11-04-2009, 09:37 AM
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CC Member
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Join Date: Sep 2008
Cobra Make, Engine:
Posts: 1,120
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Funny, the bill is 'finished' and projected to cost $800 to 900 Billion. CBO says $1 Trillion. Then the same people that said $800 to 900 Billion, now say $1.2 Trillion. A $300 billion to $400 billion INCREASE in 2 days. Multiply that over 10 years! They'll have to invent a new number.
They claim a saving of $500 Billion is available in Medicare Advantage plans. That is either a lie or very wishful thinking. But since I'm unfamiliar with Medicare Advantage plans, I attended a Med Advantage preso yesterday to see if I could identify the problems and savings. The company, United Health thru AARP Has a plan with zero premium, one pre-existing condition only [end starge renal disease] It covers Rx, again, no premium, co-pay only. 1 month supply of generics, $6.00 over the counter[less by mail in 90 day supply]
Major departure from Medicare is a $30. copay for Doc visits in network and $40. copay if out of network. For procedures 20% copay same as Medicare, but paid by UHC, not Medicare. Emergencies covered WORLDWIDE!
2 big differences I see between this plan and Medicare with a Supplement is:
1. UHC gets the part B deduction from Soc Sec. and they pays the docs, NOT Medicare. I'd guess they also get a negotiated amount in addition to the part B premium. That could be a cost to Medicare, but Medicare does not pay the bills, UHC does, so its cost vs. savings. Who is the better negotiator?
2. In Medicare + a Supplement, Medicare keeps the part B Soc. Sec. deduction, but they have to pay 80% of the medical bills. The Supplement pays the 20% of the medical bills but they collect a monthly premium in excess of $130 to $150 per person per month. Add Rx coverage and the beneficiary is at $200 per month, per person plus the RX copay.
In Medicare + a Supplement the senior has FIRST Dollar Coverage. Sounds terrific but its BAD insurance. The senior in good health is paying the $150 per month premium for nothing. Plus, even tho in good health, if the senior does NOT purchase a Rx plan [Part D] Medicare charges them a penalty premium when they finally do develop problems and need some Rx. Say a senior is 65 in perfect health and they do NOT purchase a plan D. By the time they turn 72 and now have a Rx need, their part D premium will contain 7 years of accumulated penalities, forever.
Medicare Advantage, Medicare is free from the responsibility of the senior's medical costs at a fixed, predictable price. And the senior pays no monthly premium to UHC if they are in good health. Only a $30 copay IF they go to a Doc. So that good health 65 year old saves $150 per month for the 7 years of good health but he is at risk if he gets sick. Max risk? $3950 out of pocket for the year. And the $30 copays and 20% of procedures are subtracted from the max risk number. Say the senior began developing problems and had many Doc visits and multiple tests so that his copays and 20% came to $1000, then he had to be hospitalized. His max cost for the hospital, no matter WHAT they have to do is $2950. since he has already paid $1000 out of pocket. So 26 months of no monthly premiums saves the full amount of risk.
So they are going to dig into Medicare Advantage plans and find $500 Billion in savings? Bull, and if they are looking at anything it should be the first dollar coverage plans as they are never the best way to go.
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