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Old Yesterday, 08:11 AM
 
Location: SoCal
13,696 posts, read 6,516,267 times
Reputation: 10229

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Quote:
Originally Posted by BBCjunkie View Post
There is no "Part F" in Medicare. Actual traditional Medicare consists of only two "parts": Part A (hospitalization coverage)and Part B (what used to be called Major Medical coverage back in the day.)

The so-called Part D (prescription drug coverage) is mandatory but must be obtained from private insurers which are completely separate entities from Medicare itself. The government has nothing to do with Part D except for the fact that Medicare (CMS) mandates that everyone have some sort of drug coverage. How much is up to you. How much it costs is up to the private insurers who sell those policies.

You seem to be confusing the PLANS A through F that are offered by Medicare SUPPLEMENT carriers (so-called Medigap) with the PARTS of actual Medicare. Supplement plans are private insurance plans, totally optional and have nothing to do with Medicare premiums. Premiums for Medigap plans are set by the private insurers operating within the various rules of the states they sell in. They are not set or influenced by Medicare or CMS.

Medicare premiums have no effect on Medicare Supplement Plan (A-F) premiums, or vice versa. Apples vs oranges there. Supplement polices only interact with Medicare when claims are involved. NOT premiums.

Nobody is required to buy a Medicare Supplement plan. It is private insurance just like auto and home insurance is. It is a for-profit industry and always will be. Anyone who thinks that private insurance coverage premiums (of any type) will EVER come down in any meaningful way is just kidding themselves.

Drug coverage (Part D) is required but those premiums are not affected by Medicare premiums either. Blame the private insurers in both those cases but don't blame Medicare (unless you want to blame CMS for requiring Part D in the first place -- which I do, by the way, but that's another question entirely. I do not think drug coverage should be mandatory. It should be an optional additional coverage just like the Supplement plans are.)
I agree thereís no F. But what are these parts B through D here. I donít pay for these premiums so I donít know. But Iím sure thereís cost to it.
https://www.medicare.gov/your-medica...ts-at-a-glance
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Old Yesterday, 08:23 AM
 
1,769 posts, read 621,513 times
Reputation: 3272
Quote:
Originally Posted by mathjak107 View Post
advantage plans only reduce the load if you don't fall in to their cliffs . they can end up costing 2x the amount of a medigap plan.

One of my best friends found that out the hard way. She was so proud of "only having to pay $40 a month" for her BCBS Medicare Advantage plan. Then at age 70 she was diagnosed with triple-negative breast cancer that required surgery plus radiation plus chemo, and found out that she couldn't afford to pay the deductibles and copays. Also she wanted to use the same surgeon and oncologist that I had used for my BC six years previously, but they were not in-network so she couldn't. Ended up with a general surgeon instead of a BC specialist and an oncology office she disliked but it was the closest one to her apartment that was in-network. She was going to have to skip her final chemo infusion because after borrowing money from everyone in order to pay for what the MA plan had already not covered, she didn't have the money for the final copay. The oncologist agreed to give her the final infusion at no charge and write it off.

She switched to regular Medicare after that but the financial damage was already done. What the MA plan didn't cover cost her far more than what she had 'saved' in premiums for those five years.
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Old Yesterday, 08:26 AM
 
Location: SoCal
13,696 posts, read 6,516,267 times
Reputation: 10229
Quote:
Originally Posted by BBCjunkie View Post
One of my best friends found that out the hard way. She was so proud of "only having to pay $40 a month" for her BCBS Medicare Advantage plan. Then at age 70 she was diagnosed with triple-negative breast cancer that required surgery plus radiation plus chemo, and found out that she couldn't afford to pay the deductibles and copays. Also she wanted to use the same surgeon and oncologist that I had used for my BC six years previously, but they were not in-network so she couldn't. Ended up with a general surgeon instead of a BC specialist and an oncology office she disliked but it was the closest one to her apartment that was in-network. She was going to have to skip her final chemo infusion because after borrowing money from everyone in order to pay for what the MA plan had already not covered, she didn't have the money for the final copay. The oncologist agreed to give her the final infusion at no charge and write it off.

She switched to regular Medicare after that but the financial damage was already done. What the MA plan didn't cover cost her far more than what she had 'saved' in premiums for those five years.
Itís not easy to switch back, I thought you have to go through underwriting again. Iíve warned my sister about this.
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Old Yesterday, 08:27 AM
 
Location: SoCal
13,696 posts, read 6,516,267 times
Reputation: 10229
Quote:
Originally Posted by mathjak107 View Post
advantage plans only reduce the load if you don't fall in to their cliffs . they can end up costing 2x the amount of a medigap plan. many low to no premium are basically pay as you go
Reduce their load, not your load.
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Old Yesterday, 08:43 AM
 
1,769 posts, read 621,513 times
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Quote:
Originally Posted by NewbieHere View Post
I agree there’s no F. But what are these parts B through D here. I don’t pay for these premiums so I don’t know. But I’m sure there’s cost to it.
https://www.medicare.gov/your-medica...ts-at-a-glance
"Part C" is a euphemism for a Medicare Advantage plan. Those are private insurance policies. They are an alternative to traditional Medicare and they work like a normal non-Medicare health insurance policy does in most respects, except that (and I am oversimplifying here a bit) someone who opts for one of these instead of regular Medicare will have the Medicare Advantage premium partly funded by what they would otherwise pay (via SS deduction) for Medicare Part B.

A person cannot have traditional Medicare AND the so-called "Part C" which most people simply call a Medicare Advantage plan. It is either/or. You are not allowed to have both at the same time. So you either have regular Medicare and pay $135 (in most cases) for Part B plus whatever the premium is for whatever Part D private drug coverage you choose (plus a Supplement policy if you want to add one) OR you pay a single premium to one of the Medicare Advantage ("Part C") insurance companies. Medicare Advantage policies automatically include drug coverage.

The page you linked to is a good explanation of what the Medicare premiums and costs are. Although it looks expensive it is VERY much cheaper than the average person has to pay nowadays for any other kind of individual health insurance policy. It's true that regular Medicare does not cover everything (for example eyeglasses, hearing aids, etc) but it is still MUCH less expensive than anything else out there. You cannot get the equivalent major-medical-type coverage of Medicare Part B for only $135/month (roughly $1600/year) anywhere else. If a person under 65 were to buy health insurance equal to Medicare Parts A and B privately, they would probably be paying almost that much per month rather than per year.

Regular Medicare is an extremely good deal, despite a few shortcomings. There is no such thing as "free" health insurance, despite what any politician may say.

I have been on all sides of this particular fence, having had normal insurance coverage during my working years, then went 15 years with no health insurance at all (completely self pay), and now have traditional Medicare. Luckily I take no meds and so I have the least expensive Part D (drug plan) available which costs $16.50 per month ($198 per year.) I pay it all up front in January so I don't have to bother with monthly premiums. If drug coverage wasn't mandatory I wouldn't bother with that coverage because in four years I have used it ONCE .... for a $7 prescription for an antibiotic taken after getting an implant. It irks me that I have to pay $200 a year for nothing but the law is what it is. Most people I know are taking multiple medications, some quite expensive, and so for them the Part D requirement is a good thing but IMHO it should be optional. Part D has only existed since 2006, by the way.

Last edited by BBCjunkie; Yesterday at 08:56 AM..
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Old Yesterday, 08:51 AM
 
1,769 posts, read 621,513 times
Reputation: 3272
Quote:
Originally Posted by NewbieHere View Post
It’s not easy to switch back, I thought you have to go through underwriting again. I’ve warned my sister about this.

We are lucky to be a community-rating-only state where medical underwriting is not allowed in connection with Medicare. The only question that any Medicare-associated insurer is allowed to ask you is whether you have end stage renal disease. No medical underwriting and no age-based underwriting either.

We are also allowed to add or drop Medigap coverage at any time during the year, without any medical underwriting or open enrollment periods. NY is one of the very few states (I think there are only five or six) that have this combination of consumer protections.
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Old Yesterday, 09:15 AM
 
2,364 posts, read 606,366 times
Reputation: 4144
Economic literacy has never been a defining characteristic of politicians campaigning for public office, but the call for "Medicare for All" or "Universal Healthcare" or "Single Payer" (read: Someone Else Payer) is particularly dispositive.

Instead of debating how to expand Medicare coverage, politicians should focus on fixing the financial flaws in the existing program that threaten to bankrupt the nation.

Medicare spent 3.6% of gross domestic product in 2016, more than six times the share it consumed in 1967, the first full year it was implemented. The share of GDP consumed by Medicare will rise to at least 9% within 75 years — and that’s the best-case scenario. Other plausible forecasts show that Medicare could spend more than twice that.

A spending jump to 9% would require a roughly 17.4% increase in all federal taxes or a 30.5% cut in other entitlement and discretionary spending, or some intermediate combination. If the spending jump follows the worst forecasts, we would need to raise taxes by 36.33% or cut 91.76% of other spending. And this all assumes Congress doesn’t add even more people to Medicare than the current rules allow for.

That isn't sustainable.
That isn't practical.
That isn't workable.
That isn't affordable.

What do we need to do to fix Medicare? Focus on Three Things.

There are 3 fixes we need to implement:
  • First, Medicare’s eligibility age is much too low. Back in 1967, the average 65-year-old American was expected to live 14.8 more years. In 2016, 65-year-olds live 19.3 more years on average—a roughly 30% jump while the government has not adjusted the age required for benefits. The solution is to raise Medicare’s eligibility age incrementally so it once again provides for about 14.8 years of benefits on average. It isn't practical to raise it all at once, so it should be raised by, say, 3 or 4 months each year until it synchronizes with Social Security FRA, and then both raised incrementally until Medicare once again covers about 14.8 years after retirement in about 50 years from today.
  • Second, there has been a fourfold increase since "the disabled" among working-age adults. We need to restore the original disability standard—which has become lax—so that people qualify for benefits only when they are “unable to work any job in the economy.”
  • Third, we need to raise deductibles and coinsurance premiums. The average beneficiary today consumes six times more medical services than in the previous generation, even without counting the drug benefit introduced in 2006. At the same time, most Medicare beneficiaries pay 68% less in deductibles than the previous generation and are charged coinsurance on steeply discounted rates. The solution is to charge actuarially sustainable rates for deductibles and for co-insurance.

One way or another costs have to stop consuming ever larger shares of GDP.
One way or another, rates have to go up.
One way or another, retirement age must go up.
One way or another, disability criteria must be tightened; Medicare is not a general purpose welfare system.


Talking about a grand expansion scheme like Medicare for All is pure fantasy.

Last edited by RationalExpectations; Yesterday at 09:24 AM..
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Old Yesterday, 09:33 AM
 
Location: Florida -
8,801 posts, read 10,925,762 times
Reputation: 16766
The problem has never been with Medicare itself. It is with corrupt politicians who see it as a "giveaway vote vehicle" and a 'slush fund' from which they can 'borrow' in order to pay for programs we can't otherwise afford.

By the same token, Medicare will be kept afloat by these same politicians, who will continue to print money ... leading to inflation and a devaluation of Medicare, etc..
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Old Yesterday, 09:35 AM
 
Location: Rust'n in Tustin
2,324 posts, read 2,461,322 times
Reputation: 4333
Medicare is fine, many successful business give away their products for free, to anybody that wants them.

I just can't think of any right now
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Old Yesterday, 10:01 AM
 
20,970 posts, read 16,829,324 times
Reputation: 39308
Quote:
Originally Posted by bobspez View Post
The New York Post is on par with the National Enquirer. No one is planning to reduce benefits.

They aren't reducing benefits yet, but they have been reducing reimbursement amounts to the point that care is suffering (I work in rehab mostly with Medicare). If it continues it will be hard to find care with Medicare. The newest budget the White House came up with cuts 700 biillion more from medicare over 10 years. While of course giving the military enough to buy enough planes for every man, woman and child in the country.

For the poster who said they need to raise the age, they really can't do that without a way to enable those who no longer will qualify to be able to buy insurance for a cost they can afford. When I looked at the plan I now pay $650 a month for, and changed my age to 64, the premium it gave me was $1030.00 a month with a $1500 deductible. Every year that would go up as I got older. I would never be able to afford that, especially if I am no longer capable of performing my very physical job in therapy by then (frankly I doubt I could even get hired for my job at that age).

There are other ways we can pay for health care, it's a matter of choosing priorities. But simply raising eligibility age is only going to leave millions of older Americans uninsured. Which in the long run, costs us much more than giving them healthcare. That 65 year old, without health care, may end up living out those 14.8 years in a nursing home at $12,000 a month at taxpayer expense. That;s what people don't get, getting our very sick country healthier is going to save much more money in the long run that it costs upfront. We spend many times more in health care than any other developed country by far, yet we are one of the unhealthiest in terms of heart disease, obesity and diabetes. We really need to toss out the whole system and start from BEFORE people get sick, but of course that is going to require upfront costs that will have to come from something else. But it's a short term loss and long term gain.

Last edited by ocnjgirl; Yesterday at 10:55 AM..
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