Medicare increase

[jblum315]

My Medicare supplement payment jumped from $207 to $302. Whoa!

[rubicon]

We had a modest jump

[outlaw]

Someone's gotta pay for the "affordable care act".

[debow]

My supplemental health care premium went up although my income did not. First time in my working career and retirement my net income was less than the previous year. I'm afraid it is a sign of hard times to come.

[nyclicker]

Ours went up from $185.75 to $187.75 for plan F.

[billethkid]

Just remember the quality, the service and COST is the least today it will ever be again.

We will start to feel the real effects of the wrongly named affordable care act over the coming years.

As has been mentioned previously as all those under age are continued on family policies and all the pre-existing condition and subsidized first timers all start to place claims on the providers, the pay for incident rate will increase and the amount of money paid out by insurance providers will increase, reducing their profits. Then the insurance companies as they have been doing will begin to raise premiums to recover those losses.

And as the volume of folks icreases in the health care system doctors and facilites you will see a further reduction in quality of service and increasing times before seeing a doctor. And the time the doctor spends with you will decrease and care will become less and less personal.

Folks who want to keep the same level of care they currently enjoy will opt to spend more to stay out of the "run of the mill" patient glut system.

And then we will see the impact of more doctors not accepting certain insurance providers as they cannot afford the low payments made for services. They in turn will become the providers for those of us who will pay more to retain what we currently have.

What you are experiencing now is only the beginning.

Affordable health care......not a chance.

[Bogie Shooter]

Just remember the quality, the service and COST is the least today it will ever be again.

We will start to feel the real effects of the wrongly named affordable care act over the coming years.

As has been mentioned previously as all those under age are continued on family policies and all the pre-existing condition and subsidized first timers all start to place claims on the providers, the pay for incident rate will increase and the amount of money paid out by insurance providers will increase, reducing their profits. Then the insurance companies as they have been doing will begin to raise premiums to recover those losses.

And as the volume of folks icreases in the health care system doctors and facilites you will see a further reduction in quality of service and increasing times before seeing a doctor. And the time the doctor spends with you will decrease and care will become less and less personal.

Folks who want to keep the same level of care they currently enjoy will opt to spend more to stay out of the "run of the mill" patient glut system.

And then we will see the impact of more doctors not accepting certain insurance providers as they cannot afford the low payments made for services. They in turn will become the providers for those of us who will pay more to retain what we currently have.

What you are experiencing now is only the beginning.

Affordable health care......not a chance.

And the alternative is?

[gerryh1943]

My blue cross plan f went from197.30 to 205.30. Try blue cross

[billethkid]

And the alternative is?

Too late for that now....the ACA was rammed into effect.

An alternative before would have been to leave the existing system of health care coverage in place for those who it was working OK in coverage and service.

Then they could have done something to address those areas and those idividuals they were supposedly trying to improve coverage for or help.

That would have been a much smaller, much more identifiable bite than upending the entire system.

For me the old system worked just fine. A fix was MAYBE needed for those who had no insurance or lack of coverage or could not get insurance.

Why do I say MAYBE? Because very little is said these days about the large percent of those who have no insurance who have no intention of getting or wanting insurance as long as they have to spend even $1 of their own money.

Health care costs were and are destined to increase no matter what. The ACA has only increased the eventuality and the rate of the financial increases.

[golfing eagles]

Just remember the quality, the service and COST is the least today it will ever be again.

We will start to feel the real effects of the wrongly named affordable care act over the coming years.

As has been mentioned previously as all those under age are continued on family policies and all the pre-existing condition and subsidized first timers all start to place claims on the providers, the pay for incident rate will increase and the amount of money paid out by insurance providers will increase, reducing their profits. Then the insurance companies as they have been doing will begin to raise premiums to recover those losses.

And as the volume of folks icreases in the health care system doctors and facilites you will see a further reduction in quality of service and increasing times before seeing a doctor. And the time the doctor spends with you will decrease and care will become less and less personal.

Folks who want to keep the same level of care they currently enjoy will opt to spend more to stay out of the "run of the mill" patient glut system.

And then we will see the impact of more doctors not accepting certain insurance providers as they cannot afford the low payments made for services. They in turn will become the providers for those of us who will pay more to retain what we currently have.

What you are experiencing now is only the beginning.

Affordable health care......not a chance.

:agree::agree::agree: 100% correct

[billybye]

Too late for that now....the ACA was rammed into effect.

An alternative before would have been to leave the existing system of health care coverage in place for those who it was working OK in coverage and service.

Then they could have done something to address those areas and those idividuals they were supposedly trying to improve coverage for or help.

That would have been a much smaller, much more identifiable bite than upending the entire system.

For me the old system worked just fine. A fix was MAYBE needed for those who had no insurance or lack of coverage or could not get insurance.

Why do I say MAYBE? Because very little is said these days about the large percent of those who have no insurance who have no intention of getting or wanting insurance as long as they have to spend even $1 of their own money.

Health care costs were and are destined to increase no matter what. The ACA has only increased the eventuality and the rate of the financial increases.

You obviously never had an employer cancel everyone's insurance and then try to find health care when you are over 50 or 60 years old. I did.
Let's fix ACA not just try to eliminate it just because it was Obama's idea.

[golfing eagles]

You obviously never had an employer cancel everyone's insurance and then try to find health care when you are over 50 or 60 years old. I did.
Let's fix ACA not just try to eliminate it just because it was Obama's idea.

Well, I did. Being self-employed and in the individual market, I was among the first to be cancelled as a consequence of the so called ACA. I'm not sure why you had trouble picking up new insurance. Fixing ACA sounds like a good idea on the surface, but this law is so deeply flawed that it may be unfixable. Eliminating it just because it was "Obama's idea" would be good enough reason in and of itself, but unfortunately it wasn't even his idea. Jonathan Gruber had a great deal of input for his 6 million dollars, but he is an idealist, not a pragmatist. Again, remember, ACA has almost nothing to do with health care reform and everything to do with "income redistribution" and government control of 1/6 of our economy. You cannot add 40 million uninsured people as well as those with expensive pre-existing conditions to the system without dramatically increasing costs, most of which come from "other people's money". But if this was the goal, they could have simply passed a law mandating coverage similar to the assigned risk pool for auto insurance. It would still cost more, but at least we wouldn't have the 33%+ additional cost of the feds running things. But then it would not achieve the true goal of government control.

[Chi-Town]

My BCBS went up 4%. Last year it went up 2.5%. But compared to the increases I had before the ACA it is hard to complain.

[billethkid]

You obviously never had an employer cancel everyone's insurance and then try to find health care when you are over 50 or 60 years old. I did.
Let's fix ACA not just try to eliminate it just because it was Obama's idea.

No you are right but I do have first hand knowledge.

My wife because of pre-existing conditions.
And was involved in the cancellation of company insurance.

I am not debating the need for the fall out of such events or covering those who have been deemed uninsureable for what ever wacky or legitimate reason.
Nor am I debating the merits or lack of them to cover evrybody that has not had insurance....except for the percentage within this group that do not want it and would rather spend the money on other stuff.

What I am debating is why fix what part of the old system that did not need it? Why dismantle everything to incorporate what was working into a mega, MEGA blanket for everybody....that nobody could adequately define.....that nobody could assign a cost and are still trying.

And I am most certainly debating that to fix health care issues has become a federal government project. Politicians who are trained and experienced at only one thing....election and staying in office as long as the incompetence will endure.

There was and still is no need to fix what was not broken!

[golfing eagles]

My BCBS went up 4%. Last year it went up 2.5%. But compared to the increases I had before the ACA it is hard to complain.

Apples and oranges, one has nothing to do with the other, especially if you have a group plan. Not all people with private insurance have increased premiums commensurate with the increased cost of ACA. Consider yourself lucky, my premium went up 19% last year and 12% this year.

[golfing eagles]

No you are right but I do have first hand knowledge.

My wife because of pre-existing conditions.
And was involved in the cancellation of company insurance.

I am not debating the need for the fall out of such events or covering those who have been deemed uninsureable for what ever wacky or legitimate reason.
Nor am I debating the merits or lack of them to cover evrybody that has not had insurance....except for the percentage within this group that do not want it and would rather spend the money on other stuff.

What I am debating is why fix what part of the old system that did not need it? Why dismantle everything to incorporate what was working into a mega, MEGA blanket for everybody....that nobody could adequately define.....that nobody could assign a cost and are still trying.

And I am most certainly debating that to fix health care issues has become a federal government project. Politicians who are trained and experienced at only one thing....election and staying in office as long as the incompetence will endure.

There was and still is no need to fix what was not broken!

Also remember Obama's press conference in May 2010----"If you already have insurance, this law does not affect you" and "If you like your doctor, you can keep your doctor". It actually was sold to the public as exactly what you suggested---a fix to an existing system that needed some tweeks to cover those without insurance---and of course the suggestion to many, although not expressed explicitly, that it was "free"--which he never disabused the gullible from believing. Now look what we got---so typical of big government that it was entirely predictable

[dbussone]

My Medicare supplement payment jumped from $207 to $302. Whoa!


Whose supplement do you have?

[Nucky]

I am truly a student. I have received so much valuable information on TOTV. The give & take of information helps many others I'm sure.
I worked like a fool one or two jobs my whole life and now find myself disabled. I have had my family saved by this unpopular medical coverage that was available just one month after we needed it the most. I hope it never happens to anyone else but do you know how tough it is to be a responsible family guy with no income, no health benefits during the first time in your life that you need them the most and the bills are just flying in relentlessly. Unrelated but important that during this time our youngest son is deployed, bringing the anxiety level between everything to the breaking point. Our family doctor forgave every penny we owed him for 16 office visits and his care for me during a five day hospitalization while we were in the waiting month of ACA. We will be paying our other doctor & hospital bills forever.
It's not fun circling the drain and feeling like your going down the drain but truthfully my opinion would be the same as the people who are the most harsh with their opinions and very hard words. For them I hope they never have to walk in our families shoes or the shoes of the people who worked their butts off during their entire lives and have a catastrophic health event. Its a real eye opener.

[Chi-Town]

I am truly a student. I have received so much valuable information on TOTV. The give & take of information helps many others I'm sure.
I worked like a fool one or two jobs my whole life and now find myself disabled. I have had my family saved by this unpopular medical coverage that was available just one month after we needed it the most. I hope it never happens to anyone else but do you know how tough it is to be a responsible family guy with no income, no health benefits during the first time in your life that you need them the most and the bills are just flying in relentlessly. Unrelated but important that during this time our youngest son is deployed, bringing the anxiety level between everything to the breaking point. Our family doctor forgave every penny we owed him for 16 office visits and his care for me during a five day hospitalization while we were in the waiting month of ACA. We will be paying our other doctor & hospital bills forever.
It's not fun circling the drain and feeling like your going down the drain but truthfully my opinion would be the same as the people who are the most harsh with their opinions and very hard words. For them I hope they never have to walk in our families shoes or the shoes of the people who worked their butts off during their entire lives and have a catastrophic health event. Its a real eye opener.
Your story illustrates the 'why can't we go back to the way it was, it worked for me' isn't the answer for a great country like ours.

[outlaw]

Your story illustrates the 'why can't we go back to the way it was, it worked for me' isn't the answer for a great country like ours.

That's what medicaid is for.

[golfing eagles]

Your story illustrates the 'why can't we go back to the way it was, it worked for me' isn't the answer for a great country like ours.

That's what medicaid is for.

No, we shouldn't go back to "the way it was", exactly. There were definitely about 12-15% of the population that fell between the cracks, and that needed to be addressed. I think the point some of us are trying to make is that it was not necessary to mess with the other 85-88%, which is what the president himself originally said (even though he knew better) As far as Medicaid goes, it really is 2nd rate care, you would not want it for yourself.

[Chi-Town]

No, we shouldn't go back to "the way it was", exactly. There were definitely about 12-15% of the population that fell between the cracks, and that needed to be addressed. I think the point some of us are trying to make is that it was not necessary to mess with the other 85-88%, which is what the president himself originally said (even though he knew better) As far as Medicaid goes, it really is 2nd rate care, you would not want it for yourself.
Aren't you an MD?

[CFrance]

Too late for that now....the ACA was rammed into effect.

An alternative before would have been to leave the existing system of health care coverage in place for those who it was working OK in coverage and service.

Then they could have done something to address those areas and those idividuals they were supposedly trying to improve coverage for or help.

That would have been a much smaller, much more identifiable bite than upending the entire system.

For me the old system worked just fine. A fix was MAYBE needed for those who had no insurance or lack of coverage or could not get insurance.

Why do I say MAYBE? Because very little is said these days about the large percent of those who have no insurance who have no intention of getting or wanting insurance as long as they have to spend even $1 of their own money.

Health care costs were and are destined to increase no matter what. The ACA has only increased the eventuality and the rate of the financial increases.
"They could have done 'something' to address those areas... For me the old system worked just fine. A fix was MAYBE needed for those who had no insurance or lack of coverage or could not get insurance."

I would like to see a very specific alternative to the health care bill. So far the people who are against it speak in generalities, if they even think everyone deserves health care. If the legislators who were so against it could have come up with a working alternative, why didn't they lay it out in specifics? Vague alternatives were bantered about, but no real plan.

Clearly something needed to be done for the millions who had no health care, or couldn't afford it (and I have a personal example of someone who is going to die because of it), and nobody who is against affordable health care has or had come up with a fix.

And this should be in the political forum.

[golfing eagles]

Aren't you an MD?

yes, which is why I know a little something about this subject.

[KeepingItReal]

No, we shouldn't go back to "the way it was", exactly.

As far as Medicaid goes, it really is 2nd rate care, you would not want it for yourself.

And why do people on Medicaid get 2nd rate care?

Are we saying those that pay better are getting better care?

Do those providing the care check to see who's paying and adjust their services accordingly?

Would that not be illegal or at least unethical for those on Medicaid to get substandard care??

[CFrance]

And why do people on Medicaid get 2nd rate care?

Are we saying those that pay better are getting better care?

Do those providing the care check to see who's paying and adjust their services accordingly?

Would that not be illegal or at least unethical for those on Medicaid to get substandard care??
KeepingItReal, they are denying some forms of treatment that others not on Medicaid receive. Here is one example for Hep C drugs. Might be considered substandard care? I haven't read further about it; just offering it as a possibility.
"Medicaid Denial for Hep C Drugs Nearing 50% in Some States"

Medscape: Medscape Access (http://www.medscape.com/viewarticle/854708)

[Nucky]

Every once & a while when I need a laugh I go into the political forum. If you want to turn this seriously great give and take of ideas over there and turn it into a clown show then I'm out. Yea I know alert the media. Aren't we all just trying to live our lives with as little drama as possible? I must admit that the new ACA does awaken a person to care for their health a little more because of the financial incentive to stay away from the doctor. Oh one other thing...the political forum...if your name isn't on it and you can't be held accountable for what you type when you have "beer muscles" then is a waste of time typing it. I rest my case.

[dbussone]

And why do people on Medicaid get 2nd rate care?

Are we saying those that pay better are getting better care?

Do those providing the care check to see who's paying and adjust their services accordingly?

Would that not be illegal or at least unethical for those on Medicaid to get substandard care??

It is well documented, and has been for years, that Medicaid recipients do not receive the same level/quality of care as those having insurance and Medicare. The reasons would fill a week long seminar, but include:
1) a very few hospitals do not accept Medicaid
2) some physicians do not accept Medicaid
3) Medicaid is primarily a program for the poor:
a) the poor may have difficulty getting transportation to appointments
b) the poor may not have the ability to receive post procedural care from family members or
Their social network.
c) etc, etc, etc
4) many Medicaid plans require a minimal co-payment ($1-2)
5) many recipients prefer to use a hospital ER for their care since hospitals
MUST treat virtually any patient that shows up at its door. And ERs are open
24/7.
6) hospitals and physicians can wait for 6+ months to be paid
7) when a state believes it has paid enough for its Medicaid program in a year,
It simply stops paying. But the providers must continue caring for the patients.
8) Medicaid programs typically pay far less for care than it costs a physician or hospital
To provide it
6) etc, etc, etc

Your premises are not necessarily accurate and imply a negative connotation, while simplistically understating the issue. I worked in healthcare, hospitals specifically, for decades. 8 of those years were as CEO of a 3 hospital system which included the largest hospital in the state of Mississippi. We provided many services not available anywhere else in the state, and lost 10s of millions of dollars taking care of Medicaid patients. We didn't turn a patient away if they were in an emergent or urgent situation, or if we were the only system that could provide that service. We had transfer agreements with every other hospital in the state to be sure no patient was ever denied care.

And most other hospitals act the same way. I'll let GE discuss physicians in greater detail if he wishes.

[Ralphy]

My Medicare supplement payment jumped from $207 to $302. Whoa!

I suggest that you look into the AARP insurance. It looks to me that your current carrier is ripping you off. We have the N plan. We do pay the Medicare deductible and 20% with a max of $20 per doctor’s visit. Also $50 for the ER if we are not admitted. We chose this plan because it was $50 per month cheaper for each of us. We have not come close to spending the $1,200 per year savings.

Every year I use the medicare.gov website to select our Medicare part D coverage. I have changed carriers every year for our coverage. This is the first year that my wife and I will have the same carrier.

You said that this in Medicare Supplement insurance. Therefore the increase has nothing to do with the Affordable Care Act.

[dbussone]

KeepingItReal, they are denying some forms of treatment that others not on Medicaid receive. Here is one example for Hep C drugs. Might be considered substandard care? I haven't read further about it; just offering it as a possibility.
"Medicaid Denial for Hep C Drugs Nearing 50% in Some States"

Medscape: Medscape Access (http://www.medscape.com/viewarticle/854708)

Now CF raises another very appropriate issue. The government (Feds and States) establish the rules for the Medicaid program. These include drugs, procedures, hospitalizations, and other regulations for care that are, and are NOT, covered. For example, my wife takes 2 expensive drugs for a chronic condition. Medicare partially pays for them. Medicaid would pay nothing for them.

We are fortunate that her out of pocket drug expense is limited by Medicare to approx $8000 per year. The two drugs retail for more than $76,000 per year. (That is 76 followed by 000.) Were she on Medicaid she would be responsible for the full cost - because neither drug is covered by Medicaid. Luckily there are some private programs that assist those who use expensive "orphan drugs."

My point is that docs and hospitals may not be the bad guys you think they are. Frequently their hands are tied by government regulations.

[Butterfly201]

Now CF raises another very appropriate issue. The government (Feds and States) establish the rules for the Medicaid program. These include drugs, procedures, hospitalizations, and other regulations for care that are, and are NOT, covered. For example, my wife takes 2 expensive drugs for a chronic condition. Medicare partially pays for them. Medicaid would pay nothing for them.

We are fortunate that her out of pocket drug expense is limited by Medicare to approx $8000 per year. The two drugs retail for more than $76,000 per year. (That is 76 followed by 000.) Were she on Medicaid she would be responsible for the full cost - because neither drug is covered by Medicaid. Luckily there are some private programs that assist those who use expensive "orphan drugs."

My point is that docs and hospitals may not be the bad guys you think they are. Frequently their hands are tied by government regulations.
The important takeaway here is doctors and hospitals are bound by government and insurance. And as patients under Medicare or insurance plans so are we. Therefore if a doctor wants to give you a drug or procedure---insurance or Medicare has to approve it.
That simple. And THAT WRONG. Why this can't be changed I don't understand. And forget Obamacare-- it simply doesn't work and only incurs more problems and expenses on us all.
Even if we are not covered, we will end up paying in the long run.

[tuccillo]

I can't speak for Medicare but my premiums have increased 13% per year for the last 3 years for essentially the same plan. This is obviously not a sustainable trajectory.

My Medicare supplement payment jumped from $207 to $302. Whoa!

[KeepingItReal]

KeepingItReal, they are denying some forms of treatment that others not on Medicaid receive. Here is one example for Hep C drugs. Might be considered substandard care? I haven't read further about it; just offering it as a possibility.
"Medicaid Denial for Hep C Drugs Nearing 50% in Some States"

Medscape: Medscape Access (http://www.medscape.com/viewarticle/854708)

Link requires a password?

It is well documented, and has been for years, that Medicaid recipients do not receive the same level/quality of care as those having insurance and Medicare. The reasons would fill a week long seminar, but include:
1) a very few hospitals do not accept Medicaid
2) some physicians do not accept Medicaid
3) Medicaid is primarily a program for the poor:
a) the poor may have difficulty getting transportation to appointments
b) the poor may not have the ability to receive post procedural care from family members or
Their social network.
c) etc, etc, etc
4) many Medicaid plans require a minimal co-payment ($1-2)
5) many recipients prefer to use a hospital ER for their care since hospitals
MUST treat virtually any patient that shows up at its door. And ERs are open
24/7.
6) hospitals and physicians can wait for 6+ months to be paid
7) when a state believes it has paid enough for its Medicaid program in a year,
It simply stops paying. But the providers must continue caring for the patients.
8) Medicaid programs typically pay far less for care than it costs a physician or hospital
To provide it
6) etc, etc, etc

Your premises are not necessarily accurate and imply a negative connotation, while simplistically understating the issue. I worked in healthcare, hospitals specifically, for decades. 8 of those years were as CEO of a 3 hospital system which included the largest hospital in the state of Mississippi. We provided many services not available anywhere else in the state, and lost 10s of millions of dollars taking care of Medicaid patients. We didn't turn a patient away if they were in an emergent or urgent situation, or if we were the only system that could provide that service. We had transfer agreements with every other hospital in the state to be sure no patient was ever denied care.

And most other hospitals act the same way. I'll let GE discuss physicians in greater detail if he wishes.


So do Medicare patients also receive sub standard care compared to those paying with private insurance since Medicare pays less than insurance?

So why does anyone need Medicaid since they can get a subsidy through the ACA?

Why are we still spending hundreds of millions of tax money on Planned Parenthood and other women's medical clinics when everyone is supposed to have their own insurance through ACA ?

[KeepingItReal]

Your premises are not necessarily accurate and imply a negative connotation, while simplistically understating the issue. I worked in healthcare, hospitals specifically, for decades. 8 of those years were as CEO of a 3 hospital system which included the largest hospital in the state of Mississippi. We provided many services not available anywhere else in the state, and lost 10s of millions of dollars taking care of Medicaid patients. We didn't turn a patient away if they were in an emergent or urgent situation, or if we were the only system that could provide that service. We had transfer agreements with every other hospital in the state to be sure no patient was ever denied care.

And most other hospitals act the same way. I'll let GE discuss physicians in greater detail if he wishes.



Premises are totally accurate and the issue is not as complicated as it is usually made out to be.

So we know many and likely most or all procedures, services, and meds are priced out at many times their actual value to cover services provided to those that do not pay by those that do pay.

If hospitals can turn these people away to some other hospital why would they still need to charge the inflated costs ?

A recent ER visit at VRH of about 4 hours for my wife's kidney stone came to over $12,000.00. Over $5K was for a single MRI. Our insurance repriced it all and excluded some bogus claims that were thrown in and we ended up paying less than $1,200.00 total to settle it since we had not met our deductible. Are we saying the hospital lost nearly $11,000.00 on a United Health Care claim? Is the hospital saying they really provided $12,000.00 in services?

Why is this any different for the hospital than being reimbursed only $1,200.00 by Medicaid on a $!2,000.00 claim?

Does the hospital get to show they lost the other $11,000.00 because the patient was on Medicaid? If they are losing so many millions how are they still in business?

[golfing eagles]

Link requires a password?




So do Medicare patients also receive sub standard care compared to those paying with private insurance since Medicare pays less than insurance?

So why does anyone need Medicaid since they can get a subsidy through the ACA?

Why are we still spending hundreds of millions of tax money on Planned Parenthood and other women's medical clinics when everyone is supposed to have their own insurance through ACA ?

I'll try to address this, although I can see where may be a reality gap to bridge. I don't know any physician who delivers "substandard" care on the basis of insurance or lack thereof. I really should have stated that the Medicaid SYSTEM is substandard. Unlike hospital ERs, physicians do not have to accept any insurance they choose not to, or for that matter, any patient they don't want, as long as it is not based on race/religion etc. In New York, there are very few private practices that accept Medicaid, and many now will not accept the combination of Medicare/Medicaid. This is simply a matter of economics. Let's say, for example, a 6 person internal medicine group in NY has office overhead of $3.4 million/year, which is reduced to 1.8 million by receipts from office labs and employed nurse practitioners,
and each physician has about 30 hours / week of office hours providing direct patient care, 48 weeks/year. This results in $208/ hour in overhead, or $52 for each 15 minute appointment. Since Medicaid pays $28 for that visit, no physician can afford any part of taking Medicaid patients. As a result, these patients are forced to go to Medicaid clinics and ERs (BTW, NY will pay a Medicaid clinic $134 for a 2 minute visit with a nurse to explain birth control pills). These clinics do the best they can, but are overwhelmed by sheer numbers. Also, the Medicaid population as a whole, are extremely unreliable, fail to show up to approx. 75% of appointments, and are generally non-compliant as well. I once calculated that NY could just buy super blue 0 deductible, 0 copay insurance for those who qualify for Medicaid and save 55% of their multi-billion expenditures---that's the effect bureaucracy has on your tax dollar.
Here in Florida, physicians in affluent areas such as Palm Beach and Naples have dropped out of MEDICARE --seniors are seen on a cash only basis. If you do not participate in Medicare, you are not bound by their rules or ridiculous paperwork
And lastly, Medicare does not really pay much less than private insurance, they all key off the Medicare rates for each CPT code. But they do require more paperwork which is a back end cost

Hope this helps you understand a bit

[dbussone]

Premises are totally accurate and the issue is not as complicated as it is usually made out to be.

So we know many and likely most or all procedures, services, and meds are priced out at many times their actual value to cover services provided to those that do not pay by those that do pay.

If hospitals can turn these people away to some other hospital why would they still need to charge the inflated costs ?

A recent ER visit at VRH of about 4 hours for my wife's kidney stone came to over $12,000.00. Over $5K was for a single MRI. Our insurance repriced it all and excluded some bogus claims that were thrown in and we ended up paying less than $1,200.00 total to settle it since we had not met our deductible. Are we saying the hospital lost nearly $11,000.00 on a United Health Care claim? Is the hospital saying they really provided $12,000.00 in services?

Why is this any different for the hospital than being reimbursed only $1,200.00 by Medicaid on a $!2,000.00 claim?

Does the hospital get to show they lost the other $11,000.00 because the patient was on Medicaid? If they are losing so many millions how are they still in business?




Another seminar is needed, and your premise is still inaccurate. If I wrote a tome here about hospital pricing you most likely still wouldn't make sense of it - because the pricing system does not make sense, and hasn't since the 90's. In the '70's and 80's hospitals began increasing prices for several reasons: one was to help pay for patients who couldn't or wouldn't pay for their care. Another was for negotiation with payers.

This largely resulted from the creation of Medicare in in the late '60's. As we all know Medicare is a federal program and, from it's beginning, intended to pay only for the cost of care. Medicare has morphed numerous times over the years, but holds the upper hand because they don't negotiate over price - you take it or you leave it.

Then Medicaid came along and their model was to pay less than costs. So hospitals began increasing their retail price lists to have some more leverage over insurance companies when payment negotiations took place. Insurers gained more leverage over time and now pretty much tell hospitals what they will pay - take it or leave it.

So now hospitals have a retail price list that is unrelated to any payment or cost model. It would be like Chevrolet putting a $100k price on the sticker of a Nova, knowing customers will negotiate the price down to $20k, or be told by fleet buyers that they will only pay $15k for a Nova - take it or leave it.

[outlaw]

And a perspective from the street: All you can eat buffets used to be a good deal....until people started to abuse them, and tried to eat two meals worth of food. Now, buffets are overpriced for a "normal" appetite. Health care has the same problem. Everyone knows the person that has had one or two knee surgeries so that they could keep playing golf or tennis or pickleball. I was told by my orthopedic surgeon that I needed surgery on both knees. This was two or three years ago. Instead, I laid off activities that hurt my knees. Now I am probably 95% healed and I have resumed all my activities. I know smokers who have had a couple of bypasses. Still smoking; never exercising. Unless one has serious skin in the game ($$$$), healthcare will continue to be abused in this country. Try getting a knee replacement so you can continue playing your favorite sport in Canada or England. They'll see you in two years...maybe.

[dbussone]

And a perspective from the street: All you can eat buffets used to be a good deal....until people started to abuse them, and tried to eat two meals worth of food. Now, buffets are overpriced for a "normal" appetite. Health care has the same problem. Everyone knows the person that has had one or two knee surgeries so that they could keep playing golf or tennis or pickleball. I was told by my orthopedic surgeon that I needed surgery on both knees. This was two or three years ago. Instead, I laid off activities that hurt my knees. Now I am probably 95% healed and I have resumed all my activities. I know smokers who have had a couple of bypasses. Still smoking; never exercising. Unless one has serious skin in the game ($$$$), healthcare will continue to be abused in this country. Try getting a knee replacement so you can continue playing your favorite sport in Canada or England. They'll see you in two years...maybe.

Well said.

[golfing eagles]

And a perspective from the street: All you can eat buffets used to be a good deal....until people started to abuse them, and tried to eat two meals worth of food. Now, buffets are overpriced for a "normal" appetite. Health care has the same problem. Everyone knows the person that has had one or two knee surgeries so that they could keep playing golf or tennis or pickleball. I was told by my orthopedic surgeon that I needed surgery on both knees. This was two or three years ago. Instead, I laid off activities that hurt my knees. Now I am probably 95% healed and I have resumed all my activities. I know smokers who have had a couple of bypasses. Still smoking; never exercising. Unless one has serious skin in the game ($$$$), healthcare will continue to be abused in this country. Try getting a knee replacement so you can continue playing your favorite sport in Canada or England. They'll see you in two years...maybe.

And this is part of the problem with healthcare in America and why European style socialized medicine would not work here. We are used to 24 hr instant service, get whatever you want whenever you want internet shopping, and abhor lines and waits. This promotes both increased cost and fraud. Note again that foreign citizens that can afford it come here for healthcare, Americans don't go to Luxembourg. And yes, there are some morons who go to Thailand for plastic surgery, you can generally recognize them by some degree of disfigurement

[champion6]

My Medicare supplement payment jumped from $207 to $302. Whoa!Let's get back on topic ... My Medicare supplement - AARP Supplemental Plan F - went from $173 to $175.

[golfing eagles]

Let's get back on topic ... My Medicare supplement - AARP Supplemental Plan F - went from $173 to $175.

same for my wife

[Fredster]

My Mutual of Omaha plan F supplement went up about $157 to $169/month, but part was because of my age!
I had both my knees replaced, because of pain and discomfort, went as long as I could, had to give up long walks. Had the surgeries about 6 years apart. I really don't know of anyone that went through the procedures for convenience.

[debow]

Seriously. No one goes thru knee replacement for the convience of wanting to play golf. I Have had both knees replaced due to severe discomfort. Bone on bone is unbelievable pain.

[Fredster]

[QUOTE=debow;1165844]Seriously. No one goes thru knee replacement for the convience of wanting to play golf. I Have had both knees replaced due to severe discomfort. Bone on bone is unbelievable pain.[/QUOTE

Yes it is, even at night, and thank God for TKR surgery!

[jblum315]

Whose supplement do you have?

It is AARP Medicare Supplement Plan F. I've had the same plan for at least 10 years. It went up a few dollars but never like this

[golfing eagles]

It is AARP Medicare Supplement Plan F. I've had the same plan for at least 10 years. It went up a few dollars but never like this

Something's wrong, if alone based on everyone else's premium increase of a few dollars for AARP/UHC plan F. Did you check with them to see if it was possibly an error?

[Fredster]

It is AARP Medicare Supplement Plan F. I've had the same plan for at least 10 years. It went up a few dollars but never like this
The reason I researched and switched to Mutual of Omaha supplement years ago was that my BCBS premium was increased quite a bit. There can be a substantial price difference between insurers for the very same plan!

[CFrance]

The reason I researched and switched to Mutual of Omaha supplement years ago was that my BCBS premium was increased quite a bit. There can be a substantial price difference between insurers for the very same plan!
My husband had the same problem with Mutual of Omaha Plan F. They started him out at around $160 when he turned 65, then proceeded to raise the premium every six months "due to age." When it went up over $230 two years later, we said the heck with this and went shopping. Got AARP Plan F for him and back down under $200, plus no automatic raises due to age.

I have had Priority Health Plan F (brought down from MI; not available in FL) for three years and only been raised a few dollars.

[Boomer]

Until the end of 2016, the medical deduction for those who itemize will remain based on the amount that exceeds 7.5% of AGI if you have turned 65. It is now 10% if you are under 65.

With the higher and higher cost of premiums, increased co-pays on prescriptions, qualified long term care premiums, dental costs, glasses, etc. you can reach a pretty big number.

For many of us, the medical deduction was something we never needed to consider because while we were working and had employer insurance, medical expenses never exceeded that 7.5% of AGI. But constantly rising costs coupled with a change in AGI because we are now retired can make it worth at least getting a big envelope to shove receipts into while hoping you don't need it but being ready if you do.

Being aware of how medical expenditures are adding up might become another factor in a decision about whether or not to tap an IRA.

I know you probably already know this if you itemize. And I know I am not an accountant and you should talk to one if you are interested in learning more about the medical deduction. But I am citing my source with a link to the IRS site, Topic 502, that will tell you more if you want to know. (The list of what expenses can qualify is actually fairly long.)

https://www.irs.gov/taxtopics/tc502.html

Boomer

[dbussone]

It is AARP Medicare Supplement Plan F. I've had the same plan for at least 10 years. It went up a few dollars but never like this


I agree with GE. I believe there is an error. I have an AARP supplement and I believe it went up slightly less than $3 per month.

[yabbadu]

Did you not know of the increase during the open enrollment time frame? Everyone has the opportunity each year to evaluate upcoming years premiums!