Medicare Supplement Plan G vs Medicare Advantage: What's the Difference?

This is the Truth Network. Welcome to Finishing Well, brought to you by CardinalGuide.com with certified financial planner Hans Scheil, best-selling author and financial planner, helping families finish well for over 40 years. On Finishing Well, we'll examine both biblical and practical knowledge to assist families in finishing well, including discussions on managing Social Security, Medicare, IRAID, long-term care, life insurance, investments, and taxes.

Now, let's get started with Finishing Well. Welcome to Finishing Well with certified financial planner Hans Scheil, and today's show. Medicare Supplement Plan G versus Medicare Advantage. What's the difference? And really, kind of for such a time as this, because as we're entering the annual enrollment period, a lot of people are like, oh, I got to do something.

Well, a great time to listen to this finishing well episode because there are some differences. Really, really, really helpful. And as I was thinking about this, Um in the book of Nehemiah, which is just a An amazing book altogether. You may remember that he came back to Jerusalem. They needed to rebuild the temple, but they also the walls were broken down so they couldn't protect their people.

And rather than just running out there with a bunch of spackle, you know, and again, insurance is kind of like walls in its own way and need protection, but rather than just running out there with a bunch of spackling rocks to start fixing things. It says in Nehemiah 2.11 that he he went out at night and inspected the damage first. In other words, he was looking into what are my vulnerabilities. Where is it that I need to be short up? And so when it comes to Medicare, Um Advantage or Medicare supplements or those kind of things.

It's extremely important to me to look at my vulnerabilities because I have vulnerabilities personally. I have them in my health. I have them in the prescription medications I'm on. I have vulnerabilities financially. Like, oh my goodness.

And so that's what insurance is for. But it's also insurance when I get bad sick, not just like if my health is good. But what happens if something tragic happens?

So all those things are. Or You know, out there for us to think about as we process this particular episode because these choices. Are huge and they can come with penalties and things, and so it's important to know what you're doing. Yeah. Certainly is.

And you know, it's September now. And so we're about a month before. the annual enrollment period. or as they with the acronym they say AEP. which consumers don't know what that means.

But It's that time of year, it's Medicare season. It's coming up October 15th to December 7th. And all you got to say is Medicare. Yeah, and everybody that's on Medicare all you know, 70 million people or whatever. whatever that number is.

they're all kind of freaking out and they're saying, you know, Well, I think I know what it is, but... If you really sit down and I have a conversation with them. they're going to make about a 60%. On the 10 question quiz. Or see what that means, what you can and can't do.

What you have to do. What you can't do During October 15th to December 7th.

So that's kind of what this video is about. Yeah. The title, you know, Medicare Supplement. Plus it Plan G. Versus Medicare Advantage, what's the difference?

Well, the very first thing I want to get across to everybody listening That there is a difference.

Okay, so You are if you're on Medicare You are either on original Medicare And then you've purchased a supplement. or a Medigap plan. that works with your original Medicare. And You're on a Medicare advantage. And then if you're on a Medicare Advantage plan, you don't have a supplement.

So you're in you're in one camp or the other camp? Yeah. If I lost you at this point, We need to work on that first.

Okay, and so I'm going to move on because I'm going to think that most people know. Which camp they're in?

Okay. But if you don't. then you need to find that out just about as quick as you can.

Now So What is the difference? It's a lot. I mean, with Medicare, original Medicare Part A and B. You get that from the government. I mean, the government, the division of the government within health and human services.

And then Medicare. But Dr. Oz is now currently the Pad of Medicare. Um He's a doctor as well, but I mean, if you're getting your Medicare A and your Medicare B. directly from the government.

And it has big holes in it. as a big deductible. We had this on the video that goes with the show. The deductible is um Um seventeen hundred and thirty six dollars For a hospital stay.

So original Medicare, if you're on that. You're not on a Medicare advantage. Thank you. You're on original Medicare, you go to the hospital. You pay the first one thousand seven hundred and thirty six dollars.

And then Medicare pays the entire rest of your hospital stay. If it was a hundred thousand, if it was three hundred thousand, it was fifteen thousand. Doesn't matter. You pay is $1,736. to get into the hospital.

And then if you have a Plan G supplement, Your plan G supplement pays that $1,736 for you. That's what you have, Robbie. Yeah. So you can go in the hospital. and your cost for being in that hospital between original Medicare and the supplement for zero.

Okay, have I got you you got me so far? I not only have you, I've experienced it on more than one occasion to know that since I am on original Medicare. And I do have that large You know, deductible.

However, my supplement. Plan G, it pays that And as the case was, and I had an extremely large bill earlier this year, and it was zero. I did have to pay for my annual Deductible That $100, what is it, $150 or something at the beginning of the year. But other than that, as far as going into the hospital, that's all that was involved.

Okay, so now we've covered the original Medicare. And the supplement. But for the other half of you listening. You might not be on that. You might be on a Medicare Advantage plan.

All right. Or you might be thinking of going on one. And it's the Medicare Advantage Plan. that we're messing with during this Medicare season. October 15th to December 7th.

During This season With time coming up. You can enroll in a Medicare advance plan.

So if you want to go to one of these. We can do it during those seven weeks. If you're already on one. But you want to change to another one. You can do it during these seven weeks.

And if you're already on one. But you want to leave it. And go back to original Medicare and buy a supplement. You do that during these seven months. But for you, Robbie, you're on original Medicare, you're back in the first camp.

And you've got a Plan G supplement. You can change your Plan G supplement. to another company And you just did that, by the way. Yeah, I just did that in August. Right.

365 days a year. Because the government The government regulates that, but not in the same way. The annual enrollment period does not apply to your suffering.

Okay. So Just to start out the video, and I started down going over original Medicare a little bit. You gotta decide what camp you're in. And even just listening to this radio show And now we're going to compare the two camps.

Okay, and we're just going to start down, and this is going to go past the break, and then we're going to have the break, and then we're going to spend the second half of the show. Getting down to the comparison. all the way of the of the two camps.

So Moving on. Is let's say you stayed in the hospital on original Medicare longer than 60 days. It doesn't happen very much, but it could. Is beginning the sixty-first day You have a $434 a day. Essentially co-payment or deductibility.

So if you stayed in there for thirty more days. After your first sixty You gotta pay $434 a day if you didn't have a supplement. But guess what? The supplement pays the whole 434 a day.

So again, you're paying zero. And then from the 91st to the 150th day. You got an $868 a day. The doctor bowl. On original Medicare.

So now you're in the hospital 150 days, which is not a lot of people. But if it happened... Understand, an original Medicare and you had no supplement, you're out a lot of money. And then The supplement indemnifies you totally.

So 150 day hospital stay. Between original Medicare and the supplement. Your out of pocket is zero. and I got one more step to take up the stairs. If you were in there more than 150 days.

Okay, Medicare pays nothing. We're going to answer that. That's a big thing with the Medicare before they're looking at that and they say What if?

Well, first of all, it's very rare. But this is another reason you need a supplement. Because the Medicare Supplement policy, Plan G, yours, Robbie. Pays All costs that Medicare would have paid. for another 365 days.

So so now you're in the hospital five hundred and fifteen days. Yeah, I I don't know the statistics on that, but I don't I don't I don't think it exists.

So Between a route. where I was in there well over 60 days.

So I can relate. I saw what the hospital bill was. I was not on Medicare at the time. Thank goodness. God took care of it all in some way, and I'm here today with you, but I can assure you that it's not.

out of the question. that certain types of infections or whatever, I had a brain abscess. And that caused me to, and again, they're not going to let you out of the hospital if you have a brain abscess. And they're going to get it under control or you're not going to be around. And so that just leads to that kind of thing.

And good time to remind you that the show is brought to you by Cardinal Guide, CardinalGuide.com. And if you go to CardinalGuide.com, you're going to see very prominently the seven worries. And the one we're talking about today is actually Medicare. And so you click on that and you're going to find a show with this exact same title of, you know, Medicare Supplement Tying G versus Medicare Advantage. And there they have the board that Hans is talking about.

With these financial examples right there where you can see them. They've got show notes, all sorts of more resources there. It's all there under, again, Medicare, the Seven Worries tabs at the website, as well as Hans's book. Complete Cardinal Guide to Planning Foreign Living and Retirement and the Workbook that goes with that. And of course the Very easy to reach contact page where you can, of course, contact them and get some direct answers based on your vulnerabilities.

Again, the contact page at cardinalguides.com will be back with a whole lot more Medicare Supplement Plan G versus Medicare Advantage. What's the difference? Investment advisory services offered through Brookstone Capital Management LLC, abbreviated BCM. a registered investment advisor. BCM and Cardinal Advisors are independent of each other.

Insurance products and services are not offered through BCM, but are offered and sold through individually licensed and appointed agents. Cardinal Advisors is not affiliated with or endorsed by the Social Security Administration or any other government agency. Welcome back to Finishing Well with Certified Financial Planner Hans Scheil and today's show is Medicare Supplement. Plan G versus Medicare Advantage, what's the difference? And So going on from there, Hans.

Yeah, so we in the first part of the show we talked about original Medicare. and a supplement, we got all the way through Part A.

So now we move to Part B. quickly and part B is your medical outpatient.

So when you would go in the hospital for a long stay, the whole hospital bill would be covered under Part A. But the doctors that are coming to see you. Good now.

Okay, so when you went into the hospital earlier in this year, I'm sure your doctor bills were. in the tens of thousands of dollars. Those were covered differently than your hospital bill itself.

Okay. They'd be under Part B. In Part B of Medicare, Now we're not talking the supplement here, we're just talking original Medicare. has an annual deductible of $283.

So you had met that two hundred eighty three dollar deductible earlier before your accident.

So that didn't come into factor here. Right. One time a year you got to pay the first two hundred and eighty three bucks. And here's the deal. The Plan G supplement doesn't cover them.

So that's the one expense. that the Plan G doesn't cover is the first 283 bucks.

Okay. Now After that's paid, Medicare pays eighty per cent. of your bills.

So let's just say your doctor's bills when you're in the hospital, we're twenty grand.

Okay, so you take the twenty grand times eighty percent. Original Medicare Paid. sixteen thousand dollars Two. I'm sure they were more than that, but just for the example, they paid $16,000 to the doctor.

Okay. And then your plan G supplement. Paid $4,000. to the doctor. Giving you a total of $20,000.

So you're out of pocket again with zero.

Now that's how good the coverage is. Between Original Medicare and then a plain G supplement.

Now we're going to shift. and talk about a Medicare Advantage plan. Yeah, the first thing I'm going to tell you. Because they're all different.

Okay, so so like if you're in Winston-Salem you would have an opp a choices at least with us of United Healthcare, they probably got five or six plans. uh going. Heavanna, they got five or six plans. Etna. They got five or six plans.

I could keep going. Signa. They got two or three plans. whale care, or as you call it, whale care. They got two or three.

I mean, you've got a whole bunch of Medicare Advantage plans. They're very similar, but But they're all different.

So when people talk about, oh, I'm going to compare all these. And I'm going to pick the best one for me. Yeah, good luck with that. Um But Nonetheless. A lot of people just end up with one of them.

Okay, and I'm going to get into why that is. Later, but for the purposes of the video that we ran, which you can find on YouTube or on our website. We used a United Healthcare plan.

Well Yeah. Will you In your hospital, if you'd have been on this. You'd have had to pay out of your pocket $550 a day for the first five days.

Okay. So you would have had an expense. of 2,500 bucks plus a little bit. that you would have to probably pay to the hospital. when you're checking out because They're in cahoots with the Medicare Advantage plan.

They know which one you have. and you have a daily deductible of 550. And when you stayed longer than that, Sounds good. It's all costs are covered. Um Then you would have co-payments.

And your co-payments would have been when the doctor came to see you. You know, you would have a twenty dollar co pay. in the hospital. When they did the surgery Perhaps you'd have had a $100 or a $200 copay. They're not real big, the copayments.

That's what people tout with these things. is that maybe collectively You would have owed. you know, maybe a cut another couple thousand dollars. In co-payments out of that state, so it's not terrible, you would have owed. We just guessed at a couple thousand dollars of co-payments.

for this big hospital stay and then About $2,500 for the daily deductible in the hospital, you would have owed somewhere around five grand.

Okay. which is not the same as owing 283 bucks. Right, plus the ambulance bill.

Okay. Yeah, well you get into ambulance spills. That's you know, that's a horse of a different color.

So I don't really want to get into the details. I'm just trying to explain. Fundamentally the differences between the two. But here's what I'm going to tell you is The 4,500 bucks or the 5,000 or the zero example. is not the whole reason.

you're going to use to make the decision.

Okay. It's part of it. And the way I've just explained it is people are like sign me up for original Medicare in one of those plan jeeps.

Okay. Yeah. I can see why. But remember, when you're on the Medicare Advantage side, You're not paying. I mean, your premium for your Medicare supplement is about $150 a month.

Is that? Yeah, this right.

Okay. So you're paying $1,800 a year for this supplement. And if you were over on the Medicare Advantage side, your your premium would be zero in a lot of cases. You you are saving money by being over there. And then you're getting some extra benefits.

If you were there, Dental and Vision and you know they have food programs and you can listen to Joe Namel. Talking about all that stuff.

Well But By and large, comparing how they pay when you're sick. is only part of the equation. And what I really want to talk about Yes. What's the difference? That you would have gone through.

I mean, first of all, you were sent to the Big hospital in an ambulance And you didn't really have a choice of what hospital are you taking me to. They took you in there. And then they weren't calling Medicare. Or the Medicare, or they wouldn't have been calling the Medicare Advantage Plan to get permission to do stuff. They would have just done it.

And then you would have just ended up wherever you ended up. But What I want to get across is if you get, you know, as you've used the term, which comes from one of my old. salespeople, if you got bad sick. Right. you know, with something like cancer.

Okay, I want to explain the difference between these two planes. My wife's just been through this. And we've been through it together. Yeah. You know When we got this cancer diagnosis, we made an immediate B line for the Duke.

Cancer sign. I mean, that's woo you know, that's it's good enough for Ted Kennedy. Yeah, it's good enough for us. And all people come from all over the world there. And we didn't have to check any networks.

And with a Medicare Advantage plan, typically Before you go see a doctor. or you go into a clinic, you gotta see if they're on the planet. And to me That's enough. I mean, I I'm just if I got a choice on the one side, That's all I got to do is make sure they take Medicare, and the other side. I've got to look in my book.

Or I've got to choose the one. What if they told us you can't go to Duke? You know, you you got to go over here. I'm not saying these other over here people are bad. There's people we even considered at one point not too long ago, going down to M.

D. Anderson. That was on the table. Yeah. I'll promise you M D Andersen wouldn't be on the same network thing.

Yeah. Duke would be. Yeah, anyhow, so I just want to make the point That The network thing is a big issue. Ian I get a lot of people say, oh man, I'm on a Medicare Advanced plan. I go to the doctor.

No problem. All my friends are on the same one. I'm going for that. I got no premium for my Medicare supplement. I'm good.

I got my dental. I'm good. And then my question. Is have you been bad sick or have any of your friends? I mean, because usually I find these people that are just singing.

The hymn's about Their Medicare Advantage plan. They haven't been sick. Are seriously sick. They've just had stuff that they've run to the doctor, they had a little copay. And of course they picked the Medicare Advantage plan that their doctor's already on.

But where this becomes real relevant is when you get seriously sick. Right. And so I For lots of reasons, interestingly, ones. My wife is on a Medicare Advantage plan, which we ran into all those things that you just described many times that, oh, well, we got a call to make sure. No, we can't do that procedure.

So we went to the hospital at the same time. We can't do that procedure. We can't get this x-ray, that kind of thing. That's the next point. He has the pre-authorization, because that's different from in the network.

So now you're at the doctor that's in the network. And they want to put my wife on a study or they want to do some type of procedure And then the question is, is it experimental or You know, and you get in.

So now we gotta go to the Medicare Advantage plan. I know you've experienced this because we talked about it. Exactly. Yeah. I don't want that to go on either.

I mean, if she needs something and the doctor thinks she needs it. When we're on original Medicare and a supplement, That's where we go.

Now, that's a lecture. I can afford the Plan G premium. And I could project to afford it 20 years from now because it's probably going to be a lot more. And so I don't want to totally dis Medicare Advantage plans. I'm just pointing out the facts here.

that there is a difference and it's not just the price you're paying in premium, and it's not how the policy pays. then the amount they pay In a given situation, it's partly that. But the main issue is the networks. And The pre-authorization. And if you can stay away from those, That's what I'm doing.

Yeah, because I cannot tell you how many times we have faced that with my wife, not just with this latest issue, but with lots of issues that. the doctors were trying to get authorized for this or for that and Oh. I mean And it's very, very, very different coverage, a lot of difference in the money, but There's no doubt in my mind that the beauty of And we haven't even talked about drug coverage, which is Kind of fits into the equation.

Well, you need to throw it in there because the drug coverage. is something you get or change during this October 15th to December settlement. It's just a smaller issue. Then the other stuff I'm talking about.

So, just understand that if you're on a drug plan and you want to change to a different one. It it's October 15th to December 7th. is when you do that. Right. So me, I'm on original Medicare, so this is the open window for my drug plan.

And there's nothing more helpful in the world than to me than to call Tom or call Hans. At CardinalGuide.com and say, here's my medications. Which drug plan should I take? I guess it'd be a good time to remind you that this show is brought to you by CardinalGuide.com. And if you go to CardinalGuide.com, you're going to see the very thing we've talked about today, this very show on a video, which has a board, which gives you more information on the difference between a Medicare supplement Plan G versus Medicare Advantage, especially for such a time as this in the open enrollment season.

And then, of course, Hans's book explains tons about this. And that's the complete Cardinal Guide to Planning Foreign Living and Retirement. And the easiest thing of all: contact Hans, Tom, Drew, Paige, like, man. And get somebody to help walk with you through this that cares that'll be there when your wife calls and they're trying to figure out what we need to do. It's amazing to have those resources.

It's all at cardinalguide.com. Great show, Hans. Thank you and God bless you. The opinions expressed by Hans Scheil and guests on this show are their own and do not reflect the opinions of this radio station. All statements and opinions expressed are based upon information considered reliable, although it should not be relied upon as such.

Any statements or opinions are subject to change without notice. Investments involve risk and unless otherwise stated are not guaranteed. Past performance cannot be used as an indicator to determine future results. Any strategies mentioned may not be suitable for everyone. Information expressed does not take into account your specific situation or objectives and is not intended as recommendations appropriate for you.

Before acting on any information mentioned, please consult with a qualified tax or investment advisor to determine if it's suitable for your specific situation. Finishing Well is designed to provide accurate and authoritative information with regard to the subject covered. Investment advisory services offered through Brookstrone Capital Management LLC, abbreviated BCM, a registered investment advisor. BCM and Cardinal Advisors are independent of each other. Insurance products and services are not offered through BCM, but are offered and sold through individually licensed and appointed agents.

Cardinal Advisors is not affiliated with or endorsed by the Social Security Administration or any other government agency. We hope you enjoyed Finishing Well, brought to you by CardinalGuide.com. Visit CardinalGuide.com for free downloads of this show or previous shows on topics such as Social Security, Medicare, IRAs, long-term care, life insurance, investments, and taxes, as well as Han's best-selling book, The Complete Cardinal Guide to Planning for and Living in Retirement and the Workbook. Once again, for dozens of free resources, past shows, or to get Han's book, go to CardinalGuide.com. If you have a question, comment, or suggestion for future shows, click on the Finishing Well radio show on the website and send us a word.

Once again, that's CardinalGuide.com. CardinalGuide.com.