Ah...The 'Crisis' Continues.......

[Dan40]

Originally Posted by cobra de capell

I’m just curious, why does she? Does it cover prescriptions or services? Does she have a supplemental plan to cover those services that Medicare doesn’t pay for 100% and a prescription plan as well?

A supplemental plan, along with a prescription plan run about $135 per month and, with those plans, there is normally no or very little out of pocket expense.

Of course, if ObamaCare is actually passed – MediCare either will end up not being taken for payment by doctors or services will be unavailable as part of MediCare, e.g. either rationed or simply not offered period. Why? Payments to doctors/hospitals will be reduced by $500 Billion to help pay for a public option under ObamaCare.

It's important, for you and your Grandma, that ObamaCare be defeated.

CdC,
Medicare supplement rates are by zip code. $135 might cover a med Sup and Rx plan in Bumdum, Iowa. But in the southern half of Florida you could not get a Med Sup plan B for $135. And an Rx Part D plan [cheapest] is $44. plus co-pays. My Rx plan equals $111.per month. Last year it was $63 including one more expensive drug. That drug was $33. per month and without it this year I'm up to $111. So a REAL increase from $30. pm to $111. pm in one year. That's a Government plan for you.

[cobra de capell]

Originally Posted by Dan40

CdC,
Medicare supplement rates are by zip code. $135 might cover a med Sup and Rx plan in Bumdum, Iowa. But in the southern half of Florida you could not get a Med Sup plan B for $135. And an Rx Part D plan [cheapest] is $44. plus co-pays. My Rx plan equals $111.per month. Last year it was $63 including one more expensive drug. That drug was $33. per month and without it this year I'm up to $111. So a REAL increase from $30. pm to $111. pm in one year. That's a Government plan for you.

Actually, that increase is not so bad - drugs can be expensive and if one needs the really expensive ones, one must pay.

Personally, I think that MediCare is a great plan - as long as one can afford supplemental coverage and Part D coverage - if one cannot it can be a difficult financial road in retirement.

The bottomline - maintain a healthy lifestyle from birth the grave and life will be one hell of lot better, financially speaking. If you don't, pay to play kicks in - big time - as it should.

Too many people want to do whatever they want to do through life and expect someone else to step up and pay, especially during the last few years. Only those whe take care of business should benefit fully.

[Dan40]

Originally Posted by cobra de capell

Actually, that increase is not so bad - drugs can be expensive and if one needs the really expensive ones, one must pay.

Personally, I think that MediCare is a great plan - as long as one can afford supplemental coverage and Part D coverage - if one cannot it can be a difficult financial road in retirement.

The bottomline - maintain a healthy lifestyle from birth the grave and life will be one hell of lot better, financially speaking. If you don't, pay to play kicks in - big time - as it should.

Too many people want to do whatever they want to do through life and expect someone else to step up and pay, especially during the last few years. Only those whe take care of business should benefit fully.

Perhaps I said it wrong. Last year drugs were $63 per month INCLUDING 1 drug that was $33. of the $63. This year I'm off that drug and no drugs have been added, so if prices stayed at last years level, I would be paying $30.per month, instead I'm paying $111. per month WITHOUT last years expensive drug. That is a 370% increase. How high does it have to be for you to call it bad?

And Medicare supplements are a waste of money. WORST for those that can least afford them.
A silly expenditure for those that can afford them. Insurance is to protect one from a catastrophic loss. No such loss is possible under Medicare WITHOUT a supplemental policy.
Imagine a $800,000.00 hospital bill under Medicare Part A, patients responsibility, $1068.
Coupled with $50,000 in Doctors bill under Medicare Part B. The Medicare approved amount for that $50,000 would be about $15,000. Patients responsibility 20% or $3000.
Total of $4068. of $850,000. $4068 is not a catastrophic loss at any income level. At the lowest level, it would simply be written off. Doctors ROUTINELY write off the 20% patient share. Its too small to try to collect.
How often and how many ever face that kind of expense? Medicare supplement premium at ONLY $100 per month [much lower than one can get in my area] 5 years of good health and $100 per month =$6000.
To give you a better idea, my wife had 2 torso XRays per day for 18 days. The total was in the thousands. After Medicares adjustment, out share of the XRay charges,,,,,,,,,,$9.80. That's NINE DOLLARS AND EIGHTY CENTS.

That is why I say Medicare is terrific, but it could not exist without the support of the , in place, for profit, health care system we now have. Reduce the reimbursement rates of a "public option" to what Medicare pays and the hospital would become a condo and the Doctors would have realtors licenses to sell the condos.

I have another thought for you to ponder. The Congressional Black Caucus says they insist that ANY health care reform bill absolutely MUST have the 'public option.' They are welcome to their position.
What I'm pondering and ask you to ponder as well is, why is their NO Congressional White Caucus? And how much hell would be raised if there was a White Caucus?

[cobra de capell]

Dan40 - Hmmm.....interesting input.

So, was your option to go with another Part D policy (drug insurance) not viable to lower your increased monthly cost?

Supplemental policy - the math sure works out for not having such a policy, is that why it's offered by insurance companies so relatively cheap, e.g. their bet is that outgoing payments can accurately be projected as very small over time within the covered group of people?

By the way, are you stating that you don't carry supplemental coverage?

As to the Black Caucus - that has always been a queer thing to me as well, as is the continuing existence of the NAACP. I suppose that there was a valid reason for those types of organizations back in the early to mid 20th Century, but how they can be justified now is beyond strange. If I were black, I'd want them eliminated in favor of no color designation assigned to any group, by law. As long as they exist, they will directly and indirectly support the recognition of color as some sort of 'difference' between humans - I don't see how that can be good for blacks or whites, but especially for blacks.

On the other hand, since they do exist, I’m thinking that it would be fun to start a White Caucus, along with a National Association for the Advancement of White People (NAAWP). That would at least be entertaining for a short time and may point out how silly it is the have Black and Latina organizations at this time in American. The ironic scenario in the future may be that once Latinas take over America a white organization just may be necessary to do whatever it is that the NAACP does for blacks at this time - I'm really not sure what that is other than collect dues.

[Dan40]

Originally Posted by cobra de capell

Dan40 - Hmmm.....interesting input.

A So, was your option to go with another Part D policy (drug insurance) not viable to lower your increased monthly cost?

B Supplemental policy - the math sure works out for not having such a policy, is that why it's offered by insurance companies so relatively cheap, e.g. their bet is that outgoing payments can accurately be projected as very small over time within the covered group of people?

C By the way, are you stating that you don't carry supplemental coverage?

As to the Black Caucus - that has always been a queer thing to me as well, as is the continuing existence of the NAACP. I suppose that there was a valid reason for those types of organizations back in the early to mid 20th Century, but how they can be justified now is beyond strange. If I were black, I'd want them eliminated in favor of no color designation assigned to any group, by law. As long as they exist, they will directly and indirectly support the recognition of color as some sort of 'difference' between humans - I don't see how that can be good for blacks or whites, but especially for blacks.

On the other hand, since they do exist, I’m thinking that it would be fun to start a White Caucus, along with a National Association for the Advancement of White People (NAAWP). That would at least be entertaining for a short time and may point out how silly it is the have Black and Latina organizations at this time in American. The ironic scenario in the future may be that once Latinas take over America a white organization just may be necessary to do whatever it is that the NAACP does for blacks at this time - I'm really not sure what that is other than collect dues.

A
The policy renews in nov. dec. and the new price is announced in jan. A new part D plan cannot be purchased in Jan. Will not happen this year.

B
A pure money maker for insurance companies. No catastrophic risk to the insured, means no such risk to the insurance company either. I sold them only because people insist on buying them and if I sold it, they got the best policy for the least premium, not the one that paid the highest commission.

C
No I do not have a supplement policy. I do not give advice that I do not follow as well.


NAAWP, Wouldn't that be welcomed with open arms! Or loaded arms.

[Anthony]

Originally Posted by Dan40

--To give you a better idea, my wife had 2 torso XRays per day for 18 days. The total was in the thousands. After Medicares adjustment, out share of the XRay charges,,,,,,,,,,$9.80. That's NINE DOLLARS AND EIGHTY CENTS.

That is why I say Medicare is terrific, but it could not exist without the support of the , in place, for profit, health care system we now have. Reduce the reimbursement rates of a "public option" to what Medicare pays and the hospital would become a condo and the Doctors would have realtors licenses to sell the condos.

What you have stated in the beginning of the post is basically correct, but what I have highlighted in the 2nd part of the post is for the most part incorrect. In todays medical business enviroment, practically all medical providers (hospitals and doctors have agreements not only with medicare, but with the vast majority of health insurance companies, such that almost every service provided is under some type of contract to reduce the reimbursement to the medical provider. This is called "in network". If you see a physician "out of network", then yes, legally, the patient is responsible for the rest of the money that was chrged by the provider and not payed by the insurance, but in todays enviroment, most people "stay in network", meaning that their medical costs are significantly discounted, like Medicare, and in fact, most insuranc companies use Medicare rates as a guideline for the rates they pay in their contracts, so for the vast majority fo the time, medical providers are basically being payed "medicare" rates, no matter from medicare itself or from participating insurance companies. The US medical system has basically adjusted all rates to about medicare levels, even for insurance companies, which is why hospitals are closing, doctors are retiring earlier, etc. Contrary to what the politicians may have you think, there is not much "fat" in the system to cut out from the medical providers (doctors and hospitals).