Shows
Medicare For The Lazy Man PodcastEp. 833 - UnitedHealth under incredible assault - much like Germans at Omaha Beach!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 Medicare Advantage plans.
Moody's has downgraded their rating from "Stable" to "Negative". As if that weren't enough, Lefties AOC and Lloyd Doggett have formerly requested the DOJ to turn the heat up even higher!
...2025-07-2135 minMedicare For The Lazy Man PodcastEp. 832 - Love 'em all but the best 5-star review so far is from a SHIP pro: Cleaning Fairy!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 Medicare?
Finally, due to a situation that befell an old friend from High School, I share the results of my research on the Illinois Fair Patient Billing Act. This places limits on how medical providers can...2025-07-1833 minMedicare For The Lazy Man PodcastEp. 831 - Expensive drugs like Jardiance on your list? Let Medicare for the Lazy Man help!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? I review an article that presents strategies for spending less while enjoying life more.
Finally, a personal friend of mine had been paying $800 for quarterly refills of his expensive drug. On vacation in St. Maartin...2025-07-1436 minMedicare For The Lazy Man PodcastEp. 830 - Ignore the speculation about Mr. Reich; he has been invited to the Lazy Zone!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 of duty-bound to discuss something about Medicare, I think we will find common ground upon which to discuss the future of MA.
On the other hand, Howard Farkash is still a question mark.
New client Curt ne...2025-07-1133 minMedicare For The Lazy Man PodcastEp. 829 - Who has 500,000 thumbs and hates Medicare Advantage plans? 250,000 angry, lawyered-up NYC retirees, that's who!!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 llawsuit against the city since 2021. They do not want the crappy Medicare Advantage retiree plan that the city says will save $600 million per year.
On a lighter note, we spend the "Your Medicare Benefits 2025" segment learning...2025-07-0934 minMedicare For The Lazy Man PodcastEp. 828 - Each 5 years 50% leave their Medicare Advantage plans; Here are reasons why: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 Medicare rejected. She explains the possible reasons and the most reasonable solution.
Finally, we try to figure out the rationale behind a list of the best and worst states for working fathers.
2025-07-0733 minMedicare For The Lazy Man PodcastEp. 827 - MEDICARE DRUG PLANS; SIMPLE D-I-Y GUIDE: New tool for everyone to use!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 Macular Degeneration tests and treatments.
The meat of this episode consists of a thorough description of my new book: Medicare Drug Plans; Simple D-I-Y Guide.
Contact me at: DBJ@MLMMailbag.com
...2025-07-0432 minMedicare For The Lazy Man PodcastEp. 826 - Declaring war on Prior Authorization rules in Medicare Advantage! To arms...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 we learn how Medicare is likely to cover lymphedema compression treatment items.
Do you like to get stabbed? We cover a list of vaccinations recommended for adults.
Finally, an advisor...2025-06-3031 minMedicare For The Lazy Man PodcastEp. 825 - Special Edition: PAIN! Fifteen things (two from the hosts) you do not want!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 under what circumstances and to what extent Medicare will cover lung cancer screenings.
Even more details are to be had as we review an article entitled "Does Medicare cover the Shingles vaccine"? Turns out the answer is "Yes"!
Finally, we tear into a list of thirt...2025-06-2737 minMedicare For The Lazy Man PodcastEp, 824 - Do you like Medicaid fraud schemes? Arizona wins the trophy at $2.7 billion!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 Medicare might cover Long Term Care expenses.
Finally, in the largest Medicaid fraud scheme known to mankind, crooks used the identities of dead patients in order to bilk billions from government coffers.
Contact me at: DBJ@MLMMailbag.com
...2025-06-2533 minMedicare For The Lazy Man PodcastEp. 823 - Missouri genius builds a $54 million dollar fortune in Medicare! Coulda been me!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 Bill" affect Medicare? Some areas of concern involve Medicare Advantage and the upcoding that so many MA plans are wont to do.
Finally, we discussed some of the locations on a list of "12 Great P...2025-06-2338 minMedicare For The Lazy Man PodcastEp. 822 - A turbulent month for...the largest health insurance company in the USAAccused 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 many large claims.
In the "Your Medicare Benefits 2025" segment, we learn how Medicare would cover kidney transplants.
On a very serious subject, 11% of Medicare participants rely solely on original Medicare. This has the possibility of turning out to b...2025-06-2036 minMedicare For The Lazy Man PodcastEp. 821 - Healthy woman drops Medicare to save $250/month; now has deadly condition!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 supplement again.
We started this episode by detailing some of the employee layoffs that at least 18 insurance companies must endure due to uncontrolled expenses.
This apparently includes 30,000 to be terminated f...2025-06-1833 minMedicare For The Lazy Man PodcastEp. 820 - TRIBUTE TO MASSACHUSETTS (with a single-fingered salute to BC/BS MASS)!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. This is an awkward way of saying that Medicare will pay to educate people about the ravages of Kidney Disease.
Did you know that Massachusetts is one of only three states that is allowed to design their...2025-06-1638 minMedicare For The Lazy Man PodcastEp. 819 - What is 6% of 50 million? Recent Medicare Advantage prior authorization refusals!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-pocket limit!
Moments before recording time a plea for assistance arrived from a victim of the barrage of MA plan brutality that happens to everyone who turns age 65. After hearing a radio interview he decided to emerge from hiding and take a chance...2025-06-1336 minMedicare For The Lazy Man PodcastEp. 818 - A potential client asks ,"Doug, what is your fee?" Who knew I could charge a fee?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 Care.
The rest of the episode consists of correspondence and questions from clients and soon-to-be clients.
Just what the content curator ordered!
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A+) Visit us o...2025-06-1132 minMedicare For The Lazy Man PodcastEp. 817 - $260,000 bill but only $39 out-of-pocket? The power of Medicare supplement!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 that, if passed, would directly affect Medicare.
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A+) Visit us on: BabyBoomer.ORG
Inspired by:
"MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on A...2025-06-0935 minMedicare For The Lazy Man PodcastEp. 816 - Dr. Oz has lots of freedom-loving people worried. What will he "scrutinize" first?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 disgust with your medical problem untreated?
As it turns out, somebody measures these things in all 50 states plus DC! Also, the results are less politically biased than we have seen in many other survey results.2025-06-0632 minMedicare For The Lazy Man PodcastEp. 815 - News story starts: REVEALED: UNITED HEALTHCARE... You'd better strap in!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 Benefits 2025" to learn exactly how Medicare might cover humidifiers.
A valued client writes in to ask whether a recent disturbing encounter with solidified intestinal contents might drive him to debtor's prison. After detailing the mathematical calculations Medicare will...2025-06-0533 minMedicare For The Lazy Man PodcastEp. 814 - Want to become my most favorite client in the whole wide world? Just listen...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 discussion about hospital beds.
Further discussions touched on Bass Ale and finally settled on a lengthy description of the best client I could ever want to have!
Contact me at: DBJ@MLMMailbag.c...2025-06-0232 minMedicare For The Lazy Man PodcastEp. 813 - Medicare or MA: Which is best? Answer: Medicare + a Medicare supplement!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: DBJ@MLMMailbag.com
(Most severe critic: A+) Visit us on: BabyBoomer.ORG
Inspired by:
"MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.
Official w...2025-05-3032 minMedicare For The Lazy Man PodcastEp. 812 - Weight loss drugs: Medicare limits and market demand on a collision course!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 in order to determine whether inflationary trends are still exerting upward pressure on insurance premiums.
They are.
Medicare is not allowed to provide and pay for drugs whose only function is weight loss. Some of the newly distributed...2025-05-2831 minMedicare For The Lazy Man PodcastEp. 811 - Stuck in expensive Plan F? Pricey Plan G? Maybe a new Birthday Rule can save you!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 of Medical inflation that has caused his HDG rates to increase 19%. His home state has just enacted a birthday rule whereby Robert can change companies without having to provide evi...2025-05-2633 minMedicare For The Lazy Man PodcastEp. 810 - High Deductible Plan G (HDG): the very best Medicare supplement of all!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 follows is a short description of shopping for the best Medicare Supplement plan at the lowest cost: SIMPLIFIED!
One of my insurance companies is good enough to notify me when clients are scheduled for a rate increase...2025-05-2331 minMedicare For The Lazy Man PodcastEp. 809 - Serious consideration: Should we invite another Medicare maven to the inner sanctum!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 Advantage Minute we report on the Department of Justice filing charges against three giant insurance companies. Apparently, they have been paying huge kickbacks to brokerage firms using unscrupulous tactics while pushing victims into MA plans.
2025-05-2138 minMedicare For The Lazy Man PodcastEP. 808 - Part D drug plans: We take a peek into the future...what is likely to happen to them?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 and the extent to which Medicare will cover Hepatitis B screening and treatment.
Finally, a quiz reveals the healthiest states vs. the unhealthiest states in the USA for older Americans.
Contact me at: DBJ@MLMMailbag.com2025-05-1937 minMedicare For The Lazy Man PodcastEp.+807 - Medicare Advantage plans are evil. So why are we increasing their payments?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 reimburses the cost of hearing aids.
Finally, Randy is challenged with a quiz concerning which of the states are most favorable and which are least favorable for working mothers.
He needs to sharpen his guessing s...2025-05-1633 minMedicare For The Lazy Man PodcastEp.+806 - GOP regretting a creation: Medicare Advantage plans need to be crushed!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 segment drawn from the pages of "Your Medicare Benefits 2024".
Quiz for the Podcast Producer: Which are the best and worst states for nurses?
Finally, we address one dozen FAQs (frequently asked questions) about Medicare. According to t...2025-05-1438 minMedicare For The Lazy Man PodcastEp. 805 - $queezing billion$$ more from the US Gov't. Gee, who do you suppose would do that?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 inflation is still causing upward pressure on insurance premiums.
Finally, a sister recommends "Medicare for the Lazy Man" to a potential new client and her husband. Her letter points out an often overlooked point. Those who are age 65+ and covered by an employers group insurance plan have the...2025-05-1233 minMedicare For The Lazy Man PodcastEp. 804 - Gym memberships & fitness programs: covered benefits under Medicare?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" history!
In Iowa news, a nurse has been sentenced to a stretch in the Big House for allowing a patient under her care to die of neglect. This episode reminded me of those I have helped escape MA plans after they were f...2025-05-0933 minMedicare For The Lazy Man PodcastEp. 803 - Best kept secret in Medicare: enjoy hearing a highly skilled expert struggle to explain it!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 finest health insurance protection with the most cost-effective premium rates. Almost everyone who sees it ends up buying one!
How about "Your Medicare Benefits 2024"? In that article we find out how glaucoma...2025-05-0732 minMedicare For The Lazy Man PodcastEp. 802 - Trump to Oz: "Love & cherish Medicare". Instead, target fraud, waste & abuse!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 likely to cover routine foot care plus foot care for diabetics.
Then we recount the facts in the heinous murder of Brian Thompson, the 50-year-old CEO of United Healthcare who was gunned down in Manhattan in...2025-05-0535 minMedicare For The Lazy Man PodcastEpisode 801 - Are we about to get OZed? ...or will the enemies of Medicare Advantage prevail?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 the biggest MA slut: United HealthCare.
From the pages of "Your Medicare Benefits 2024" we learn the short story of how Medicare covers flu shots.
CMS (the Federal Government) in a magnificent return to sanity ordered that q...2025-05-0234 minMedicare For The Lazy Man PodcastEp.+800 - Answer: Dr. Christian Bernard in the Conservatory with the Lead Pipe. Ignore DeBakey!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 date.
In the "Your Medicare Benefits 2024" we learn about Federally Qualified Health Center Services.
The final subject centered on an article listing "The 8 Things That Medicare Does Not Cover" which included a surprising number of items demonstrating trouble with Medicare...2025-04-2936 minMedicare For The Lazy Man PodcastEp. 799 - Hey Tubby! Would you like to drop a few pounds? Maybe Medicare can help!"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 pharmaceutical solutions. As with most new developments, it will take time for the price to become more affordable.
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A+) Visit us on: BabyBoomer.ORG
Inspired by:
"MEDICARE FOR THE LAZY MAN 202...2025-04-2835 minMedicare For The Lazy Man PodcastEp 798 - Had AETNA while working, docs liked it; I want AETNA Medicare Supplement!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 insurance company will draw the initial premium right away on the date of approval.
Also, after discussing the Medicare situation with friends, he confirmed a fact featured in Medicare for the Lazy Man: Many people are not told about the High Deductible Medicare s...2025-04-2531 minMedicare For The Lazy Man PodcastEp 797 - MA plans brag about their free extras; studies show those freebies often go unusedIn 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 covers "enteral" nutrition supplies and equipment.
Unfortunately, we never hear a definition of the term "enteral"!
In response to a valued client, I share my dissection of the cost advantage of HDG over Plan G. This is an esoteric concept...2025-04-2334 minMedicare For The Lazy Man PodcastEp. 796 - $257K up to $543K annual income: Which medical specialty would you study?"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 clients, and all responsible Medicare participants, will have acquired a Medicare supplement plan to enhance the Medicare reimbursement amount.
Average earnings of Medical Doctors by specialty in an interesting way to decide whether you could have chosen a...2025-04-2134 minMedicare For The Lazy Man PodcastEp. 795 - UP-CODING! Sounds like fun until you wind up on the wrong end of a $100,000,000 settlement!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 increases. Conclusion?
Medical inflation is still with us and Medicare supplement rate increases exceeding historical averages will plague the industry for the foreseeable future.
Contact me at: DBJ@MLMMailbag.com
(Most...2025-04-1833 minMedicare For The Lazy Man PodcastEp. 794 - Skip Plan G; Buy High Deductible Plan G (HDG) & enjoy the monthly savings!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 Medical Equipment is paid for by Medicare under certain circumstances. Very important: make sure the supplier is enrolled in Medicare!
Tragedy strikes Medicare for the Lazy Man: Alert reader Dominick Regina noticed that all of the many customer reviews earned by...2025-04-1635 minMedicare For The Lazy Man PodcastEp.+793 - Relax Texans! SWHR and BC/BS of Texas are together again!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 Linda, wife of a happy MLM Medicare supplement client. Two years away from Medicare age herself, she is concerned because her favorite hospital and long-time doctor have been deemed "out of network" due to a merger or an acquisition.
Turns out...2025-04-1432 minMedicare For The Lazy Man PodcastEp. 792 - When it comes to being celebrated; I'd rather be a nurse than a doctor!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 that are held for medical professionals. Were all of those years of med school, internship and residency really worth it?
Finally, the listener will hear some solid evidence proving that HDG is a much more cost effective supplement plan than...2025-04-1136 minMedicare For The Lazy Man PodcastEp. 791 - CORRECTION: SWHR and BC/BS of Texas have kissed and made up!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 Disease) are eligible for Medicare coverage in spite of their youth due to a special clause in the Medicare regulations.
New clients are disappointed to hear the wife's primary care physician (or the staff) assert that the...2025-04-0933 minMedicare For The Lazy Man PodcastEp. 790 - Lightbulb goes on when realization strikes right between the eyes!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 a million questions to ask. A 50+ year veteran of the health insurance biz is able to field almost all of them without too much difficulty. However, Jim has a revelation during one Q & A session. Apparently, the excellent benefits of High Deductible Plan G...2025-04-0734 minMedicare For The Lazy Man PodcastEp. 789 - Alzheimer's? Take a 5 minute blood test, the most certain answer available!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 supplies.
Finally, learn about the blood test that may confirm the presence of Alzheimer's disease with 90% accuracy.
The most accurate current tests have maxed out at about 73% accuracy while primary care doctors doing in-office memory tests top out at 63%.
Contact...2025-04-0431 minMedicare For The Lazy Man PodcastEp. 788 - Possibly the most exciting Medicare Advantage Minute segment ever! ...or not."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 the 10 fattest cities.
Finally, four years after Dave first made contact he reaches out again with some unsettling news about his health and the need move more quickly on his plans for Medicare supplement than he originally anticipated.
2025-04-0235 minMedicare For The Lazy Man PodcastEp.+787 - Locked in combat with....his cancer AND his Medicare Advantage plan!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 Medicare is likely to cover depression screenings. Won't help the hero in the previous story though; Medicare Advantage participants have Medicare taken away from them!
Good news for those who value a happy workplace...2025-03-3135 minMedicare For The Lazy Man PodcastEp. 786 - IRMAA: The evil, evil success penalty!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 some cancer treatments, transplants and undergoing treatment as an inpatient may be enough justification for Medicare to authorize payment for some dental procedures.
Then enjoy a tutorial on the IRMAA penalty (Income Related Monthly Adjustment Amount) and my recommended method...2025-03-2834 minMedicare For The Lazy Man PodcastEp. 785 - Now is the time to switch! Medicare Advantage plans are tightening their belts!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?
Finally, the MLM Podcast has been awarded a Humanitarian & Investment fund in the amount of $10,500,000 American dollars.
In recognition of this award I have just hosted my last podcast ever!
Contact me at: DBJ...2025-03-2633 minMedicare For The Lazy Man PodcastEp. 784 - Dental benefits are rotten in more than 90% of Medicare Advantage plans!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 letters threatening data breaches have been received by several hospitals according to the AHA. In this podcaster's opinion, repeal of HIPPA would remove the incentive and free the medical industry of a great deal of costly burden.
Valued client Dean, fresh f...2025-03-2432 minMedicare For The Lazy Man PodcastEp. 783 - MLM 2025: A review so thorough you may not even have to buy the book!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 additional interest for returning readers, of which there will be many!
This episode starts with the Medicare Advantage Minute reporting on a discovery: Medicare spends 27% more on those who flee from MA plans back to Medicare than...2025-03-2137 minMedicare For The Lazy Man PodcastEp. 782 - Medicare for the Lazy Man 2025 has arrived!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 insurance broker: Humana invitation to an afternoon of Pickleball and beer! Meanwhile, Randy is parked in the Brazen Head, a Dublin pub founded either in 1198, 1613 or 1754 according to a confused Perplexity AI.
Next a r...2025-03-1932 minMedicare For The Lazy Man PodcastEp. 781 - Sad stories: encounters with Medicare Advantage that didn't go well!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 health questions asked of applicants for a supplement plan.
Why might it fail? There are only certain times of the year during which one can disenroll from an MA plan and...2025-03-1737 minMedicare For The Lazy Man PodcastEp.+780 - Medicare Q & A asked on behalf of a youth minister.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 Airway Pressure) machines.
Finally, Bill asks a series of questions about Medicare for the benefit of his friend Cathy who may need to leave her job and make the switch very soon.
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(Most severe critic: A++) Visit us on: Baby...2025-03-1433 minMedicare For The Lazy Man PodcastEp. 779 - Greatest gift to Medicare supplements: state birthday rules!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 asserts that you meet the criteria for eligibility.
Some purchasers of Medicare supplement plans are risk averse and afraid of the very limited cost sharing imposed by the low priced High Deductible "High Value" Plan G. S...2025-03-1232 minMedicare For The Lazy Man PodcastEp. 778 - Delayed & denied care: Medicare Advantage plan complaints!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 a complaint about Too Much Medicare Marketing.
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"MEDICARE FOR THE LAZY MAN 2024; S...2025-03-1033 minMedicare For The Lazy Man PodcastEp. 777 -Evil IRS attacks Mark, but he crushes them! The weapon? Form SSA-44!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 IRMAA success penalty from Mark, his reduced retirement income allows him to successfully employ the weapon I suggested he use against them.
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(Most severe critic: A+) ...2025-03-0732 minMedicare For The Lazy Man PodcastEp. 776 - Need a colonoscopy? Medicare might pay for it!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 Deductible Plan G (HDG) is the best choice for him. However, he wants to know how cautious and conservative he should be when selecting his Medicare supplement insurance company.
Contact me at: DBJ@MLMMailbag.com2025-03-0534 minMedicare For The Lazy Man PodcastEp.+ 775 - Dental & vision insurance? I use AI to help clients select their plans!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.
Ameritas and NCD by Metlife are the first two companies I suggest. There are many, many others to choose from!
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(Most severe critic: A++) Visit us on: BabyBo...2025-03-0333 minMedicare For The Lazy Man PodcastEp. 774 - Once banned due to shocking effects, an old drug has new uses.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 Care Plan Services.
If you have failed to enroll in Part B of Medicare, the General Enrollment period can bail you out. We enumerate the three big reasons people may end up in that predicament.
Finally, we list...2025-02-2835 minMedicare For The Lazy Man PodcastEp. 773 - Tragic tale: altruistic insurance agent & 93-year-old in need of help!Contact me at: DBJ@MLMMailbag.com
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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.
2025-02-2431 minMedicare For The Lazy Man PodcastEp. 772 - See how "The Walking Dead" would sound if the zombies could speak.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 plan online enrollment process has been improved to allow me to enroll my clients. On the other hand, in order to select the "best" plan I must be able to predict the needs of the client will face...2025-02-2129 minMedicare For The Lazy Man PodcastEp. 771 - Pay no attention to the phlegm-ridden man behind the curtain!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 with High Deductible Plan G and now his 65th birthday is approaching and he wants in on the fun!
Finally, we learn that some new programs are coming down the pike, including dementia support services in which...2025-02-1933 minMedicare For The Lazy Man PodcastEp. 770 - When Advantage plans order "JUMP", Gov't squeaks, "How high?"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 how Medicare will pay for Chronic Pain Management in "Your Medicare Benefits 2024".
Looks like they are planning to cut doctor reimbursements again but the AMA purports to be fighting that action. We should...2025-02-1730 minMedicare For The Lazy Man PodcastEp. 769 - Demonstrators cause ruckus at HQ of largest US health ins. company!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 insurance company more accountable to its customers.
In Your Medicare Benefits 2024, we learn how Medicare will help you if you have more than one serious medical condition and need expert assistance.
Finally, Jeffrey, who say...2025-02-1430 minMedicare For The Lazy Man PodcastEp 768 - Lady Parts: Medicare will help fix plumbing problems!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 affected when he enrolls in Tricare For Life.
Talk about a complicated situation!
Contact me at: DBJ@MLMMailbag.com
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"MEDICARE FOR THE LAZY MA...2025-02-1232 minMedicare For The Lazy Man PodcastEp. 767 - Do you need Coke bottle bottoms to see? Medicare can help!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 and will soon turn 65. Can she ignore Medicare? Turns out, Perplexity AI said no, she can't. The good news is that after she enrolls in Medicare, Medicaid may step up to pay the Part B premium for a "...2025-02-1034 minMedicare For The Lazy Man PodcastEp. 766 - Do you have a caregiver? Medicare will train her for you!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 segment we wrap up the podcast by listing nine changes affecting Medicare in 2025.
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"MEDICARE FOR THE LA...2025-02-0835 minMedicare For The Lazy Man PodcastEp. 765 - 1 phone call gut punches the largest US health insurance company!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 insurance company rate filings shows that we are still suffering the ill-effects of a long inflationary spiral.
Finally, Steve's brother-in-law strongly suggested the purchase of "Medicare for the Lazy Man". While waiting for delivery he thought up some questions...2025-02-0534 minMedicare For The Lazy Man PodcastEp. 764 - A wife's forgotten birthday leads to confusion and turmoil!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 the "Your Medicare Benefits 2024" we take a look at Cardiac Rehab and how Medicare would cover that if your heart problems required serious medical intervention.
Then we read a list of the top 20 hospitals...2025-02-0330 minMedicare For The Lazy Man PodcastEp.+755 - Jim, The AI Educator, is back for another dose of "Cornball Humor"!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 filed for rate increases in various states.
Finally, Jim checks in again with advice from his employer's group insurance agent. Good advice, generally speaking!
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A++) Visit us on...2025-01-3135 minMedicare For The Lazy Man PodcastEp.+753 - Crippled parking at a trampoline store: How many spots required?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 discussion of the state of freedoms in America.
Free association? You be the judge!
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"MEDICARE FOR THE LAZY MAN 202...2025-01-3134 minMedicare For The Lazy Man PodcastEp. 763 - Are you blind? Need a cane? You'll have to paint it white yourself!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 to help his recently arrived father. A Vietnam era Marine, Vince Sr. seemed to be having trouble with the VA and with his dental health.
Stay tuned for an update!
2025-01-3131 minMedicare For The Lazy Man PodcastEp. 762 - Why did Diane, a valued Medicare supplement client, blow her stack?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 Benefits 2024" come articles about how Medicare covers braces and breasts. More specifically braces for: arms, legs, backs and necks and for breasts: prosthesis!
As mentioned above, Diane applied for Medicare supplement coverage scheduled to...2025-01-2933 minMedicare For The Lazy Man PodcastEp. +761 - Is your Congressman a worthless slug? Here is a chance for redemption!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 who understands the risks and consequences of this condition.
Finally Toni King, our favorite (easily distracted) Medicare Belle, takes a question from Evelyn who asks what her recourse is when her local Social Security office loses her application paperwo...2025-01-2733 minMedicare For The Lazy Man PodcastEp.+760 - Hero saves audience from a guest threatening somnolence!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 Medicare pay the cost plus buy you a pair of glasses to boot!
Check out the Medicare payment rules and how you might benefit.
Contact me at...2025-01-2632 minMedicare For The Lazy Man PodcastEp+759 - Everybody loves Medicare Advantage - until they get sick!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 Security Administration is in charge of signing people up for Medicare. In some places, it doesn't seem too interested in doing its job!
One soon-to-be client had to call his senator in order to...2025-01-2635 minMedicare For The Lazy Man PodcastEp. 758 - Now called "Medical Escorts"; Gen. Joe Hooker might be spinning in his grave!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 visits. Fraudulent? You make the call!
According to "Your Medicare Benefits 2024", If you need behavioral health integration services, Medicare will use the Psychiatric Collaborative Care model. Don't ask me, I am perfectly well adjusted.
Finally, the current state of me...2025-01-2131 minMedicare For The Lazy Man PodcastEp. 757 - Which would you prefer, five gold stars or a Barium enema?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.
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Inspired by:
"MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever...2025-01-1734 minMedicare For The Lazy Man PodcastEp. 756 - Taken to the cleaners by his own insurance plan: Mr. Erk!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 drastically reducing the number of states in which it will do business in 2025. What might the consequences be?
One client needs Evenity injections for a year. Her thought is that she will be writing big...2025-01-1534 minMedicare For The Lazy Man PodcastEp. 754 - Wisconsin is home to Medicare MSA for those who like a FREE plan!!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 and difficult elements of this subject concerns the ability of a disabled person who is under age 65 to deal with the system if they lack knowledgeable advice.
Contact me at...2025-01-1136 minMedicare For The Lazy Man PodcastEp. 752 - Medicare pays for a chopper ride? Judy Tenuta would say, "It could happen!"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 efforts used to collect overpayments from the miscreants.
How about some special enrollment opportunities? Listen to a lengthy, albeit confusing, array of periods in which certain rules of enrollment welcome certain segments of the Medicare eligible population to snatch their opportunity!
2025-01-0632 minMedicare For The Lazy Man PodcastEp. 751 - Quick, name a North American country with horrible health system!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!
In the new book "Your Medicare Benefits, we read about alcohol misuse evaluations.
In a related story, I describe an encounter with an Arizona doctor who has a blind spot where one particular...2025-01-0334 minMedicare For The Lazy Man PodcastEp. 750 - A reader asks, "Help!!!! Us, Please!!!" How could I refuse?Medicare Advantage Minute headline:
HCA Medical System sees way too many prior authorization denials!
This Nashville based health system (with 186 hospitals and 2400 care sites in 20 states and the UK) is fighting back against the intense Medicare Advantage pressure of prior authorization service denials: trying to beat them at their own game!
From the government publication "Your Medicare Benefits" comes a description of how Medicare covers Advanced Care Planning.
Finally, the plaintive plea for help from our new client arrives. This sets in motion a plan to use the "Medicare Advantage Open Enrollme...2025-01-0133 minMedicare For The Lazy Man PodcastEp. 749 - AI forced to cough up accurate facts by a new client!In the "Medicare Advantage Minute" segment, the headline is:
"Hospitals Sick of Fighting for Medicare Advantage Dollars!"
This article lists a few more hospitals giving up the struggle[e and resigning from Medicare Advantage networks (notably United Healthcare).
Also, spend some time learning about abdominal aortic aneurisms, the problems they cause and the way Medicare covers the diagnostic testing for them.
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"MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever...2024-12-3037 minMedicare For The Lazy Man PodcastEp. 748 - Here comes a relatively new Medicare Free-For-All!It's the "Medicare Advantage Open Enrollment Period" when you may escape from that MA trap and return to original Medicare if you like!
Smart government authorities would authorize enrollment into Medicare MSA plans during this period. Maybe under the next administration!
In The Medicare Advantage Minute: star ratings are taking a big hit as the scores are revised downward. One source is quoted as saying, "The quality of Medicare Advantage Plans ain't what it used to be"!
Humana is bleeding providers to such an extent that the government is allowing some of their...2024-12-2733 minMedicare For The Lazy Man PodcastEp.+747 - Voodoo meets Blackjack: can there be a Medicare connection?In the "Medicare Advantage Minute" segment, we hear that the government plans to establish new guardrails on MA prior authorizations and marketing.
New government best selling thriller: Your Medicare Benefits!
In other health news, 200 Voodoo practitioners were slaughtered in Port-Au-Prince by a gang whose leader assumed they caused his son's illness.
Rick, husband of a blackjack dealer, has worked out a complex health insurance plan for the first year of retirement. Fingers are crossed that neither of us overlooked any important details.
Finally, client Paul is very pleased with the coverages...2024-12-2533 minMedicare For The Lazy Man PodcastEp.+746 - Prior Authorization Denials: Medical care vs. financial accountingHave you ever eaten at Bud Harkert's in Omaha? Let us know!
The numbers are growing: more participants are being lured and/or forced into Medicare Advantage plans and more participants are falling victim to "care rationing".
Forty-six million episodes of denial in 2022 alone!
The pervasive effects of our current inflationary trends are illustrated in a review of the Medicare supplement rate increases imposed on participants during recent months.
A soon-to-be client refers to me as a "very busy national figure" who may not have time to attend to his concerns...2024-12-2333 minMedicare For The Lazy Man PodcastEp.+745 - New York: No rate increase on my strongly recommended plan!Hard to believe in these inflationary times:
My recommended plan HDG (known as G+ in New York) is the only plan in its family not being forced to endure a rate increase.
Shocking: Financial analyst describes the damage to Humana caused by a government rating reduction. The company is described as "reeling"!
M has her choice of Part D prescription drug plans:
After a scientific search, her agent advises a Wellcare plan that will cost $60 all year. Her dopey friend suggests a Humana plan at $4000.
Finally, a valued client...2024-12-2036 minMedicare For The Lazy Man PodcastEp. 744 - It's back(in Wisc.): The only Medicare Advantage plan I don't hate!Medicare MSA is alive and well in Wisconsin, just waiting for the right people to come along:
Those who will fail Medicare supplement underwriting, those who want a $0 Medicare plan that will pay them cash each year, frequent travelers willing to trade a high deductible for $0 premium....only in Wisconsin!
MA Minute: Providers are fed up with Medicare Advantage!
When you acquire a Medicare supplement from, let's say Bob's Storm Door and Supplement Company, don't ask the office clerk "Do you accept Bob's Insurance"? She'll say, No, we don't" without even thinking.
2024-12-1835 minMedicare For The Lazy Man PodcastEp.+743 - Here comes the new $2K limit on drug plan cost sharing!FYI, if you take expensive prescription meds, 2025 will bring a $2000 limit on out-of-pocket cost sharing for covered drugs.
This failed attempt to buy votes in the recent election has left behind a trail of unintended consequences and unanticipated turmoil.
Mr. Young pays another visit to the podcast to ask how this new limit is likely to work with his prescriptions for Otezla and Skyrizi.
My speculation is that the Feds will find a way to mess it up.
In the Medicare Advantage Minute: "The sickest patients are fleeing private Medicare plans...2024-12-1633 minMedicare For The Lazy Man PodcastEp.+742 - The world's dumbest question: Which drug plan do you like?It is absolutely moronic to pick a Part D prescription drug plan by recommendation from friends, neighbors or Facebook prowlers.
There is only one way to identify the "best" (cheapest) plan: A scientific search by an experienced expert.
OTHER QUESTIONS ADDRESSED IN THIS EPISODE:
MA Minute:
What might Trump's 2nd term mean for Medicare Advantage plans?
Diane is new to Medicare: she has six rapid-fire questions!
Joel wants to know if he is crazy: He wants to use Form SSA-44 to appeal the imposition of IRMAA on a recent retiree...2024-12-1333 minMedicare For The Lazy Man PodcastEp. 741 - Leftist nuts applaud the murder of health insurance executive!In out "Medicare Advantage Minute" the question is posed.
"Is Medicare Advantage a good deal for enrollees?"
We are nudged to spend some time on correspondence from clients and potential clients. For instance
A wife charged with guiding her husband through Medicare enrollment has questions. For instance, exactly what does the term "creditable" signify?
Finally, we salute original listener and friend of the podcast Dominick Regina who sent his brother-in-law to MLM for professional Medicare guidance.
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A+...2024-12-1133 minMedicare For The Lazy Man PodcastEp. 740 - Medicare agent tells a big fat lie, just as predicted in MLM!1,000,000+ Patients are likely to lose their Advantage plan providers!
As more doctors and hospitals refuse to accept patients with Medicare Advantage insurance, those victims will have increasing difficulty finding convenient and reasonably priced treatment options.
The Medicare Advantage Minute: "Lessons from the 1990s".
As pressure on MA plans builds, the author of this article suggests that there are things to be learned from the early days of managed care Medicare plans.
Client correspondence: a New Yorker writes in to ask how he might cut down on his Medicare supplement expenses. Plan N...2024-12-0934 minMedicare For The Lazy Man PodcastEp. 739 - Murder in Manhattan: the health insurance biz ain't for sissies!!Tales of two mothers:
One, age 96, has a daughter that fell victim to Medicare Advantage Zombies; she was duped into offering up her mother as a sacrificial lamb.
The other was recently widowed with nobody but her insurance agent to guide her.
Fortunately, each story has a happy ending.
Finally, in the Medicare Advantage Minute, someone suggests that MA plans be contracted for longer periods, like two or three years.
At the end of this fairy tale, I explain in detail why this seemingly innocent idea should never be a...2024-12-0634 minMedicare For The Lazy Man PodcastEp 738 - Pearl Harbor Day: Last chance to pick a better drug plan for 2025!Wake up! Time is running out to select a better drug plan for next year. Did your ANOC predict unpleasant changes for the plan you have?
In the Medicare Advantage Minute we learn about one health system's secret to Medicare Advantage success!
Medicare enrollment period scams are plentiful this year, including a "smishing" expedition!
Finally, enjoy our tutorial about SOAs (Scopes of Appointment).
Contact me at: DBJ@MLMMailbag.com
(Most severe critic: A+) Visit us on: BabyBoomer.ORG
Inspired by:
"MEDICARE FOR THE LAZY MAN 2024; Simplest...2024-12-0430 minMedicare For The Lazy Man PodcastEp. 737- BABYBOOMER.ORG - Our new home! (well, we have to share it!)Hello Baby Boomers, it's great to make your acquaintance!
We are very happy to have been invited to join you on: BABYBOOMER.ORG.
If anyone needs me, I'll be browsing all of the interesting content over on the very busy site at BABYBOOMER.ORG.
In the Medicare Advantage Minute today, we take a peek into the future with an article entitled:
"The Great Disruption Coming for Medicare Advantage!"
Finally, meet the likely new head honcho at the CMS: Dr. Oz! Are we happy to see pro-Trump doctor appointed to head...2024-12-0233 minMedicare For The Lazy Man PodcastEp. 736 - What about Plan B? ..or Plan N?...asks a prospective client.We deliver cogent reasons to Darrell, explaining that High Deductible Plan G is the greatest!
Jim & Jill ask when it would be wise to consider changing Medicare supplement insurance companies.
In an article headed by a photo of maniacally grinning ladies at the bowling alley, we get to hear some hints about looking for a new drug plan for next years.
In the Medicare Advantage Minute, the question is "Can MA be a good deal for its participants? (Hint: Randy says "No chance!")
Most important, we welcome another McMillin into the...2024-11-2934 minMedicare For The Lazy Man PodcastEp. 735 - A bad omen for hospitals? Medicare Advantage growth, some say!A conservative podcaster's mother is suffering at home with substandard hospice care. Little Joe's Conservative Corner blames "the system" but I wonder if the real problem might be a substandard Medicare Advantage plan. If I find out, I will report back to the audience.
Recently widowed Niki wants to know if she has any recommended insurance tasks, now that her husband, my friend, has died.
Finally, Randall wants to know how Part D drug plans can stay in business while charging $0 premium each month.
Randall, you silly goose! The taxpayers are being drained t...2024-11-2734 minMedicare For The Lazy Man PodcastEp. 734 - Told you so! High Deductible Plan G is the greatest!Minnesota client Michael is starting to regret purchasing expensive Plan G for maximum Medicare health insurance protection.
As his long-suffering agent predicted. Michael is weary of paying for Cadillac insurance when HDG works so well for so much less!
The Medicare Advantage Minute sees Independence BC/BS contending with "Election Anxiety" and using extraordinary measures to "get their story out". Is their "story" really worth hearing?
Disappointments in the course of business for an Medicare insurance agent:
Frank & Mrs. Frank partake of an agent's professional services. When the agent discovers the...2024-11-2530 min