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…

"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…

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…

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…

"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…

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…

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…

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…

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…

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…

The Federal Government, specifically CMS, proposed some rule changes for MA plans. We list ten of them in the Medicare Advantage Minute. Your Medicare Benefits 2024: This segment tells us how Medicare will cover laboratory and non-laboratory diagnostic tests. An inquisitive prospective client named Jim has studied legal insurance documents and has …

In the Medicare Advantage Minute: Proposed regulations would mandate that MA agents should tell their sales prospects about Medicare supplement plans. The thought is that this might ease some of the confusion in the Medicare marketplace. In the "Your Medicare Benefits 2024" segment we learn how Medicare covers diabetic services and diabetic supplie…

"CMS Proposes New MA Audit Appeals Process. Don't worry, when it became apparent this was a proposal to benefit MA plans, I baled out very quickly. In "Your Medicare Benefits 2024" we learn how Medicare is likely to cover diabetes screenings and self-treatment meetings. Another rip-roaring contest from Wallet-hub: we learn about the 10 slimmest and…

Randy Carson is temporarily suspended while we recount the sad tale of a multiple cancer victim who is fighting his disease and also fighting his Medicare Advantage plan, those who are supposed to help him get treatment. Just what a cancer patient wants to spend his time and energy doing! In the "Your Medicare Benefits 2024" segment we learn how Me…

In the "Medicare Advantage Minute" we learn what hospitals are trying to do about the tensions created by MA plans. For instance, in a recent year claim denials surged 55% on Medicare Advantage plans! In "Your Medicare Benefits 2024" some of the situations in which Medicare will actually pay for dental work are listed. Medical complications like so…

The message conveyed by this episode is, " Get out while you can!" MA plans are trimming their offerings in order to protect their profitability. The subject of "Your Medicare Benefits 2024": Defibrillators! How does Medicare cover their purchase price as well as installation. Which are the best (and worst) states in which for women to reside? Fina…

In the "Medicare Advantage Minute" an investigation concluded that the vast majority of dental plans attached to MA plans do not meet the standards generally available from employer group insurance. The "Your Medicare Benefits 2024" segment revealed that Medicare will pay 100% of the charges for testing and treatment of Covid-19 (Wuhan Flu). Ransom…

The last portion of this episodes takes a leisurely stroll through the newest in the series: Medicare for the Lazy Man 2025, Simplest & Easiest Guide Ever! There are several new elements and other radically revised sections. The overall effect is to give the book a fresh approach for those who are reading it for the first time while offering additi…

Unfortunately, the dopes in this recording are not aware of that yet. They do present an MA Minute wherein a new official names Medicare Advantage denials as the top revenue priority at Orland Health! In the "Your Medicare Benefits 2024" we learn how Medicare covers "Counseling to Prevent Tobacco Use and Tobacco Caused Disease". Perks of being an i…

Medicare Advantage prior authorization rates keep on climbing! In "Your Medicare Benefits 2024" we read about how Medicare might cover Cosmetic Surery Finally, Bill's wife Susan has hatched a plan to enroll in an MA plan while she is healthy and switch to Medicare + a supplement if she gets sick. Why would it work? They live in New York with no hea…

In the Medicare Advantage Minute, we learn that the Dept. of Justice is investigating United Healthcare billing practices. Billions of dollars of fraudulent government payments suspected for questionable diagnoses. In the "Your Medicare Benefits 2024" segment we learn how Medicare covers CPM (Continuous Passive Motion) and CPAP (Continuous Positive…

Medicare Advantage Minute, content provided by Diane Omdahl: MA plans typically have two caps on out-of-pocket, unreimbursed costs; one on the drug benefits and one on the medical expenses. Your Medicare Benefits 2024: How does Medicare cover Concierge Care? Not at all. How does Medicare cover Continuous Glucose Monitors? Very likely if your doctor…

Backlash in the wake of the murder of Brian Thompson brings out complaints from dissatisfied patients of MA plans. In the "Your Medicare Benefits 2024" segment, Medicare will apparently cover Social Determinants of Health Risk Assessments. We address an article stating that the health industry is bracing for the arrival of RFK Jr. Finally, we have …

The shocking headline in our Medicare Advantage minute: Problems with MA plans keep mounting! Denial of service and slow care approvals seem to be used as methods of profit maximization. The "Your Medicare Benefits 2024" segment takes a deep dive into the specifics of how Medicare covers "commode chairs". Finally, when the IRS tries to extract the …

In the Medicare Advantage Minute, we hear again about all of the negative changes coming to MA plans in 2025. The "Your Medicare Benefits 2024" segment describes the requirements one must meet in order to be colonoscopized on Medicare's dime. I think there is some wiggle room there. New client Tim writes to say that he is convinced that High Deduct…

In our Medicare Advantage Minute, we learn that ten companies are exiting MA markets in 2025. Do you need cognitive assessment? Some say that I do! Read all about how Medicare will pay for that plus care plan services. Finally, I use perplexity AI to provide information to prospects who are considering the purchase of dental & vision insurance. Ame…

Part of the cautionary tale about thalidomide illustrates the fact that Medicare alone is often not enough to persuade doctors to perform non-emergency treatment. In the Medicare Advantage Minute, we learn that: "The Great Disruption is coming for Medicare Advantage"! In "Your Medicare Benefits 2024" we take a brief look at Cognitive Assessment and…

Contact me at: [email protected] (Most severe critic: A+) Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.By Douglas B. Jones, CLU, RHU with Randy Carson of C2C Consulting

In the Medicare Advantage Minute we learn that algorithms used by the big 3 MA companies automatically reject 1 in 4 requests for post-acute care. Your Medicare Benefits 2024 teaches us how the program is likely to cover Chronic Care Management Services, in case you ever need them. In answers to questions from Randy, I explain that the Part D drug …

Enjoy the fascinating story of how the geniuses at Medicare failed to figure out that Medicare Advantage plans have been dodging the claims of their members who also receive treatment at the VA! In "Your Medicare Benefits 2024", we learn how Medicare pays for Children's Kidney Disease and Chiropractic Services. Doug's wife has been a happy client w…

In the Medicare Advantage Minute, we learn: Government Scrapped a MA Rule Over Industry Opposition Let the Billions of dollars in fraudulent payments continue to drain the US treasury! MA plans have managed to drag their feet for ten years after government review of patient records fails to find treatments they thought they had paid for. Check out …

Program note: Pay no attention to the man behind the curtain! This episode was recorded after I endured the "Fungus Among Us" but is presented out of order. References to my disease should be ignored. The "Peoples' Action Network" sounds like the Symbionese Liberation Army. On at least one day last summer they expressed interest in making a health …

In Texas, South West Health Resources is ending their Medicare advantage plans due to "headwinds" from our Medicare Advantage Minute. Your Medicare Benefits 2024 describes how Medicare will cover checkups and testing for female problems. David writes a lengthy paragraph full of questions about how the insurance each of his family members will be af…

According to "Your Medicare Benefits 2024" Medicare will pay to have your cataracts burned off those baby-blues! You might have some decisions to make, though. United Healthcare lost another of their in-network hospital chains in six states: Trinity Hospitals. Finally, a fan of MLM named Lola wrote in with a perplexing question: She is on Medicaid …

In the Medicare Advantage Minute, a hospital chain based in Huntsville, AL and environs parts company with United Healthcare, leaving many former members in the lurch. If you acquire a caregiver (or "caretaker" as I prefer), and that person needs some training in order to perform effectively, Medicare will assist in accomplishing that. In a lengthy…

United Healthcare sues the Feds due to a reduction in star ratings. This trouble started with a single marketing call that went south; probably a secret shopper. Learn how Medicare would cover cardiovascular counseling and screenings. If your doc accepts Medicare reimbursement you will probably pay nothing for these procedures. A lengthy list of in…

In the MLM Medicare Advantage Minute we address the following: "Insurers Brought In $50 Billion Through Questionable Diagnoses!" It's an old story that never seems to end; evidence is that MA plans are fabricating "proof" of the rotten health of many of their clients, thereby earning larger payments from the US Treasury! This is known as "Upcoding"…

In our Medicare Advantage Minute for today we take it to the enemy with, "Medicare Advantage Star Ratings Fall Again!" An excerpt from "Your Medicare Benefits 2024" explains the coverage available for Medicare participants who need artificial eyes or limbs. Evidence of inflation in the health insurance arena: a list of the Medicare plans which have…

Medicare Advantage Minute: Humana's profit prospects dim as star ratings drop off a cliff! Their clients in four+ star rated plans fall from 94% to 25%. The exciting excerpt from "Your Medicare Benefits 2024" addresses Ambulatory Surgical Centers. Finally, a discussion of one source of potential food contamination devolves into a wide-ranging discu…

In the Medicare Advantage Minute we learn that Premera, one of the 54 members of the BC/BS Association, is ending the sale of MA plans. Deep in the pages of "Your Medicare Benefits 2024" we find that Medicare will pay for needed canes as they do for DME (Durable Medical Equipment). White paint is extra. A newcomer named Vince needs advice about how…

We start out with the Medicare Advantage Minute, in which the article stated, "The Medicare Advantage world is facing turmoil!"! If you can medically qualify for a Medicare supplement, it is time for you to dis-enroll from your MA plan, return to Original Medicare and purchase a supplement. I recommend High Deductible Plan G! From "Your Medicare Be…

In the Medicare Advantage Minute segment, we learn: "MA Customers Face A Shrinking Pool of Insurers!" The item for today in "Your Medicare Benefits 2024" is: Bone Mass Measurements, diagnosing Osteoporosis; what are the eligibility criteria and how are these tests covered by Medicare? Stay tuned for an interview with an actual Osteoporosis patient …

Cigna Insurance, on the verge of being acquired by a BC/BS holding company, joins the stampede to scale back its Medicare Advantage footprint in eight states. Would you prefer a blood test to a colonoscopy? I sure would! Find out how Medicare will pay for such a test...if you qualify. How about cataract surgery? Clear up your vision and let Medicar…

In today's MA Minute, we hear about the downside of managed care. That is the part where insurance company accountants manage your care rather than you or your doctors! There is power in those green eyeshades! In "Your Medicare Benefits 2024" we learn about blood, or rather how Medicare will pay for procedures involving blood. Finally, the Social S…

Unlike more traditional escorts, these will see to it that you arrive home safely after a rough day at the clinic. Headline in the Medicare Advantage Minute: Insurers collect billions in dubious Medicare Advantage payments. "Dubious" because many members were reported as having grievous conditions. After payments, MA plans reported no follow-up vis…

The more gold stars a Medicare Advantage plan is gifted by the government, the deeper it is allowed to reach into the US Treasury! On the other hand, a Barium enema can lead to early diagnosis of cancer, so I will take the Barium every time! Finally, we present a short tutorial on how arbitrary and petty Medicare supplement rate setters can be. Con…

In The MA Minute: Medicare Advantage Plans Need More Oversight; Less Overpayment! Do you dream of bariatric surgery? Wonder whether Medicare will pay for it? Apparently it depends on the extent of your obesity. We pay a visit to "Your Medicare Benefits 2024" to find out. ACCENDO, an Aetna subsidiary providing Medicare advantage plans, appears to be…

We lead off with the Medicare Advantage Minute article: "Senate Report Slams MA Insurers for Using Tech to Deny Claims" Three apparent culprits are: United Healthcare, Humana & CVS! In the "Your Medicare Benefits 2024" segment we delve into the exciting world of anesthesia. How is it covered and how much of it is paid for? One of the most confusing…

Ambulance services and, under certain circumstances, even helicopter rides can be provided by Part B of Medicare. This according to the latest government publication: Your Medicare Benefits 2024. In the Medicare Advantage Minute we hear sickening reports of the billions of $$ that have been siphoned off by this program as well as the pathetic effor…

The story on the state of the Canadian system made reference to one Greg Price. He was a 31 year-old pilot from Alberta who was allowed to die in 2018 from testicular cancer due to the ineptitude inherent in their single payer Communist health system. Take a peek back in the crystal ball at AEP 2024. Pundits predicted turmoil and they were right! I…