare Benefits 2025" we learn how Medicare would cover home infusion therapy services. Then we spot check some rate increase statistics i…

1
Ep. 811 - Stuck in expensive Plan F? Pricey Plan G? Maybe a new Birthday Rule can save you! 33:37

3M ago33:37

33:37

In our MA Minute we scan the article: Medicare vs. Medicare Advantage; Ill health often leads to a plan switch! Bottom line: if one gets sick, one begins to see how MA plans can cause misery! In today's "Your Medicare Benefits" we learn how and when Medicare will help with Home Health Services. Client Robert from Virginia is unhappy with the level …

1
Ep. 810 - High Deductible Plan G (HDG): the very best Medicare supplement of all! 31:45

3M ago31:45

31:45

In the Medicare Advantage Minute" we hear news about seven prior authorization updates from various locations. Since prior authorizations are a big problem with MA plans, this could be good news for the improvements these plans sorely need! In the "Your Medicare Benefits 2024" segment we find out how Medicare might cover HIV screenings. What follow…

1
Ep. 809 - Serious consideration: Should we invite another Medicare maven to the inner sanctum! 38:22

3M ago38:22

38:22

My appearance on a Phoenix radio show led to a brief expression of admiration for another guest's revised professional opinion. That, in turn, confused the hostess who expressed consternation that one would make reference to some other guest. Go figure. I expect an invitation will be issued soon to my new best friend! Meanwhile, in the Medicare Adv…

1
EP. 808 - Part D drug plans: We take a peek into the future...what is likely to happen to them? 37:27

3M ago37:27

37:27

The Medicare Advantage Minute is pre-empted so that we can spend the time examining the current state of Part D Prescription Drug Plans (PDP). We also do some speculation about the economic pressures facing these plans and what changes might be necessary for the year 2026. In the "Your Medicare Benefits 2024" we learn the eligibility requirements a…

1
Ep.+807 - Medicare Advantage plans are evil. So why are we increasing their payments? 33:36

3M ago33:36

33:36

After a spirited history lesson that finishes our Axis Sally hunk, we enter the "Medicare Advantage Segment". There we learn a little about part of the basis upon which payments by the Federal Government are made to the MA plans. In the "Your Medicare Benefits 2024" segment we are treated to a very complete explanation of precisely how Medicare rei…

1
Ep.+806 - GOP regretting a creation: Medicare Advantage plans need to be crushed! 38:51

3M ago38:51

38:51

First order of business today is a history lesson: Axis Sally gave her last propaganda broadcast this date in 1945. In the Medicare Advantage Minute we learn good news: Republicans are waking up to the reality that MA plans are turning on Medicare participants like rabid dogs! How will Medicare cover Hearing & Balance exams? Find out in today's seg…

1
Ep. 805 - $queezing billion$$ more from the US Gov't. Gee, who do you suppose would do that? 33:24

3M ago33:24

33:24

Medicare Advantage Minute: MA plans are the ones squeezing more billions of dollars from the US Government. In the "Your Medicare Benefits 2024" segment, we learn how Medicare would cover Health & Wellness Education Problems A review of some insurance company rate increase filings (requests) as reported by several states seem to indicate that infla…

1
Ep. 804 - Gym memberships & fitness programs: covered benefits under Medicare? 33:53

3M ago33:53

33:53

Interrupting a lengthy run, our usual kick-off feature has been temporarily suspended: No Medicare Advantage Minute article warning new Medicare eligibles about the dangers of MA plans. In our other regular segment we learn how Medicare might cover Gym memberships and fitness programs. Possibly the shortest segment in "Your Medicare Benefits 2024" …

1
Ep. 803 - Best kept secret in Medicare: enjoy hearing a highly skilled expert struggle to explain it! 32:30

3M ago32:30

32:30

In the "Medicare Advantage Minute" segment, our article of the day has a headline that reads: "The Decline of PPO in Medicare Advantage". When times are tight, MA plans reduce the number of plans with the greatest freedoms. This leads to a discussion of the greatest Medicare supplement plan ever created: High Deductible Plan G. A combination of the…

1
Ep. 802 - Trump to Oz: "Love & cherish Medicare". Instead, target fraud, waste & abuse! 35:01

3M ago35:01

35:01

Article headline featured in Medicare Advantage Minute: Doctors say, "Dealing with Health Insurance is only getting Worse"! The sad story of an ophthalmologist who was driven to despair and forced to sell his practice in order to cope with the extra work caused by insurance requirements. In "Your Medicare Benefits 2024" we learn how Medicare is lik…

1
Episode 801 - Are we about to get OZed? ...or will the enemies of Medicare Advantage prevail? 34:59

3M ago34:59

34:59

Lots of chat about Dr. Oz and his plans for the future of the Centers for Medicare & Medicaid Services. Unfortunately, the articles I prepared fell into what might be a bottomless pit. In the Medicare Advantage Minute, Democrats sent a nasty letter to Dr. Oz questioning his support for Medicare Advantage and criticizing his substantial holdings in …

1
Ep.+800 - Answer: Dr. Christian Bernard in the Conservatory with the Lead Pipe. Ignore DeBakey! 36:55

3M ago36:55

36:55

During the prelude to our "Medicare Advantage Minute" segment, I erred in identifying the surgeon given credit for the first heart transplant, which was performed in South Africa. Eventually, our subject centered an article with the headline: "Insurers Brace for Continued Medicare Advantage Medical Costs" which was abandoned due to being out of dat…

1
Ep. 799 - Hey Tubby! Would you like to drop a few pounds? Maybe Medicare can help! 35:16

3M ago35:16

35:16

"Health Systems Brace for More ... Uncompensated Care" - Medicare Advantage Minute "Fecal Occult Blood Test Screenings" "Flexible Sigmoidoscopy screenings" - Your Medicare Benefits 2024 The rest of this episode is dedicated to those with body mass indexes over 30 and health problems related to excess weight. Medical science has started to provide p…

1
Ep 798 - Had AETNA while working, docs liked it; I want AETNA Medicare Supplement! 31:14

4M ago31:14

31:14

Medicare Advantage Minute: MA in the headlines...10 recent updates! Your Medicare Benefits 2024: Are routine eye exams covered? How about with diabetes? How about with macular degeneration? How about some correspondence from clients? Brian wanted some details about the Medicare supplement application process. One important fact is that the insuranc…

1
Ep 797 - MA plans brag about their free extras; studies show those freebies often go unused 34:30

4M ago34:30

34:30

In Medicare Advantage Minute: we learn about a prestigious study conducted in Boston. The results showed that patients with MA have out-of-pocket expenses that are very close to those with Medicare supplement coverage, in spite of all the crowing about additional free benefits. In the "Your Medicare Benefits 2024" segment we learn how Medicare cove…

1
Ep. 796 - $257K up to $543K annual income: Which medical specialty would you study? 34:16

4M ago34:16

34:16

"10 Key Questions Facing Medicare Advantage" is the subject for our Medicare Advantage Minute. More trouble ahead? This is the reason we spend time in every episode warning listeners of MA plan dangers! In "Your Medicare Benefits 2024" we learn about how Emergency Department Services are reimbursed by Medicare. As usual they ignore the fact that my…

1
Ep. 795 - UP-CODING! Sounds like fun until you wind up on the wrong end of a $100,000,000 settlement! 33:58

4M ago33:58

33:58

A whistleblower snitched on an allegedly cheating MA plan, leading to a huge negotiated settlement, in our Medicare Advantage Minute. EKGs, ECGs and how Medicare covers them is the subject of our tribute to: "Your Medicare Benefits 2024" The balance of the episode is given over to an analysis of the recorded and requested Medicare supplement rate i…

1
Ep. 794 - Skip Plan G; Buy High Deductible Plan G (HDG) & enjoy the monthly savings! 35:18

4M ago35:18

35:18

Medicare Advantage Minute: MA stocks soared following the 2024 election. The implication is that the new administration is more friendly to the evil Medicare Advantage plans. I am not convinced that is true and I have faith that Medicare supplement plans will remain available for responsible, discriminating Medicare participants! DME: Durable Medic…

1
Ep.+793 - Relax Texans! SWHR and BC/BS of Texas are together again! 32:55

4M ago32:55

32:55

The Medicare Advantage Minute points out more trouble for Medicare Advantage plans. Hospitals have seen increasingly aggressive denials of payments with every expectation of more denial pressure to come! In Your Medicare Benefits 2024 we learn how Medicare covers doctor services. No secret, their fees are Part B expenses. Finally, we hear from Lind…

1
Ep. 792 - When it comes to being celebrated; I'd rather be a nurse than a doctor! 36:13

4M ago36:13

36:13

The government has proposed more crackdowns on Medicare Advantage marketing and agent payments. We list these proposals in the Medicare Advantage Minute. In "Your Medicare Benefits 2024" we learn how Medicare is likely to cover kidney dialysis services and supplies. Then we present an editorial that compares and contrasts the annual celebrations th…

1
Ep. 791 - CORRECTION: SWHR and BC/BS of Texas have kissed and made up! 33:48

4M ago33:48

33:48

Medicare Advantage Minute: The Feds propose "health equity" mandates that will address a couple of the worst elements of MA plans...for poor people only! What about all of the non-poor victims of Medicare Advantage plans? In the "Your Medicare Benefits 2024" we learn all about kidney dialysis for children. These victims of ESRD (End Stage Renal Dis…