So, as part of my life experience of walking a mile in everyone's shoes, I'm now going to be placed on Medicare for my healthcare (previously Medicaid). One of the choices I have for Medicare Advantage is the PPO plan, or the ability to visit doctors outside of my plan's network. It wasn't possible before, on Medicaid, because I could only visit doctors on my plan's in-network approved list of doctors. Now, if I want/need medical care and there are no in-network specialists in my area, I can choose to visit a doctor nearby (who accepts Medicare) and pay a slightly higher fee (20% in my case). I'm still worried about how I'm going to pay for my medications on Medicare vs Medicaid, but I don't have a choice in the matter. After about 25 weeks on Social Security Disability, I'm moved into Medicare automatically. Learning about Medicare...
I don't know that Medicare A or B helps with drugs at all. I just purchased Part D to cover that, plus I have a supplemental policy.
Yes, no Medicare parts A and B don't cover drug costs. That's where part D comes in. Thanks George W Bush!
You can choose original Medicare and its parts, and go to any Medicare doctor in the US, or get Medicare advantage, which is like private insurance.
If you are in a low income bracket, medicare will pay the substantial portion of the cost of your meds. If you are on the advantage plan, medicare will still pay most of your medicine costs. But, if you are a high earner, I don't know. If you are in SSD, they should definitely pay it.
I was rejected for the PPO plan, but I was automatically enrolled in an HMO plan provided by my current insurance company. That means I still have to go to an approved network of doctors. It's a dual Medicare-Medicaid plan. I have both now.
I just got a business card from a Medicare insurance specialist. He has an office at our doctors office. He will laminate my Medicare cards for free. I am suspicious. As much as I hate trying to understand Medicare over the phone and the irritating phone calls I have a feeling this guy will cost me dearly. Now, I am a poor boy and can't afford to make mistakes with my money. I have to eat.
You can go to the official Medicare website (Medicare.gov: the official U.S. government site for Medicare | Medicare) and shop around for insurance (during the Medicare open enrollment period, or a special enrollment period, like me who just became qualified for Medicare). And you can view information pages on Medicare topics. I wouldn't go with the guy just because he can laminate your Medicare card.
Yes, A = hospital B = doctors C = Medicare Advantage D = drugs Part C covers part D. Plus bonuses like Vision and Dental coverage, but you lose the ability to go to any hospital or doctor in the USA. It isn't original Medicare. It's more like private insurance.
So, I just came into some money. Not much. Just enough that I'm going to lose eligibility for Medicaid. So, I started the change by selecting a Medicare plan that I pay for each month. I'm back to the PPO Medicare Advantage plan. And I'm going to pay for it from my monthly SSDI benefit. The benefit wasn't that much to begin with, and the combined Medicare part B premium and the Medicare part C premium is going to cut my monthly benefits by 3/4. Bad news #1: The Medicare plan doesn't start until April 2022. Bad news #2: In New York State it's against the law to sell temporary health insurance. Bad news #3: I'm going to have to hide this change to my Medicaid eligibility until my Medicare insurance kicks in. And, I will have to pay back all of my Medicaid healthcare costs that I incur in the meantime. I was under the impression that under Obamacare that Medicaid eligibility doesn't end until 1 year after eligibility status changes, just for this situation of a poor person getting a bit of money and losing health insurance. But, I haven't seen this being said anywhere. So, I don't know if I was mistaken, or if Trump got rid of that while he was sabotaging our healthcare system.
I hope someone in the New York State government reads this message above and re-considers the rules on temporary health insurance.
Nevermind I sent my state representatives the following note: Hi, Please consider legalizing temporary health insurance in the state of New York. I don't know why it's illegal, but allowing people to have temporary healthcare in-between health insurance options can prevent periods of medically uninsured status. Such as transitioning between Medicaid or Metal-based insurance policies and into Medicare. It could also allow tourists to insure themselves for a visit to New York state. Thank you, Walter Gabrielsen III
Um, no, that's Medicaid which is not Medicare. Well, color me impressed. You actually have a clue. The only things I would add is that Medicare Part A only covers 80% of hospitalization, just as Medicare Part B only covers 80% of doctor care. The amounts covered by Medicare Parts C & D are dependent on the plan(s) that you purchase. Additionally, there are "gap" plans that cover the 20% that Medicare Parts A & B do not cover. The Medicare HI Trust Fund (Part A) is insolvent. The Medicare SMI Trust Funds (Parts B, C & D) are solvent over the infinite horizon (~75 years).
Unfortunately, that ain't gonna happen because you don't have as much money as the American Hospital Association lobbyists that are hell-bent on screwing you. Thanks to the American Hospital Association, your State in a manner most-Soviet dictates insurance policies. The only health plan coverage I need is $500,000 coverage for catastrophic disease/illness/injury and $50,000 for ER coverage. That would cost me about $28/month but thanks to the American Hospital Association and State legislators, I have to pay for pregnancy/maternity, birth-control, doctor office visits, prescription drugs, and boat-load of other crap that I don't need, want or have any use for. And thanks to the American Hospital Association and State legislators, I have to use a monopoly cartel hospitals that will price-gouge me and bill me $80,000 for something that would cost $5,000 or less on the Free Market.
Well, I don't care about mandatory coverage for pregnancy, maternity, etc. because it makes health insurance cheaper for women. But, I'm also an expensive patient myself with a load of health conditions, high drug costs, and a small possibility of being hospitalized. Monthly premium: $121 +$170.10 part B =$291.10 So, my monthly bill will be: $291.10 But what do I get? $0 Health and Drug deductibles. $602.20 total drug cost per year. Max out of pocket (both in and out of network): $3,400. This is somewhat of a steal. I've heard many people complain that the Obamacare metal-tier plans are worse than their old plans, with high deductibles. Well, a similar plan in the health insurance marketplace would cost over a thousand dollars. Medicare really does help out. Keep up the hope guys. It can work out in retirement.
Well, I and Millions of others do care because our function on this Earth is not to subsidize the life-styles of others. And if non-governmental organizations like the American Hospital Association and your own State and federal government would stop interfering, your system of monopoly hospitals and monopoly hospital cartels would devolve into clinics and polyclinics like Europe and result in tremendous cost-savings. Monopoly hospitals are why child-birth costs $9,200 in the US. Birthing clinics and mid-wives are why it only costs $2,400 in Germany and other Euro-States. Overlaying a universal system onto a broken system created by your State and federal governments and the American Hospital Association will not lower the cost of child-birth from $9,200 to $2,400, but it will increase the cost. Which is why we need to move from fee-for-service to bona fide insurance. That would bring the moral hazard into play, and so insolent people bear the brunt for their insolence by paying for the cost of their insolence instead of dumping the cost onto others.
So, what you're saying is that being a woman is a lifestyle choice?! Did you actually say that? I can hardly wait until we advance by far, and can create new adult bodies for ourselves and move our minds into them. Then maybe women can choose to be men, for convenience. But if you're a heterosexual you might not like it, because your woman would move from the front of you to the back door, if you know what I'm saying... Here you go claiming to be Amecian in your profile but having experience of Europe's healthcare system? How? Are you a foreigner or military deployed overseas? Part of Obamacare put into place the mandate of moving patient medical data online and in one place. It's simplified having a few numbers of hospitals taking over the clinics. It helps health info sharing across the medical industry. And, also Obamacare is expensive and smaller clinics can't absorb all the Medicaid/Medicare costs and new patients. Oh, so that's why my Mom had home births with a Midwife after the third child. It was to save money. I was hospital-born. I was also the first child of the family. It's quite expensive to get a first-world birthing. The hospitals need to hire staff for their maternity ward, use medical supplies, etc. But, after the passage of Obamacare, and I was assigned to Medicaid, when my pharmacy prescriptions went from $10 to $1 I knew it was something special. I was also able to access health care and not pay $299-$599 per visit. That's when I decided that this level of healthcare should apply to everyone! But, when I tell people this they recoil in horror, I don't understand it. Everyone should have a certain level of healthcare, whether they can pay for it or not. And, yes, I'm not just talking about the poor on Medicaid, but also those in the middle-class who are cutting back on medical care because they can't afford to pay for it along with an increase in costs involved in Obamacare metal-level health plans. Under Obamacare, the fee-for-service model was fazed out a few years after Obamacare went into effect. It was an intentional transition. Now it's pay-for-results. I don't know if President Trump sabotaged it. Anyway, disability is actually pretty common. One in four will be disabled during their working lifetime, 25%. That's just huge! We're all more fragile than you think, and it doesn't come down to personal choices.
