Week of April 1
Apr 8, 2019 8:51:42 GMT -6
Post by greykitty on Apr 8, 2019 8:51:42 GMT -6
jkjacq, I hope your father feels better very soon. He is blessed to have caring people around him. And I admit I also thought his responsible payment was not actually too bad for a Medicare patient. It's the reality we deal with now.
Just as a note to people not familiar with Medicare, and as I understand it as a layperson, traditional Medicare A&B pays 80% of covered services (not all services are covered) and that's where the supplemental plans jkjacq mentioned come in - to help pay that 20% Medicare does not cover. Caveat - not all doctors/facilities accept Medicare assignment. If they do not, the insured is still responsible for additional coverages. Not all tests are covered by Medicare - if they are not, the insured is responsible for the cost.
Traditional Medicare is roughly $135/month to cover Part B for most taxpayers - you have to have paid in 40 quarters of Medicare taxes to qualify, I believe, and it's somewhat income restricted - if you make a lot more money, your premium may be higher.
Supplemental plans F or G (the 'good' ones in most people's eyes) will vary from state to state and carrier to carrier, and after the first guaranteed acceptance period, may also depend on any existing conditions regarding premium rates or even acceptance into a new plan if you decide to change carriers. Plan G carries a yearly deductible. Supplemental plans are just that - each individual chooses whether to buy one or not within the sign up period, and premiums may be budget busters for many.
Plan D covers prescription drugs, on a tiered formulary protocol, so monthly premiums range (by area) from roughly $15 for bare bones plans to quite a bit more. You put in your current drugs to see which plans work best for you, but you are pretty much restricted to the pharmacies associated with the plan chosen to receive the maximum benefit, as well as to how the plans authorize prescriptions, pretty much like all insurance carriers currently work. So a patient's preferred drug may not be immediately covered until a different, generally accepted, drug protocol to treat the condition is tried.
Medicare Advantage is becoming more popular every day - monthly premiums may be less, but choice of physicians/facilities/drug stores may be more restrictive. Sort of like an HMO, but can be a good choice for many.
So many retirees say they cannot afford Medicare, let alone the supplemental plans which I believe are basically essential to ensure even reasonable coverage of covered costs.
I just see so many references to Medicare for All as a generalized panacea - going to a more single payer formula may indeed be the best way to ensure coverage for most people, but it's going to be a heck of a transition IMO, and it may not be as all-inclusive as people may hope for. I do think if we go to a Medicare for All, including younger people, tax rates are going to increase a lot, and there are going to be a lot more plan restrictions than currently in place. Not saying it may not be worth it, but as I've said often, IMO the devil will be in the details and it will not be accomplished on one grand wave of the hand, no matter how anyone may want it to.
Politically speaking - IMO it's a given that Medicare is a third rail issue for most voters over age 55, and it's still pretty much a given that that's the age group that historically, up to the current date, can be counted on to turn out in elections. Politicians making radical changes detrimental to current recipients will be doing so at their own risk, I believe. It's a heck of a balancing act for those running for office.
I do not know much about Medicaid, and that's an entirely different program as I understand it.
And, yes, those who simply 'do not pay' raise taxes/prices for everyone else. It's a hell of a circle.
Just as a note to people not familiar with Medicare, and as I understand it as a layperson, traditional Medicare A&B pays 80% of covered services (not all services are covered) and that's where the supplemental plans jkjacq mentioned come in - to help pay that 20% Medicare does not cover. Caveat - not all doctors/facilities accept Medicare assignment. If they do not, the insured is still responsible for additional coverages. Not all tests are covered by Medicare - if they are not, the insured is responsible for the cost.
Traditional Medicare is roughly $135/month to cover Part B for most taxpayers - you have to have paid in 40 quarters of Medicare taxes to qualify, I believe, and it's somewhat income restricted - if you make a lot more money, your premium may be higher.
Supplemental plans F or G (the 'good' ones in most people's eyes) will vary from state to state and carrier to carrier, and after the first guaranteed acceptance period, may also depend on any existing conditions regarding premium rates or even acceptance into a new plan if you decide to change carriers. Plan G carries a yearly deductible. Supplemental plans are just that - each individual chooses whether to buy one or not within the sign up period, and premiums may be budget busters for many.
Plan D covers prescription drugs, on a tiered formulary protocol, so monthly premiums range (by area) from roughly $15 for bare bones plans to quite a bit more. You put in your current drugs to see which plans work best for you, but you are pretty much restricted to the pharmacies associated with the plan chosen to receive the maximum benefit, as well as to how the plans authorize prescriptions, pretty much like all insurance carriers currently work. So a patient's preferred drug may not be immediately covered until a different, generally accepted, drug protocol to treat the condition is tried.
Medicare Advantage is becoming more popular every day - monthly premiums may be less, but choice of physicians/facilities/drug stores may be more restrictive. Sort of like an HMO, but can be a good choice for many.
So many retirees say they cannot afford Medicare, let alone the supplemental plans which I believe are basically essential to ensure even reasonable coverage of covered costs.
I just see so many references to Medicare for All as a generalized panacea - going to a more single payer formula may indeed be the best way to ensure coverage for most people, but it's going to be a heck of a transition IMO, and it may not be as all-inclusive as people may hope for. I do think if we go to a Medicare for All, including younger people, tax rates are going to increase a lot, and there are going to be a lot more plan restrictions than currently in place. Not saying it may not be worth it, but as I've said often, IMO the devil will be in the details and it will not be accomplished on one grand wave of the hand, no matter how anyone may want it to.
Politically speaking - IMO it's a given that Medicare is a third rail issue for most voters over age 55, and it's still pretty much a given that that's the age group that historically, up to the current date, can be counted on to turn out in elections. Politicians making radical changes detrimental to current recipients will be doing so at their own risk, I believe. It's a heck of a balancing act for those running for office.
I do not know much about Medicaid, and that's an entirely different program as I understand it.
And, yes, those who simply 'do not pay' raise taxes/prices for everyone else. It's a hell of a circle.