Seeking primary care physician that accepts Medicare

[BuckeyeKen47]

"...the most frequent use of Medicare is retired people with a large amount of excess money. Multiple house/boats."
I'm also finding this a little hard to accept. It defies logic. Most retired people are on Medicare and most are living on a fixed income. Most retired people do not have Multiple houses or boats. Retied or not - most people don't have multiple houses or boats. It is true that people are Medicare eligible even if they are well to do so you will see Medicare patients with money. These people would be the exception rather than the rule. Just look at the average earnings for retirees. If you can get multiple houses & boats on those earnings please let me know how this is accomplished. I'm obviously doing something wrong.

[lurtsman]

I should have phrased that differently. I only had access to the stories that patients decided to tell me.

Keep in mind that if they are very poor and retired they have medicAID, rather than medicare. If it was just a sampling of people that were eligible for medicare, the result would show a dramatically poorer grouping. However, removing those that are eligible for medicaid creates a positive skew to the data.

Having a boat is not very expensive, depending on the kind of boat. Rather than houses I should have said residences, since in some cases what they are doing is buying up 1 or 2 time shares in addition to a primary house. These still represent significant uses of disposable income.

Now, I recognize that many patients will lie. However, there was a startling trend towards those with more money using medicare even if they could've easily afforded private insurance. As for how the people I met were able to afford it -- they never bought those things in retirement. They bought them while they were working and maintained them in retirement. Having high earnings in retirement is rare, but being able to carry savings into retirement is not.

It is true that my presentation of that fact left something to be desired, and I fear that may have an undermined an otherwise solid thesis about the abuse of the system. My sampling may also have been biased by working at a top ranked hospital that was able to attract patients from long distances since wealthy patients are more likely to travel for world class medical care.

[Mike from back east]

Unless it's changed, MedicAID primarily covers long term nursing home care for the elderly who are essentially bankrupt and/or have no long-term health care, and, IIRC for non-seniors who are too poor to pay and have no health insurance.

To get MedicAID for my mother we had to sell every asset she had in order for her to "qualify" which means that she could prepay her funeral and then use her own assets to cover the nursing home until all she had left was $2500.00 and then the state of MD will step in and cover the nursing home costs that were $6000/month plus meds. That was the law in MD ten years ago.

So it's my understanding that someone in your hospital or nursing home who is on MedicAID should not be owning any houseboats, etc, however, those assets may be in some sort of family or MedicAID bypass trust that DOES allow one to own assets and still get MedicAID. Such trusts have to be set up at least 5 years before applying for MedicAID; which is probably the best way to avoid being bankrupted by the need to "spend down to MedicAID" as it's called.

Medicare (Part A) covers hospital care for seniors, whether they're rich or poor, since we all pay into it. If the seniors take Part B it covers doctor costs and if we elect Part D it covers a lot of prescription costs too.

So, my understanding is that when you describe someone as "are very poor and retired they have medicAID" then my understanding from having gone through this with my late mother is that you are describing nursing home care, since MedicARE should cover hospital costs for the "retired."

I just turned 65 and had to get familiar with what MedicARE does and doesn't cover. We have long-term care insurance, about $3k per year, that covers us for eight years worth of nursing home care if we ever need it, and it allows us to not have to face the impoverishment that "spending down to MedicAID" causes millions of old folks who are not aware of these issues.

Now, to answer the OP's question, Colorado Springs Health Partners does take MedicARE patients and is involved with several insurers who have some sort of partnership deal with MedicARE. CSHP honors my MedicARE parts A&B coverage and I now have no co-pay for doctor visits.

[BuckeyeKen47]

Let’s start with the difference between Medicaid & Medicare. Please follow the link: http://www.diffen.com/difference/Medicaid_vs_Medicare Basically Medicaid is for low income people and Medicare is for retired people.
Since retired people had various levels of income when they were employed, retirees have a normal distribution of wealth. While working, all of us contributed to Social Security and Medicare through payroll deductions. Just like wage earners, most retirees are not wealthy although obviously some are. This program was not designed to help the indigent. It was designed so that retirees, who loose company sponsored insurance when they retire, can get health coverage at an affordable price.
It suffices to say that Medicare is quite confusing and convoluted. In addition the basic Medicare retirees can purchase private supplemental insurance to help offset what Medicare does not cover.
The important part here is that Medicare is designed so that people, after working their entire life, can afford health insurance when they retire. It is available to both the wealthy and poor alike. If a wealthy person uses Medicare to cover part of their medical expense they are not jobbing the system – they are simply using a system which was designed for all citizens.
If you contend that people who have wealth greater than a specific threshold should not be using government sponsored programs – and frankly I agree with you – talk to your congressman and let’s get that portion changed.

[BuckeyeKen47]

Mike,
I am preparing to retire and have been trying to do my due diligence with regard to Medicare. So far I have decided to elect an AARP United Health Plan Supplemental plan N. The cost to me including Part B, Prescription & Dental is about $277 a month.
I’ve been avoiding the Lone Term Care issue. There seems to be so much to try to figure out just with Medicare I planned to look at it after I get Medicare figured out.. Judging by your post you are a little bit ahead of me. Any insights you can provide would be greatly appreciated.

[Carrera32]

My wife and I are approaching 65 (still have a couple of years to go), but we both have long term care insurance. Medicare and most health plans have little if any long term care that falls under the heading of "custodial" care (your insurance will often take care of non-custodial care, such as recuperation in a nursing home from an auto accident requiring occupational or physical therapy). My mother was in custodial care for the last 18 months of her life. She had long term care insurance that paid $150/day. That was a Godsend. Her monthly Social Security check, the long term care payment, and some interest from her bank accounts were enough to pay the costs of care, without being a financial burden to us or her having to "spend down" her assets to the $2500 required for her to be eligible for Medicaid. Nursing home care is extremely expensive and the costs rise every year. I'd strongly suggest you look into a long term care policy; the older you are and the longer you wait, the more expensive it will be. Note: I'm no expert on insurance or Medicare, but I think my comments are pretty accurate. If not, pls correct me.

[Mike from back east]

Agree with Buckeye and Carrera....

MedicARE will only cover nursing home care for a MAX of 90 days AND provided that the nursing home care was due to something you were in the hospital for. You have to go straight from the hospital to the nursing home, for the SAME medical reason, or MedicARE won't cover the nursing home.

I also agree with Buckeye that some sort of means testing ought to be implemented for MedicAID. Any wealthy person who puts their wealth in a MedicAID bypass trust ought to carry long-term health care insurance and be done with it, rather than sticking the taxpayers with the bill for nursing home care.

In my Mom's case, it was a godsend that MD covered her care for the last year of her life, after we spent her funds down to near zero. Who among us could afford to pay $6k a month for one of our parent's care?

A few side points: If a married couple own a home but have no real wealth or income to speak of, and one needs a nursing home, the state will cover the cost of the nursing home under MedicAID but will put a lien on the home. The remaining spouse can live in the home for as long as need be, but someday the state will get it's money out of the home when it's sold. Dirt poor elderly folks with no assets and who rent a living space, probably don't need to worry about it, they will get MedicAID someday if they need nursing home care. Those of us with homes and assets need to look out for OUR own best interests and do so years in advance, as things like trusts have to be in place for about 5 years to have MedicAID honor it. You can give assets to your children but that is rife with horror stories, and also has to be done 5 years before you have that critical stroke and are bedridden - it's a real crapshoot to put off doing this due diligence and planning. See an Elder Care attorney for a complete set of "end of life" documents, probably won't cost more than $750 to $1000.00

Don't get caught with your plans down.