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@…

Medical costs were lower and more affordable before the heavy hand of government created a perpetual drain on US prosperity. It should never have been approved and it should be pared down before it does even more damage to our economy. Also, Enjoy correspondence with clients. One states, " You were right...". Another has several meaty questions abo…

If you purchase HDG, historical trends suggest that your premium savings will grow larger and faster in the coming years! How does Medicare treat claims for your colonoscopy? Finally, our MA Minute features the article: Medicare Advantage - a $104 billion scam! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR TH…

The "Trap" is sprung when a disappointed Medicare Advantage victim tries to escape to Medicare Parts A & B. Eventually, it is determined they can't qualify for a Medicare supplement to complete their health insurance protection. Also, a major Medicare Advantage carrier will not pay bonuses for agents to pester their clients to fill out HRAs (Health…

A new Medicare participant has one critical choice to make: Advantage plan or supplement plan? The Medicare supplement wins, hands down! Also, research has exposed some fundamental differences in the characteristics of those who select Advantage plans vs. those who purchase supplement plans. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+…

The government has been conducting "secret" audits of Medicare Advantage plans to measure the amount of overpayments siphoning off your tax dollars. Finally, test your knowledge of basic Medicare facts as we run through a quiz of 12 frequently asked Medicare questions. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICAR…

If you need a transplant and want to have a say in your surgical team plus your recovery facility, you had better avoid a "Managed Care" plan like Medicare advantage! .Find out how much a house call cost my father-in-law (and my parents) back in the last millennium. A chart purporting to show the average cost of a day in a hospital in each state ac…

Gee, how surprising is that? Also, a very nice non-client wonders whether she and hubby were granted a deserved "12% Household Discount" from their Medicare supplement company. Finally, a new client credits my book plus Suze Orman's Podcast for her "Kick Butt" Medicare knowledge. Just a few questions remain to be answered... Contact me at: DBJ@MLMM…

How about a clash of the Titans? Omaha's own Warren Buffet was gifted a McDonald's Gold Card, good for a lifetime of free eats at any McDonald's in his home town. In contrast, Bill Gate's Gold Card is good anywhere in the world! Amazon is expanding it's $5 monthly pharmacy benefit with a limited formulary. It won't beat this year's most popular Par…

Reading the smoke signals, it's starting to look like increasing costs and decreasing benefits will be on the MA menu for next year. Keep an eye on Humana and CVS. Inflation watch: Fierce Health says that many hospitals are operating in the red in spite of higher revenue. Finally, graphic proof that my recommendation of High Deductible Plan G has a…

Your government has spent considerable time and resources devising games to use as training tools for those working with Medicare. The least you can do is pretend to enjoy the fruits of their labors! Also, we haven't forgotten about the Medicare Advantage Minute! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR …

In each episode there will be a short piece describing a noteworthy element of the MA world. As I always say, a Medicare Advantage plan is just fine until one actually needs to use it! Medicare Supplement Plan G shows a trend toward higher rate increases while an example of a High Deductible plan G increase is about $1 per month for one particular …

It always ends with your lawyer making sure your wishes are legal and properly communicated. How does one get started? Look for and download the simple but thorough questionnaire we describe in order to get things rolling in a painless and organized way. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY …

Correspondence with clients; They come up with some of the darndest things! 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 leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.…

Abrupt exit leaves 30,000 members scrambling to find new insurance next year. The smart ones will take advantage of Guaranteed Issue Rights and purchase Medicare Supplement plans! BC/BS of Illinois abruptly stops paying commissions on 3 Medicare Advantage plans in three of their five state BC/BC companies. What gives? Finally, we list eight things …

This is my favorite part of the job! Medicare is a complex set of circumstances no one source can anticipate all of the questions that will occur to those who enroll. Curious and thoughtful clients often come up with a wide range of questions; loose ends that are best neatly tied up at the conclusion or our business together. This is my favorite pa…

Enjoy the fun as I quiz Randy on these basic Medicare facts and then neglect to keep score! 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 leave a short customer review & help future readers. Official website: https://www.MedicareForT…

The world of MA plans appears to be entering a period of turmoil and pressure for change from outside sources. Will they be able to maintain the level of growth they have been enjoying in recent years? Also, new client Dean speaks very highly of the affordable and high quality state of health care in Panama! Contact me at: DBJ@MLMMailbag.com (Most …

Check out the average earnings of 40 medical specialties. Do they really earn their compensation? Should that compensation be even more substantial? First, find out why Trinity Health has taken a stand against insurance giant UnitedHealth in a fight for their financial survival. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by…

A highly respected Medicare expert stops short of guiding his client to the best, most money-saving plan available. Also, check out the many absolutely free preventive services offered to women under Medicare. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on …

Great news: the dopes promoting Calcare, Canadian style single payor plan in California have had their posteriors handed to them! How about those anti-aging drugs they wanted to give to little kids? 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.…

The growth in Medicare Advantage enrollment is in large part due to retirees who have been promised lifetime medical insurance being forced into MA plans; sometime against their wishes! Do you in an insurance agency with 15 warm bodies hanging around? If so, get ready for your new, government mandated non-discrimination czar! Contact me at: DBJ@MLM…

MA carriers are bracing for tough times; CVS says it is willing to say good-bye to 10% of their members. A basic primer: What does Medicare NOT cover? This includes a note about MA plans accused of denying medically necessary treatment for patients that would be treated without question under original Medicare. Contact me at: DBJ@MLMMailbag.com (Mo…

MA plans are preparing to undergo financial stress in coming years. This may cause them to cut back on the extra benefits some of them include. One carrier was cited as choosing "(profit) margins over (adding) membership"! Enterprising insurance agents in Utah may have devised a clever way to excuse rate increases to their clients: blame them on th…

RSV stands for "Respiratory Syncytial Virus". We wade into a description of the disease plus some information about the vaccines. Finally, what American sport draws its players and fans from the older ages than any other? PICKLEBALL! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & …

According to our first article, Plan F is Changing from a Cadillac into a Yugo! The prognosis is even worse with many large rate increases just ahead. A widowed acquaintance asked me for help just days after her husband (my old friend) suffered an untimely death. Instead of taking my advice, she ignored my warnings and allowed herself to be victimi…

As an example, Humana is planning to terminate plans in some areas, citing the fact that rising costs are squeezing profits. Question: can an employer force an employee of it's plan and on to Medicare? Walmart decides to close all of its 51 medical clinics. Finally, we review the mental health benefits offered by Medicare. Contact me at: DBJ@MLMMai…

We list six signs that indicate the imminent need for hiring home health care aides. After that list, consulting the "What's covered" app tells us whether and to what extent these services are covered by Medicare. Also, learn about three big changes coming to Medicare in 2025! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: …

We have some fun answering a listener question about physical examinations with the help of the "What's Covered" iPhone app. Get your Crayons & construction paper ready to take notes: we list 13 of somebody's idea of the best retirement podcasts. Finally, the definition of "old age" moves from 71 up to 74. Damn, I'm still a loser! Contact me at: DB…

One of the concerns with AI is that it will replace caring medical professionals. A visitor to the website used the (soon to be removed) chat feature to ask if his state allows insurance companies to off High Deductible Plan G.. One problem: I have no idea where he or she lives! Finally, nationwide troubles with Medicare Advantage plans have caused…

Long term stays in skilled nursing facilities: what happens when Medicare payments peter out? One course of action is to appeal to Medicare for relief from the payment denial. We list the steps in the appeals process. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Inspired by: "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ev…

Also, a medical expert expresses his opinion on the value of colorectal screening for older people. ESRD: end stage renal disease, finally accepted by MA plans although Medicare has a bunch of special rules surrounding the transplant process. Benefit changes, acquisitions and divestitures; do we see turmoil coming in the near future for Advantage p…