Quote:
Originally Posted by Scott S
Ex...
If Medicare is good why does my my 75 year old mother pay $310 a month out of pocket to cover what Medicare won't?
As a small business employer I have pretty much had it with shilling insurance for anybody! Being the middleman for insurance companies sucks, I am a fantastic logger, let me do what I do best and find a way to get coverage for anybody who WANTS it.
My plan is simple, a 3% payroll deduction for everybody, no income ceiling...
A *copay for every medical procedure of 10% of your bodywieght, double if you smoke. No exceptions, if you got skin you got to put some of it in the game. To get care beyond a bandaid or Kotex for any injury you gotta double triple prove you are a legal US citizen.
*children excluded..
Any questions?
Scott S
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What is the $310. per month for?
A Medicare Supplement policy?
OR
Prescription drug costs?
OR
Her co-pay?
I spent many years in the health insurance business. Had an agency with over 100 agents in a number of states. Personally made over $100K yearly from Med-Sup. sales. Only sold them because people are completely convinced they MUST have a supplement. I lead off EVERY sale with the statement, "You DO NOT need a Medicare Supplement."
Can you imagine having a Supplemental policy to cover what your major medical policy doesn't? Assume your MM policy covers you 80/20.
You visit the Doc. Office visit is $100., you pay $20, your policy pays $80.
Would you buy an extra policy at over $100 per month to cover that $20.?
If a Medicare beneficiary was in the same office on that same day, seeing the same Doc, the Medicare APPROVED amount for an office visit would be $38. to $42. Call it $42. Medicare pays 80%, the patient OR their supplement pay 20%. EIGHT DOLLARS AND FORTY CENTS. The remaining $58. of the normal office visit charge VANISHES.
IF your Mother is racking up $1550 in Medicare APPROVED Doctor calls per month, she would be paying the same $310. per month with no insurance. If she sees Docs at a rate of less than $1550 per month, the insurance is only giving her 'peace of mind' at a high cost. IF the $310. is for a supplement. I don't have a supplement, my wife doesn't have a supplement, they are a waste of money.
If the $310 is for drugs, then THAT is and has been the real GAP in Medicare. Medicare did not cover drugs [except in hospital stays at all. PART D was the Government solution for the drug GAP. It is terrible.
The insurance companies that offer it are all but unregulated. They can ONLY carry drugs THEY choose to carry. If a certain brand name drug costs them too much one year, the next year they DROP it off their formulary.
A simple fact of insurance, insurance MUST take in more money than it pays out from all but a few. You carry a major medical policy to protect you and yours from a catastrophic medical cost. Under Medicare, there are no catastrophic costs. Ref: My wife's $80,000 Plus hospital stay above. Our cost with Medicare alone, $1068. Had her hospital stay cost $750,000. or a million or two, our cost would still have been $1068. The lowest priced supplement in our area would be $130 per month EACH. $130X12=$1560 to cover $1068. Plus another $1560 to cover my $0 cost.
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