Katie Porter leads letter urging Biden not to dump more money into Medicare Advantage

[turbinetree]

By Jake Johnson, Common Dreams
Published April 23, 2022

Democratic Rep. Katie Porter led a group of lawmakers this week in urging the Biden administration not to increase taxpayer funding for Medicare Advantage plans after a government report showed that the privately run program received $12 billion in overpayments in 2020—a problem driven by insurers exaggerating how sick their enrollees are.

"Medicare Advantage has failed to achieve savings in any year since its inception."

Despite the March report's findings, the Centers for Medicare and Medicaid Services (CMS) announced earlier this month that Medicare Advantage (MA) plans will see an 8.5% revenue bump on average in 2023—one of the largest payment increases to MA insurers in the program's history.

https://www.rawstory.com/2657202206/

[Lars39]

1. Here's the original link..

https://www.commondreams.org/news/2022/04/22/katie-porter-leads-letter-urging-biden-not-dump-more-money-medicare-advantage

[turbinetree]

2. Wado................thank you

[Lars39]

3. You're welcome!

Good article!

[Samrob]

53. Problem is unaware folks or MAGA folks believe this is a government run Medicare program.

It is not but any failures of the program will be blamed on the Feds. Biden needs to clean that up as well. They need to change the logos and signs because they look like official Medicare emblems.

[dchill]

69. That's what we're INTENDED to believe.

[Demsrule86]

163. I can't afford regular medicare so I have an advanage plan that has great coverage and I really

like...Katie Porter should mind her own business and legislate. What makes her think she has the right to dictate to President Biden? Millions who can't afford regular Medicare will have no insurance if Sen. Warren House Member Porter gets their way...don't listen President Biden dumping people off of insurance is not the answer.

[Ms. Toad]

180. You won't have NO insurance -

You will have original medicare part A (which generally covers hospitalization), and Medicare Part B (which covers 80% of doctor's visits, routine and emergency care, and some preventative services), you cannot have a Medicare Advantage Plan unless you are enrolled in Part B. If Medicare Advantage vanishes, you will still have 80% of medical services covered under your Medicare Part B.

https://www.aarpmedicareplans.com/medicare-education/original-medicare.html

I don't have any particular objection to concept of Medicare Advantage plans, but there needs to be a lot more transparency about the various options. Your impression that you wilil have no insurance is typical of the confusion around Medicare (without any kind of supplement), supplementing Medicare with a Medicare Advantage plan, or supplementing it with an original supplement.

[dchill]

4. Medicare Advantage is a poison pill that needs to be redone.

The one fact that NONE of those annoying commercials ever mentions is that once you're with Medicare Advantage, you're NOT on Medicare anymore. Medicare Advantage is a leech - a vampire on real government insurance.

As intended.

[turbinetree]

5. So true and that in my opinion is false advertising.......

[dchill]

18. False advertising is just one more way to get ahead!

[Demsrule86]

164. Those who love regular Medicare likely have grandfathered in plans that are no longer available.

Regular Medicare's out-of-pocket and deductibles are too high...and unless you pay those in advance, you could be turned down for life-saving treatment or any treatment.

[Ms. Toad]

182. Not true.

When I started my unexpected search for health care for retirement in November 2021, I expected to end up on a Medicare Advantage plan. It was very early in my research that I rejected the possibility of a Medicare Advantage plan. Although they look attractive becasue of the $0 premium options, they leave you far more open to unaffordable care because the out-of-pocket caps are so much higher than Plan G or Plan N options

Depending on the supplement plan you choose, your total out-of-pocket expenses on currently available plans can be capped at $233 (for the entire year). A plan G supplement covers all out-of-pockets except for $233 (the current deductible); Plan N covers all but the $233 deductible and $20/per doctor's visit.

In contrast, Medicare Advantage plans are permitted to have out-of-pocket caps as high as $11,300 per year. You can find lower out-of-pocket caps by careful selection, but you are unlikely to find any as low as $233.

But for a more fair comparison, since there are $0 premium MA plans, I'll add my monthly premiums in as an out-of-pocket cost which you wouldn't have on a MA plan. On my plan (with a G supplement), the premium is ~$90/month. So - treating my premium + deductible as my out-of-pocket & deductible for the year, my costs are $1313 ($90 x 12 + $233)

Assuming you're on a $0 premium MA plan, unless your out-of-pocket expenses are capped at less than $1313, you are more likely to get you turned down for life-saving treatment if you can't pay up front. If you're paying a premium, deduct that from $1313 to determine the break-even point between MA and original medicare with a G supplement.

[Hortensis]

187. We each have Plan G supplemental policies. We've had some very

substantial medical costs and never paid a dime over our very modest annual deductible.

[Ms. Toad]

189. Absolutely right!

We've had a few missteps with providers billing our old insurance - so there have been hassles in the transition between plans.

But we've each hit the $233 cap for the year. The only additional we paid was $35, because my spouse didn't understand that checking her vision for glasses was not covered. (We have a vision plan for $15/month that covers both of us - she just messed up in the process of figuring out how this new stuff works.)

My mother in 25 years on Plan F. In that entire time, she has paid for one test which she requested. (I suspect even that would have been covered, but she doesn't think it is worth the hassle to pursue it) . That plan is no longer available, but Plan G is very similar and even for those eligible for Plan F, it is more cost-effective to buy Plan G. My father is on Plan N (for 25 years), and has never paid more than the deductible and a small copay for office visits - that plan is still available.

[Hortensis]

198. Our monthly premium is higher than yours, close to $120/mo per person,

but as I said could now be lower.

We turned down Medicare Advantage because it's a RW commercial plan, heavily advanced by libertarian extremist Paul Ryan, to privatize Medicare. Reportedly that plot is coming along nicely, but of course it'd only lead to increasingly serious problems getting needed coverage in future. Nothing's free, after all.

[Ms. Toad]

201. The plans in my area range from $90 to $150 for a new enrollee betweeen 65 and 69

Climbing over time with age to between $179 and $384 (in today's dollars). We actually went wtih a brand new AARP plan which does not include glasses, dental, and gym. (Previously all of their plans automatically included it, but a number of people had been asking them for plans with cheaper premiums because they didn't want to pay for things they either wouldn't use or could get cheaper outside of the plan.)

The insurance agent we bought ours through (she's a friend, so I was trying to give her the commission) said she regularly has people who ignored her advice to go with original medicare in her office crying because they developed costly, chronic illnesses and can no longer afford the annual MA out-of-pocket expenses. She has to scramble to try to find a (now more costly) supplement plan which will take them - or a MA plan with lower annual caps on out-of-pocket expenses.

[Hortensis]

214. Ouch. How nice to have a friend who's an expert in these

markets.

I forgot to mention it, but a huge factor in our decision to stay with Medicare was the years of sometimes crippling out-of-pocket expenses from our workplace insurance. In earlier decades of raising children, we had to get care, routine exams, etc, and seems we were always paying off medical bills. In the last 15 years of work we were older but mostly healthy and paid our insurers hundreds every month for insurance that was almost never used because of what had become typically very large deductibles that we never met. That became avoiding getting medical care for years as we aged (risky) because we had to pay it out of pocket -- on top of our now very costly monthly premiums.

Btw, love that the ACA requires insurance companies to provide annual physical and lab exams/preventive care as part of what's purchased with the basic premiums. Those who refused to join Democrats to take healthcare reform all the way prolong the national tragedy, but we did do that, and goodness knows how many lives that one change has saved. Until the far-right SCOTUS that 2016 brought down on us rules all federal healthcare programs unconstitutional anyway.

[BComplex]

71. AND that is a point that needs to be publicized in the upcoming elections! Republicans (trump)

did this!!! This was an attempt to TAKE AWAY medicare! Democrats need to shout the truth to the heavens, and repeat it over & over! If people who vote republican actually KNEW how come things get so fucked up, they might quit voting for those assholes!

[Demsrule86]

83. No one sees it like that amd such rhetoric will cost us the election. Older DUers have plans

That are cheaper than what is available today. They are grandfathered in.

[Skittles]

6. there are DUers who love their Medicare Advantage

to me it's like FB, not worth what they are trying to do

[dchill]

17. Trouble is, it seems we're all subsidizing it.

It's supposed to be private insurance. Nice work if you can get it.

[Skittles]

36. NO SHIT - it is FOR PROFIT

and often people with MA find out they get what they pay for, when they actually have to USE it - the "savings" are recouped in other ways

[Demsrule86]

78. The wraps for traditional Medicare cost money too.

[Demsrule86]

81. Many here have good regular Medicare plans that are no longer offered.

[JohnSJ]

117. Actually F was replaced with G, which is very similar to F, but G has more co-pays

Advantage plans limit can limit people’s choice where they may want to go, but for a lot of folks it is all they can afford

[Demsrule86]

131. Exactly, it has more copays thus it is not a good plan. My advantage plan is much better.

If I could not pay the copays, would be refused treatment.

[Hoyt]

137. If they had Kaiser in my area, I'd sign up. I prefer coordinated care.

If I get cancer or something, just want to be told where and when to go, and what to take. Not gonna spend my last days looking for a nice doc — assuming there are many left — who can’t produce a miracle..

Nowadays, treatment is pretty much by protocol.

[JohnSJ]

148. You are right. If everything is at one place it is much easier to co-ordinate the care where

everyone would be on the same page

[Demsrule86]

177. It is not similar as it costs way more, has higher deductibles and huge out of pocket costs.

If I agree to be in a network...what business is it of yours or anyone else? I choose what I can afford. Here in Ohio if you can't pay deductibles and out-of-pocket costs upfront, you don't get treatment. Thus the plan, you suggest would leave me essentially without medical coverage if I need expensive possible life-saving treatment...I suggest that Ms. Porter work towards improving original Medicare which undoubtedly needs to be fixed.

[Ms. Toad]

184. I am in Ohio, on original medicare, and my total deductible and out-of-pocket costs are $233/year.

And Ohio is currently safer than most other states because it prohibits excess billing (up to 15% in some instances). But a plan G supplement protects even against that.

If you are still in the period when you have the option to revert to original medicare, you ought to explore it. You have a lot of misunderstandings about what is available through original medicare.

[Ms. Toad]

183. That is not correct. G does not have co-pays.

Plan G has a single expense beyond the premium: the annual deductible - which is currently $233/year. Plan F pays the deductible - but, at least currently for people still eligible for Plan F, the additional premium (around $50/month) costs more than just paying the deductible. My spouse was eligible to purchas a Plan F (since she turned 65 before the magic date). We rejected it because it makes no sense to pay $600 per year to avoid payuing a $233 deductible.

Plan N has more co-pays - specifically doctor's visits cost up to $20/visit (that's it). There are two significant differences etween plan N and plan G - the doctor's visit co-pays and Plan G covers excess charges. Many states allow excess billing of up to 15% in some instances. Where we live (Ohio does not), bu the likelihood is that I will need to be cared for in Texas at some point and might be subject to excess billing (it is allowed there). That tipped the close balance between gambling on fewer than 8 doctor's visits a year v. the slightly higher premium.

So our total out-of-pocket costs on plan G for the entire year are $233 (per person). No matter how many doctor's visits I have. No matter how many days I'm hospitalized. There are no copays once you meet the deductible for the year.

[Ms. Toad]

181. My spouse was eligible for both the "good regular Medicare plan{} that {is} no longer offered

The only difference between that plan, and the plan she chose was the $233/year deductible. The premium difference between the two plans was about $50/month. Silly to pay $50/month ($600/year) to avoid paying a $233 deductible.

At age 65 (not eligible for the "good" plans) and 69 (eligible for the good plans) - which we enrolled in in January, our total out-of-pocket plans for everything covered by Medicare for each of us is about $3,400. (That includes premium and deductible; the plans we chose have no additional out-of-pocket expenses.) Both of us hit the deductible in January, so no more expenses (beyond the premium) all year.

Just for comparison, we do have drug costs on top of that (sometimes they are included in Medicare Advantage plans, sometimes not). That additional cost (total drugs + premium based on what we take on a regular basis is $345 for me and $695 for my spouse.

(My mother is on the "good" plan that is no longer offered; my father thinks she is silly - for the reasons we rejected the "good" plan for my spouse - the premium cost was more than the additional benefit.)

[SCantiGOP]

56. Agree

I know people that like it, but I don’t think it makes sense.

[pazzyanne]

61. There are two tracts of Medicare Advantage plans.

HMOs and PPOs.
I have a PPO plan that I love. I have a fatal autoimmune disease so I use my plan often. HMOs are a rip off in my humble opinion.

https://www.ehealthinsurance.com/medicare/advantage-all/how-is-a-medicare-advantage-hmo-vs-ppo-different#:~:text=PPO%E2%80%9D%20contrasts%3A%201%20Although%20they%20generally%20have%20provider,generally%20requires%20you%20to%20get%20a%20referral.%20

[Demsrule86]

165. Well I would likely not be able to get medical treatment with regular Medicare...it is too

expensive. And take my word, many folks like the Advantage plans...this just gives Republicans a talking point to use against us in the midterms.

[dflprincess]

10. Exactly. Medicare Advantage is very profitable for the insurance companies

Last edited Sat Apr 23, 2022, 11:32 PM - Edit history (1)

and often cheaper coverage & cover more than going with traditional Medicare & suppliements (though the commercials never mention the very narrow networks they often have that can change at any time). I have a couple friends who have signed up for these scams - so far they're happy with them but so far they have not developed chronic conditions.

The first question anyone should ask themselves is why the Advantage plans get pushed so hard and the option to go with a supplement is never mentioned.

And, once they have succeeded in destroying Medicare as we know it, you can bet the cost of these plans will sky rocket.

[dchill]

13. And we'll all be paying for it.

[Deuxcents]

26. I agree. I heard n read Thom Hartman's many articles

About Advantage plans long ago. It is a cash cow for insurance companies.

[JohnSJ]

122. You don't think Medigap plans are profitable for insurance companies?

[dflprincess]

129. Apparently not as profitable or they'd push them harder.

I have yet to get a mailer or phone call trying to sell me a medigap policy.

[JohnSJ]

150. The premiums for standard Medicare and a Medigap plan are significantly more expensive,

that is why you aren’t getting any mailers, because the premiums people pay for it are helping subsidize that cost.

For two people who have standard Medicare plus a medigap plan, 650 a month is par for the course, and it doesn’t include Dental or eyeglasses

For people who live entirely on Social Security, that would be quite expensive to make ends meet

[dflprincess]

155. I'm aware of how much traditional Medicare + supplements will cost me

It's one reason I keep working. I'm in the very odd situation where my employer's plan costs me less for my monthly premium than Medicare B will (not counting supplements). My employer's plan also has no deductible & a $2500 max annual out pocket.

It is time Medicare was reformed to cover 100% or, at the least, to cap out of pocket expenses & include vision, hearing, & dental - just like Bernie wants.

Minnesota has a program for low income seniors called MSHO (Minnesota Senior Health Options) it's a combination of Medicare & Medicaid for people 65 & over. It covers everything, including hearing aids. The problem is, your income has to be extremely low to qualify. This is the kind of program needed for everyone.

[JohnSJ]

156. I agree. No argument from me, but that sure isn't going to happen before the midterms, and

bringing up that Biden shouldn’t should not cover the Medicare Advantage short fall, I am not sure what that will accomplish before the midterms

[Ms. Toad]

185. Not if you choose wisely.

Our Medigap plans (the cadillac version) cost each of us approximatley $90/month. Those will increase over time until we hit 85 (IIRC), at which time they will be capped (aside from inflation adjustments) for the rest of our lives. In today's dollars, our premium will max out at $185/month.

My father is on a slightly more cadillac plan from the same provider (it includes discounts for dental and vision and a gym membership). He pays approximately $200/month (at age 90).

You can certainly find more expensive plans. Our options ranged at our current ages as high as $140, to as high as $384 at age 100 (in today's dollars). But since the plans are uniform, there is absolutely no reason to pay a higher premium for the same benefits.

I don't know you were including the Part B premium or not in the $600 - but if you were, it isn't really a fair comparison becuase you also have to pay Part B for a Medicare Advantage plan.

[JohnSJ]

202. Which supplemental are you talking about? G, H, or if you are fortunate F. Yes I am including

Part B, because that is part of the cost, and so should an Advantage Plan because that is part of their cost for coverage.

If you are on supplemental you also are responsible for drugs Part D, Dental, and eyeglasses

The supplemental plan coverages are uniform, but the out of pocket expenses vary considerably between which supplemental plan one has

If one has an F supplemental, almost no out of pocket expenses, and because the supplemental plans allow more choice over advantage plans, out of pocket deductibles can mount up

In that cost I also included drugs, and Dental, and for two people on a F plan the premium costs, including part D, a dental plan, and part B can easily amount to 600 to 700 a month, with very little or no out of pocket expenses, which is why the higher premiums

My whole point being that Advantage Plans are very important for a lot of people who just live off social security as their sole income, and would have great difficulty making ends meet with just a standard Medicare plan plus supplemental, and dental and drugs separate

I have no problem Providing funding for the Medicare Advantage, until a real solution is found. Wanting to not fund the MA short fall will just hurt those under MA, and I don’t think it makes little sense six months before the midterms

Just rounding down numbers for an F plus Medicare B for 2:

Part B: $200
Supplemental F: $400

Plus additional for Part D and if one chooses a dental plan

It adds up

[Demsrule86]

166. Of course they are...they have huge deductibles and out of pocket costs and there premiums

300 to 400 dollars for a decent plan but not great and then you have to add in vision, dental and gym costs. This only helps the GOP.

[JohnSJ]

168. Depends on which supplemental you have how much out of pocket expenses, and directly related to

the premium one pays

I agree with you

[Ms. Toad]

186. Where are you getting your numbers?

I have a cadillac plan (total out of pocket expenses for the year $233). $233 (total out of pocket for the year) coverage of all medical care (other than vision, dental, and drug costs) is "a decent plan but not that great"???

That's better coverage than I have ever had anywhere else. What is your definition of a great plan?

For that cadillac plan - the highest premium in NE Ohio (I compared them all) was $149.58 from Medico Corp.

(In today's dollars, at age 100, only one of the 9 plans available was over $300 (Humana - $383.85)

[napi21]

11. A few months ago, during the enrolement period, I read an article fron some

major newspaper that eported there were thousands of people dropping their Advantage plans to go back to Medicare because the Advantage plans have a maximum cap on lifetime expenditures. I had heard about that back when we first enrolled in Medicre. If you're lucky and never get aeny serious illness, those plans are ok, but you never know what the future holds. Medical procedure costs are insanely high now & when someone says a cap of a million dollars, you think, WOW, I'll never have to soend that much! Think again. I had a fractured ankle which required surgery to put in 2 plates & I was hospitalized 2 days. The surgery was $100,000+ and the hospital charges exceeded $90,000. What would it cost if someone were hospitalized for weeks?

For people who are strapped for money the "no premium costs" plans are great, but if you can go with Medicare & a supplement it's a much safer way to go.

[dchill]

14. Yes. It's basically a scam.

Those has-been "personalities" in those commercials are making out, though.

[keithbvadu2]

57. I think Joe Namath has had more tv exposure time in the ads than as a football star.

I think Joe Namath has had more tv exposure time in the ads than as a football star.

[napi21]

60. Yea, it's weird. Honestly, would you ever buy an insurance plan because some FB player or

actor told you to? I know I wouldn't! But I have to confess, my ex-daghter-in-law bought health insurance because she liked the duck in the comercial. Dumb sh**!

[JohnSJ]

123. No it isn't. Not anymore than a supplemental is?

[Skittles]

39. as with other insurance scams

the savings are wonderful, until you need to actually USE it

[JohnSJ]

124. Then are you saying Medigap plans are a "scam" also?

The reality is some people cannot afford a straight Medicare plan with a supplemental

A typical premium for a straight Medicare with a supplemental plan F or G for 2 can easily have a premium of at least 650 dollars a month for 2, and that doesn’t include Dental or eye glasses

A lot of people who just live on social security can only afford a Medicare Advantage plan

[Ms. Toad]

204. Your numbers are way off.

First, you will be paying the Medicare Part B premium whether you have original Medicare with a supplement or a MA plan. I don't know if you are including that or not, but if you are it is unfair to compare a $0 MA plan (which really costs $170.10/month) with a supplement plan which costs $170.1 + the cost of the supplement.

So here's the straight scoop for NE Ohio:

I reviewed the plans for two new enrollees (ages 65 and 69).

The most costly plan G was $149.58. For two, that's $299.16. There's no reason to buy a more expensive plan G - since the benefits are generally the same, regardless of provider. The cheapest plan was the one we purchased - about $90. (I actually believe it sas $77, because there was a new plan offered after I created my chart, which we ended up buying.)

In my region, you can purchase plan G from AARP **with dental, glasses, and gym membership** for $96.45/month.

So - for purposes of comparing apples to apples, the cost for two new enrollees up to age 69, excluding the $170.10 which MA members also pay is $192.90.

Even though MA premiums are free (beyond the $170.10). MA plans charge coinsurance, copays, and deductibles. With supplental plan F, there are zero medical expenses beyond the premium. With plan G, there is a single $233 deductible.

So the comparison isn't $0 monthly premium v. $170.10 monthly premium. The comparison needs to be premium + anticipated expenses compared to premium + anticipated expenses.

If the co-pays, coinsurance, and deductible expenses for the couple on MA amount to less than $2780.80 over the year, then (at least for this year) MA is cheaper.

But you also have to factor in the reality that any chronic illness will mean our MA advantage couple will be paying up to $11,300 (in todays dollars) each and every year. And - if you initially enroll in MA plans, there is no guarantee that you will be able to buy a supplement plan later - when the large annual out-of-pocket expenses start rolling in .

[JohnSJ]

206. For supplemental F for 2 is $400. No out of pocket deductibles. Part B $170, Part D 200

for two people

Doesn’t include dental or eyeglasses

and yes I do include Part B because that is a premium expense, and applies to Medicare Adavantage also.

Also there is a difference between G and F. F is a hundred dollars more, but no out of pocket expense, and there are a few items where it covers more. There is a reason they don’t offer F anymore

Bottom line is a good number of folks don’t understand that one still has to pay premiums when they qualify for Medicare

[Ms. Toad]

208. They can always skip a supplemental plan (although I wouldn't advise it).

Generally, it isn't worth it to pay the extra premium for Plan F (for those who are eligible).

The only difference between G and F is the that F pays the Medicare deductible, G does not. In every plan I reviewed, the additional monthly premium for plan F was at least $50 more than plan G. It doesn't take a genius to multiply $50 x 12 = $600 to recognize that it makes no sense to pay $600 to save $233.

And if you are doing an honest comparison to prove that MA is cheaper than original medicare, you have to take into account the actual expenses during the year.

For 2022:

Original Medicare Plan G: $233
Original Medicare Plan F: $0
Original Medicare Plan N: $233 + $20/office visit
MA - less predictiable, but up to $11,300

You seem to be trying to stack the deck against original medicare (calculating it for 2 people, rather than one, including a cost that doesn't vanish if you choose MA, not taking into account the medical expenses you will have under MA which you won't under the plans for the premiyums you are reciting).

A true apples to apples comparison - which I engaged in in making my own decision - would require looking back for a year or two, estimating costs that would be charged under the MA plan, and compare it to the supplemental premium + costs for the supplement plan.

It isn't like MA expenses are limited solely to the $0 additional premium. There are costs you will incur each and every time you interact with the medical system - unlike supplemental plans G, F, or N.

As to "a good number of folks don't understand," you are absolutely correct. The system scatters the information all over the place, and even those whose job it is to know are consistently giving out inaccurate information. Even more immediately important than reforming Medicare, they need to creates a comprehensive, transparent source of information about the options.

[JohnSJ]

210. Everyone needs to determine their own comfort level and what they can afford. The fact

Last edited Fri Apr 29, 2022, 01:34 AM - Edit history (1)

is that many folks whose sole income is social security can’t afford the premiums for a medigap plan, plus part B, and in order to have some coverage, unless they are eligible for Medicaid, they need a Medicare Advantage plan because that is all they can afford. The estimated average social security benefit in 2022 is 1657.00 according to AARP.

Until the whole healthcare system is revamped, I don’t see much chance of that happening unfortunately in the current political climate

[Ms. Toad]

211. My point is that if they can't afford the premiums for a supplement,

it is unlikely they will be able to afford the deductible, copays, and coinsurance - let alone a catastrophic chronic illness with significant out-of-pocket expenses every year going forward.

In choosing the plan, people need to look beyond the monthly premiums to the total annual cost. Yes Medicare Supplement plans have monthly premiums. But beyond that, based on the plan chosen, the costs are minimal. Many MA plans are $0 premium - BUT the price for that $0 premium is that each and every encounter with the health care system costs - and there is no hard stop until they are in the thousands of dollars. If you stay within network $7550; if you go outside $11,300.

And, what most people don't realize, is that (as a practical matter) you have a single opportunity to buy into the Medicare Supplement program. (Beyond the initial or special enrollment period, there is no guarantee anyone will issue you a plan, let alone an affordable one.)

You also continue to manipulate the numbers to increase the apparent disparity between the two options. You pulled out numbers for a family of two when demonstrating how high the cost of the supplemental plan was. And now, when reciting the funds from which that cost might be paid you are using the benefit a single person receives.

$1657 (one person's income) - $600 (medical care for two people) sounds pretty drastic. $3314 (both persons income) - $600 (medical care for two) is much closer to being affordable.

[JohnSJ]

212. I am not manipulating anything. I never said that 1600 was for two people. I said that was

an average number for people who collect social security from AARP

Assume both collect 3300 from SS per month, and pay a premium of 600 per month, that is 18% That is a big percentage of their income which also has to go to rent, food , utilities etc.

Out of a 10 year period that the premium cost would be about 72K for a Medicare and medigap plan

The 7550 and the 11300 are the max out of pocket for MA per year. Once they exceed that there are no more out of pocket for the rest of the year with MA. I don’t know what the figures are, but out of that population under a MA plan, how many reach that limit in a year within 10 years after they become eligible for Medicare?

Yes, the limit is high, but with the costs of hospitals and for those that need expensive treatments, it protects them from excessive costs beyond that limit.

[Ms. Toad]

215. You didn't say it was for two people, but all your prior numbers were for two people

and you didn't call out the difference. That's like chopping out the bottom 90% of a graph to make the (relatively) minor variations in the top 10% more apparent - without expressly noting that you are omitting the bottom 90%.

You are absolutely correct that the 7550 and 11300 are the max out of pocket per year. That's my point (as well as the point of several recent articles criticizing MA). If you have a chronic illness - like my daughter does - you reach those limits each and every year. Her billed medical expenses each and every year are $200,000+. That means that she hits the out-of-pocket max around by the end of January.

I'm not sure why you are asking about reaching the limit in 10 years, since that limit applies on a single year basis. In other words, if you have a chronic illness which requires hospitalization, extensive imaging, chemotherapy, etc. you can be requried to pay 11,300 the first year, the second year, the third year, etc.

In contrast the out-of-pocket-max for a plan G supplement is $233 (or $233 + premiums, for a fairer comparison). The Medigap plan I'm on is about $90 per month - so a grand total of $1313 out of pocket - less than 1/5 of the risk on the MA plan (assuming in-network only) and less than 1/8 of the annual risk if you require care out of network)

As to the 18% - again, you are comparing apples to oranges. The $0 premium is not the entire cost of MA. It is very likely that they will pay a similar amount to the Medigap premiums (and may pay significantly more) in coinsurance, copays, and deductible (which are near zero on some Medigap plans).

For comparison, my annual out-of-pocket expenses (excluding prescription drugs), under my work insurance, run about $1,200. My spouse's run around $2,000, my daughter's around $3500. For all but me, Medigap is a winner out of the gate. With my newly acquired sarcoma, it is likely to be a winner. even for me

And the other big factor - if a light consumer of health care resources changes to a heavy consumer (more likely as we age), as a practical matter, they will be unable to convert to a Medigap plan to limit exhorbitant annual costs.

[JohnSJ]

216. I don't think we are really in disagreement on this.

[napi21]

162. I have had a medigap plan for at least 10 years & there haven't been any scams or

problems in that time. All weve had to pay were aour deductuble & co-pays. It''s not cheap, but there have been no problems with the docas getting paid or have they ever refused to cover any treatments. It's much better than paying that 20% that Medicare doesn't pay.

With the cost of treatmentds & tesets, that 20% can kill ya!

[Demsrule86]

167. And you plan is likely no longer available. I suggest you look at what is available and then

get back to me. "it is not cheap"...so what are those who can't afford your plan to do? Not that they can get your plan...the new plans have way higher deductibles and out-of-pocket costs. And here in Ohio, you pay those costs when you seek treatment...no money then no care.

[Hortensis]

190. This year on renewal our agent offered alternative Plan G supplemental

coverage through 2 or more other companies that were offering notably lower premiums this year, something like $20-40/month/person. For whatever reason (premiums already not high, all bills paid with no fuss even with some substantial medical costs, we have money to burn?), my husband kept our current carrier. Whatever. Also don't know why other companies were lowering their premiums, but so it was.

[Ms. Toad]

209. The corresponding new plans do not have out-of-pocket expenses, nor are the deductibles "way higher"

Plan F is identical to Plan G, with one exception: Plan F pays the Medicare Part B deductible; Plan G does not. Plan G is available to all new enrollees.

So your total costs for care under Plan F for the entire year: $0; your total costs for care under plan G for the entire year: $233 (for 2022).

And - guess what - in all the plans available in my area, the monthly premium for plan F (the one you are sad isn't available anymore) was at least $50/month more than for plan G. $50 x 12 = $600. My spouse was eligible for plan F (having turned 65 before the magic date), but chose plan G because it makes no sense to spend $600 to save $233.

There is a new high deductible option for Plan G in 2022 ($2049). But that is an option. You are not forced into a high deductible option - you choose it based you your evaluation of whehter the decreased premium is worth the risk of catastrophic illness. The original Plan G is still available and covers pretty much 100% of your medical costs (in cooperation with Parts A and B of Medicare).

[Demsrule86]

217. First of all the premiums can range from 93 to 900 dollars...and they don't include Medicare B...

so with just the $93 it would be close to 300 per month, next you have at least 170 for Part B mine is more...and you need to pay additionally for prescriptions. Also, you need to pay for Dental and vision...so it would be close to $600.00 and that is just too much. And my sister-in-law did have to pay for some hospitalization costs with her Medicare plan... she had to pay $2000. to get her hip fixed...and most of the G plans are in the 300-400 range in Ohio but they can be as high as 900 dollars and then you pay Medicare part b as well...too high.

[Ms. Toad]

220. The G plans are not mostly in the $300-$400 range in Ohio.

The most expensive G plan (I researched all of the plans available) was $149.50 for a new enrollee. The most expensive plan at 100+ years is $383.85. So it is absolutely false that "Most of the G plans are in the 300-400 range in Ohio). None are as high as $900. I can send you the chart I built, with insurance companies identified if you would like it.

You pay Medicare Part B regardless of whether you are on a Medicare Advantage plan, so to make a fair comparison you need to compare the costs beyond Part B: The Medigap premiums (under $100/month for new enrollees, unless you choose to pay more) + $233 for the deductible versus all of the deductible, coinsurance, copays you pay during the year for a MA plan.

As to vision and dental: If you buy the AARP Medigap plan, you get dental and vision included, as well as a gym membership (unless you deliberately choose a plan which excludes it). They also sell the cheapest plan at ~$95/month.

You do have to buy a drug plan on top of that - mine is a whopping $10/month. My spouse's is abougt $8/month. (The copays are simliar to those on MA).

Your sister-in-law may have had Medicare, or her supplement plan process the payment improperly, or she may have chosen a plan other than G or N (in Ohio), or she may have plan N in a state in which excess charges are permited (15% of the cost) - or she may have chosen a cheaper premium with coinsurance, or with a high deductible If your sister-in-law has a plan G (or plan N in Ohio) and still had to pay $2,000, she should review her bills, review the Medicare statements and figure out who screwed up and make them fix it.

When we first shifted from work insurance to Medicare, there were a few bills initially processed improperly by Medicare. Part Medicare's problem, part the provider's problem. They were reprocessed and completely paid aside from the $233 coinsurance.

[Ms. Toad]

188. That's a whole other kettle of fish. Most people will be stuck with MA once they make that choice.

In theory, you can always return to original Medicare. But, as a practical matter, once you realize you need it, it will likely be cost-prohibitive.

During the initial or special enrollment period, you are entitled to purchase any supplement plan without medical underwriting - AND - they have to take you.

If you enroll in a supplement plan at any time in the future, insurers may (and are sometimes reqiured by state law) to evaluate your health status and charge you premiums based on your health at that time. Insurance companies are not required to enroll you, if your health status is not acceptable to them. If they do enroll you, pre-existing conditions can be excluded for up to 6 months.

So when you realize you are paying high out-of-pocket costs under a MA plan each and every year, and decide the cap of a small deductible and small (or zero) copays look better, there is no guarantee you will find an insurer to issue you a Medicare supplement plan.

The issue with the MA plan isn't so much a cap on lifetime expenditures (just switch to a different insurer), it is the cap on annual out-of-pocket expenses. When you are healthy, you don't generally think about what would happen if you were chronically ill. Let me introduce you to my daughter: (More than) $200,000 in billed medical expenses each and every year. If that were a one-time thing, I'd be thrilled to pay the current MA out-of-pocket cap of $11,300 - that's quite a bargain!!! But when she hits it each and every year it is unsustainable.

Under an original medicare plan, her annual out-of-pocket costs can be capped as low as $233. (For a measley $90 premium each month).

[in2herbs]

21. Technically you are still on Medicare when you have an Advantage plan because the plan is

overseen by the govt (HHS). A few years back the ability of Cigna to write Medicare policies was suspended for at least a year because Cigna did not comply with the contract and screwed over seniors.

[JohnSJ]

126. Exactly. One couldn't convert to an Advantage Plan if it wasn't. Also, a lot of

people whose sole income is just social security, can only afford a Medicare Advantage plan, because a standard Medicare withe supplemental is just too expensive

I wonder how many people realize a Medicare supplemental plan is also insured through insurance companies, and their premiums have gone up, because costs have gone up

I don’t know, but reading some of the comments in this thread I think some are under the impression that when they are eligible Medicare, there is no out of pocket cost, and that simply is not the case.

[notinkansas]

63. not redone -eliminated.

[dchill]

68. Well, that's one way to redo it!

[PatSeg]

76. Yes

And these companies are like vultures. They are dishonest and ineffective. They shouldn't be getting any government funding. Use that money to make Medicare better.

[helpisontheway]

112. Oh wow..I did not know this..My mom switched to this so that

she would have dental and vision. She also has a Ymca membership included.

[JohnSJ]

118. That is not true. You are still under Medicare or you wouldn't be able to get a Medicare Advantage

Plan

The problem with Medicare Advantage plans is that you can be limited by choices where you want to go. Medicare with a supplemental is much more expensive than an Advantage plan, and some people cannot afford straight Medicare with a supplemental plan on their fixed income

Supplemental or Medigap premiums have also gone up

[helpisontheway]

157. Oh okay. Thank you for info. Nt

[Ms. Toad]

191. If your mom just switched -

And she is in the "try it" period, encourage her to speak to someone knowledgeable before the end of the "try it period" and make sure to get an objective evaluation of teh lifetime costs - because if she tries to switch back later she may be unable to obtain a supplement plan. (With few exceptions, they are not required to offer a supplement plan outside of the initial or special enrollment period. One of those exceptions is the "try it" period following a switch to Medicare ADvantage.

There are independent consultants available for a fee. They are hard to find - so the second best bet is to speak with an insurance agent who is authorized to sell a number of plans (both MA and original). Just be aware, if you are speaking with an insurance agent, they get paid when you buy a policy so they are potentially biased toward selling you a more expensive policy.

Choosing Medicare Advantage to get Dental and Vision may be more expensive than anticipated - since it may cost her the ability to avoid catastrophic coinsurance and copays each and every year if she ends up with a chronic illness.

[JohnSJ]

121. Not true. It is for people who can't afford standard Medicare with a Medigap plan

Medigap premiums have also gone up, and is considerably more expensive than a Medicare Advantage plan, and some people simply can’t afford that

It is much more complicated than presented

[PoindexterOglethorpe]

7. I have a lot of trouble understanding the hate for Medicare Advantage.

I have an Advantage plan, and it's served me very well.

A couple of weeks ago I was visiting a friend in the rehab unit of the local hospital, and the nurse checking in with her noted that her advantage plan would pay for far more rehab than traditional Medicare would.

So what is the problem here? What am I missing?

I'm reminded of the hate for annuities here, another topic altogether I realize. But all annuities are not bad. I have two, sold to my by my investment advisor (Gasp! another forbidden topic here!) that have done me extremely well, far better than those sums of money would have done had I invested that money conventionally.

Yes, we really should have some kind of universal health care that pays for all of these things, but until then we all have to make our own decisions. For me, an Advantage Plan has been a good choice.

Oh, and my plan does not cost me anything more above what SS takes out. I know there are plans requiring additional payments, but mine is not one of them.

[skylucy]

8. I agree with you about Medicare Advantage. My parents had a Medicare Advantage plan and they

both got excellent care and their last few years of life they certainly used it... Ambulance service, Emergency Room care and Hospital stays. They were charged very little for those services and their premiums were not much at all. Their plan also paid for my dad's diabetes supplies etc and a blood pressure machine. I opted for the same Advantage Plan when I turned 65 and I have been very happy with my care, small co pays and very reasonable premium payments. Oh, and the coverage for medications on my Advantage Plan has been excellent too. I don't think you're missing anything, Poindexter. I don't get the hatred either.

[turbinetree]

9. I have never enrolled in one of these advantage plans, my wife mother and father had enrolled

in one and they were/ are fairly well off, we, the family sat down and asked what exactly are they getting with that plan, that is not covered by Medicare....the concern was the 80/20 coverage that was coming out of there pockets to cover the advantage plan...what is disconcerting is that they advertise that you will get money back, how? They never received a check.....

[dchill]

16. The money that goes "back into your Social Security check..."

...is the Medicare premiums that were formerly taken out. THEN you take it back out to pay your Medicare Advantage premium.

[in2herbs]

22. I don't pay a Medicare Advantage premium. What insurance company charges a premium

for an Advantage plan?

[PoindexterOglethorpe]

95. It depends on exactly what kind of coverage you want or need.

If you want or need to see doctors outside a given plan's group, you can pay a premium to do so. There would be other things, but I'm not fully up on them.

But most Advantage plans include an awful lot just from your Medicare amount. Certainly mine does. I was in hospital for three days at the end of 2021 with a heart attack. Insurance paid $72,890.38, I paid $885.00. I have a feeling that if this had happened when I was still working -- at that same hospital -- I'd have been out of pocket more.

[Ms. Toad]

192. On a Plan G supplement, your costs for all care for 2021 would have been $203. n/t.

[PoindexterOglethorpe]

203. Depending on where I live.

A quick research of Plan G supplement tells me that in some states I would have to pay up to the deductible amount of $2490 before the policy pays anything.

I don't seem to have a deductible on my plan.

Which actually underscores the biggest problem: How complicated all these plans are, and how difficult they are to figure out. It should not be like that. It should be easy and straight forward. Plus, they are different in different states. So what I have available to me here in New Mexico isn't going to be what's available to you in a different state. Again, an unnecessary level of complication.

[Ms. Toad]

207. The deductible is fixed by the federal government, and is the same nationally.

You were looking at a plan which is new this year (and optional): High Deductible Plan G is the same as Plan G, but with a higher deductible. In 2022, for the first time, you may purchase a Plan G with a high deductible. (It was previously available for Plan F.)

They did not eliminate the standard Plan G, and The standard deductible is set by the Federal Government for each year, and for 2021 it was $203 (the number I quoted you). For 2022 it is $233. In 2021, on plan G, your costs would have been $203. In 2022, your costs would have been $233 (on standard Plan G) or $2490 on a High Deductible Plan G. In either case, that would have been your total out-of-pocket costs for the year. on a MA plan, you can be forced to pay up to $11,300 each and every year. So if you had expenses in addition to the heart attack, you would have paid the cost of care for the heart attack, plus your coinsurance for every other encounter up to $11,300 (you may have a lower cap - but companies are allowed to have caps as high as $11,300)

Standardization is actually one of the major benefits of original medicare. Whatever company you buy it from, whatever state you are in (with four exceptions: CT, MA, ME, NY) the plans are standardized. Here's a chart telling you exactly what your plan will cover - whether you are in New Mexico, or Florida, or anywhere else in the US - except the 4 states with special rules). The same is not true of MA plans.

Along with the benefit of being able to predict exactly what is covered - so you don't have to compare every single MA plan - your original Medicare coverage is good everywhere. While some MA plans offer interstate coverage, most are state-specific. You will pay more, or may not be covered at all, if you need care while out of state. In contrast - all I have to do is find a facility which accepts Medicare, in whatever state I'm in - and I have some coverage in foreign countries.

[ProfessorGAC]

114. Many Aren't Eligible, Anyway

I have to pay EXTRA from my SS every month. One has to make quite a bit less than the point where the monthly fee goes up.
So, lots of retirees aren't even eligible for that "added back" thing.
We don't have MA anyway.
We're both under supplemental policies.

[PoindexterOglethorpe]

205. Are you talking about the monthly fee for Medicare if your income is above

$91,000 individual or $182,000 joint? Honestly, if you have that high an income you can afford an extra charge. I know. In my first year on Medicare my income had been above the then-lower amount, and I had to pay extra each month. Made me a bit crazy. Then full retirement kicked in, my taxable income dropped a lot, and I didn't need to pay extra. Whew.

My Advantage Plan is paid for from my Medicare payment. It goes directly to that insurer.

I suppose it helps a lot that I am extraordinarily healthy. Even withe the heart attack in December, 2020, I am still pretty much the healthiest person my age that I know. I'm 73.

This is also reminding me of why I have an accountant do my taxes. I can get quite befuddled by what's involved with them, and as far as I'm concerned it is more than worth the fee I pay. Plus, he gives me a senior discount on his fee, which is nice.

[ProfessorGAC]

213. Yes, I'm Talking About That

Yes, we have a high retirement income, and yes, we can afford it.
I didn't mean to imply a complaint. It is what it is.
But, I called one of those numbers from a direct mailing. We're happy with our supplemental & Rx plans, I just called out of curiosity.
We were in the right zip code, but ineligible due to high income. I guess I forgot how high, high was. I was thinking the cutoff was lower.
The letter I got from the government had a table, where the more one made, the higher the monthly Medicare fee. But, I didn't memorize it. All I know is that I pay an extra $59 per month, above standard, which is deducted from my SS payment. I think it's $212 per month total, but would have to check.

[pazzyanne]

64. + 1

I have the same experience with my plan.

[Ms. Toad]

199. Your friend either doesn't have a supplemental plan, or has bad information.

A couple of weeks ago I was visiting a friend in the rehab unit of the local hospital, and the nurse checking in with her noted that her advantage plan would pay for far more rehab than traditional Medicare would.

If you have supplemental plan G or N, rehab is 100% paid for, aside from a $233 deductible/year.

The only time MA is better is when you are close to a permanent resident in an inpatient facility.

Medicare + plan G & N fully cover the first 90 days in the plan year, and Part B gives you a once-in-a-lifetime pool of 60 additional days. Supplemental plans G and N provide an additional once-in-a-lifetime pool of 365 more days.

So if I were reaching the end of my 425 once-in-a-lifetime pool of extra days which are covered by Part B and my supplement, I would look for a MA plan which covered additional days. That is the only scenario I am aware of in which I would switch to MA.

I don't hate MA - but I hate the misinformation that is out there - like the misinformation that MA pays more for rehab than original medicare (with a supplement). I'm not aware of any MA plan which covers 100% of the first 150 days in a year - and since hospitalization is completely free on an original plan (after the annual $233 deductible is paid), the cost will almost certainly be more on MA.

I hope you remain in good health - the biggest drawback for MA plans is the annual out-of-pocket cap. As long as you remain relatively healthy, it isn't an issue. But if, like my daughter, you start to need $200,000/year in care - that $11,300 cap on out of pocket expenses (which she hits every year) will be unsustainable. Meanwhile . . . my total (including premium) out of pocket expenses for the year are under $2,000 on original Medicare.

[Hoyt]

12. Oh great, let's screw over 42% of Medicare beneficiaries-- many here -

who voluntarily choose Medicare Advantage.

[Skittles]

20. they are helping privatize Medicare

so......no

[in2herbs]

23. Trump started the ball rolling on that while in office and Biden is not stopping it and I

haven't heard a peep from AARP.

Several articles about this were posted on DU a couple of months ago.

The threat of privatizing Medicare via an Advantage plan is nothing compared to what's already in the pipeline.

[Skittles]

25. it is still something

and helps the goals of repukes so....NO to "Medicare Advantage"

[Hoyt]

24. Yeah, Bill Clinton's program was designed to hurt people. Sorry,

you have the option to stay with traditional Medicare if that works better for you.

Others who can’t afford $250 to $300 a month for a supplemental and drug plan, and maybe could use a $1000 or so a year for limited dental care (that traditional Medicare doesn’t cover), etc., should have the other option.

Lots of poor people have little choice, unless they quality for Medicaid as secondary insurer.

[Skittles]

29. uh huh

https://www.dailykos.com/stories/2020/9/14/1977397/-Beyond-the-Medicare-Advantage-Scam

[Hoyt]

31. Good, DailyKoz thinks the 42% of people who choose Advantage are too stupid

to make an informed decision between traditional and Medicare Advantage.

What exactly do you propose— sorry all you stupid people, we are going to make your life better by underfunding/defunding/stagnate-funding Medicare Advantage, and forcing you to pay several hundred dollars a month in supplemental and drug coverage.

I get we need an improved Health System, but that’s not going to happen anytime soon. In meantime, I don’t think we should hurt people who choose Advantage as best for them.

Don’t have stats, but I’ll bet money the people choosing M Advantage plans lean Democratic, mainly because they are poorer and live in urban areas.

[Skittles]

33. it's not just "DailyKoz"

https://www.washingtonpost.com/health/beware-of-misleading-sales-tactics-scams-during-medicares-open-enrollment/2021/11/05/9c71fe86-3cce-11ec-8ee9-4f14a26749d1_story.html

https://justcareusa.org/the-medicare-advantage-scam-and-beyond/

[Hoyt]

34. Didn't read the article, and hate the sales tactics. But, DUers are on Advantage plans

because it best meets their needs.

I’m OK with that, until the health system changes.

I don’t like the darn ads either, but don’t presume to know what’s best for everyone on Medicare.

42% choosing MA is a lot to be written off as too stupid to know what is best for them.

If they try to take your Traditional Medicare away from you, I will be just as adamantly opposed.

[Skittles]

35. there are a lot of DUers on FB, too

[Hoyt]

37. Glad to know you know what's best for the 42% who choose MA.

[Skittles]

38. so 42% are for privatization of Medicare

GOT IT

DONE HERE

[Hoyt]

44. No. 42% are for a health plan that best meets their need, not your desires.

Until the situation changes with our healthcare system, best not to judge those 42% based upon your needs and means.

[Celerity]

42. You keep using this 42% number as if that somehow justifies the programme. If you give people

a better choice, that 42% will melt away.

The US already overspends an insane amount on healthcare, far more per person than any other remotely large advanced nation. Double in many cases, or even more, yet the overall quality is so far behind so many nations on balance.

It is only going to get worse, as by 2030 to 2032 or so, the US will be spending over 20,000 USD per capita, per annum, on healthcare. 7 trillion USD per year and rising.

Sure, if you are wealthy and cost is no object, then yes, you can get superb, best on planet (or close) healthcare, but that is not true for many, and you have tens of millions who get shit care or no care hardly at all.

The way the US health insurance industry is run is bloody criminal.

The way the profit motive is so deeply intertwined in so many aspects of the US healthcare system is even worse.

Monetising a basic human right, which thus results in the the world's largest wealth transfer/extraction scheme that takes from the many and gives to the few, is beyond the pale.

[Hoyt]

49. Thank you. Americans are well aware of our cruddy healthcare system.

But, it’s what we have to deal with.

Until, Rep Porter, etc., enact a better system, think it’s best not to mandate to mostly poor people that they have to shell out several hundred dollars a month to keep Medicare “pure.”

[stopdiggin]

67. point is TODAY (or during annual enrollment)

I have a choice between an Advantage plan - or a Medicare 'supplement' - which costs considerably more (and really doesn't have any better 'coverage'). That's it.

Now if, at some future date, you want to offer me Medicare supplementals at a much more affordable rate ... Hey, I'm all ears. But TODAY - you are not doing so. And thusly, I must chose what I can afford.

On edit: Perhaps this post should have been more correctly directed at Skittles. But the issue really kind of remains the same. Are you willing to deprive people of the options they have now - in order to bring about some more (theoretically) just system - that will happen in some theoretical future time frame?

[Ms. Toad]

196. If you choose MA today, you will almost certainly not be able to get Medicare supplement later on.

Medicare supplement plans have guaranteed issue during your initial enrollment, or a special enrolllment period if you worked and were covered past your 65th birthday. With few exceptions, outside of those two periods, there is no guarantee you will be able to find an insurer to issue one, nor is there a guarantee that the premium will be affordable. Outside of the two enrollment periods, the supplement plans work like traditional insurance before the ACA - they can jack the prices off, refuse you entirely, make you wait for coverage.

You might want to check the total annual costs for your current health - as well as consider somewhat worse health scenario, which is likely as you age.

Two supplemental plans are pretty cheap and offer near complete coverage: G and N. The difference between them is that your total medical spend for the entire year on G is $233. Your total spend on N is $233 + up to $20/year per doctor's visits.

Taking into account that I will be paying the Part B premium regardless of MA v. Supplement, my total annual medical costs under part G are ~$152/month (~$90/month for the premium + $233 deductible + $43/month in drug premiums and prescriptions).

If you have a "free" Medicare Advantage plan, are you really spending less than $152/month ($1829) in doctor's visits, hospital care, lab tests, imaging, prescription medications, etc? Does that hold true if you (like just happened to me) end up in the hospital for a few days? My hospital stay is completely free, since I've already met my deductible. MA plans are allowed to charge you up to $11,300.

Aside from the risk that I'll develop a chronic, costly condition and be unable to switch to a supplemental plan (with the lower cap on out-of-pocket expenses), my traditional out-of-pocket insurance costs over a year are about the same as I'm paying with Medicare Part G.

[Ms. Toad]

195. I was very nearly "stupid" enough to choose a Medicare Advantage plan (which would have

been wrong for me.)

I've got a bachelor's degree and two advanced degrees. My daughter is a $200,000/year medical consumer - with many insurance hassles (including navigating a bankrupt company, lack of cobra, a stint on the ACA, and 3 work insurers in a year). I do this stuff in my sleep - and I very nearly still messed up in the choices I made. (That doesn't mean that you necessarily messed up if you chose a MA plan - only that you were messed up (by the lack of easily available information) if you made that choice without knowing all of the ramifications.

It was a nighmare going through this process and ferreting out all of the information I needed to make an informed decision. In the process I encountered SHIP navigators (state health insurance folks whose mission is to help navigate), Insurance agents (who sell both MA and supplement plans), Medicare customer service, and SS customer service. More than half did not know their head from a hole in the ground as to critical details necessary to make an informed choice. I very nearly was without coverage for the month of January because of a lack of easily digestible information.

I'm on a mission to make the information much more transparent so that very, very intelligent people have access to accurate and complete information when they make this critical, life-long decision.

I don't have any particular to there being a MA option - BUT - as is evident in your post and this thread - there is a lot of misinformation about original medicare going around. I held a lot of the same misconceptions until I was forced to do a deep dive on an accelerated basis when my boss decided I needed to retire.

Just to address the misconception in your post: Supplemental and drug coverage does not cost "several hundred dollars a month."

In NE Ohio (where I researched every plan available), a cadillac supplemental plan (G) - which leaves you with a grand total of $233 in out-of-pocket medical expenses costs at most $149.58 for a new enrollee (on top of the Part B premium which you pay even if you are on MA). The maximum cost (today's dollars) for a 100+ year old person is $383.85. The plan I'm on starts at around $90 and is capped at $179. My drug plan costs $12.90/month. My spouse's costs $7.10/month. When you add in the costs for the 13 prescriptions we regularly take, the per/person monthly cost (premium and meds) is $43 per person.

So, rather than several hundred dollars a month, our total medical costs (aside from unexpected medications) -per person are: $153.50 (supplement premium, deductible, drug premium, all drug costs) + 170.10 (which you pay even if you are on a MA plan.)

[Hoyt]

197. So your supplement cost you just under $169 a month with deductible.

Last edited Thu Apr 28, 2022, 10:19 PM - Edit history (1)

Your drug plan is relatively inexpensive. Although the premium plus copays of $43. $169 + $43 is $212, or a couple hundred a month.

You have premiums on low end of scale, and are fortunate. Hopefully, you will live to 100. But you will be spending $500 a month premiums.

[Ms. Toad]

193. Our supplemental drug plans (for 2) cost $19.10/month.

When you add in the cost of all drugs we regularly take - the cost (including premiums) is $86.27 (for 13 prescriptions).

There are certainly a lot of wild assertions about how expensive original medicare is. As someone who spent about 200 hours comparing all available plans, the assertions about costs for (1) out-of-pocket costs under a supplement plan (2) premiums for a supplement plan, and (3) costs for prescription drug plans are greatly exaggerated.

As to a dental plan a robust dental plan costs around $700/year for two people. (Yes, I researched that, too.) Right now our dental costs are considerably lower than $700/year, so we're just paying out of pocket. (Most MA dental coverage is a discount, rather than insurance, anyway - and many providers who are covered by insurance plans have their own discount plans.)

[leftstreet]

40. I think some people choose it not knowing what it is

The massive mailer and tv campaigns to get people to sign up for supplementals as they reach 65 can be confusing and overwhelming

[Hoyt]

41. Glad you know what they need. Some people can't afford

$200-$300 a month for a supplement and drug coverage, and can’t afford to turn down some extra benefits, although limited.

Don’t like the advertising blitz either. But I’m glad people have the option.

If they try to take your Traditional Medicare away, I’d oppose that too.

The solution is a better healthcare system, but that’s not reality at this time.

[leftstreet]

43. lol no I don't know what people need

I was just pointing out how overwhelming the choices are, in the face of enormous advertising pressure.

It's good thing all the plans have open enrollment/change periods

[Demsrule86]

79. Exactly .

[Takket]

15. what's the alternative?

[Celerity]

19. The US healthcare system is designed for wealth extraction and redistribution, from the broad base

funnelled up to top, with loads of fraud baked into the cake.

"Medicare Advantage has failed to achieve savings in any year since its inception."

yet it's made a few fabulously wealthy

they salute you from their yachts and their villas

[Hoyt]

27. Yet 42% of Medicare beneficiaries choose Advantage. Guess they are just

stupid, poor people?

I don’t think SAVINGS is the only measure of value here, especially for the 42% who choose it, including many DUers.

[Celerity]

28. just because it is ok for some doesn't mean the overall system is a positive

[Hoyt]

47. Didn't say it was, but it is reality for those of us who have to make that

decision under our current USA system.

[Celerity]

50. The reality simply has to change for the better. The current track is headed for a train wreck.

[Hoyt]

52. Agree. But that's not situation here now. We don't have your health system.

[Celerity]

54. Well, encouraging/rewarding the rapacious for-profit private heath insurance industry to do further

wealth extraction and wealth transfer/redistribution up the pyramid is hardly a good way to start to sort things. It just further cements in the rot.

[Hoyt]

55. Appreciate criticism and shoddiness of our healthcare system, but it's what we have

and poor people have to decide what works best for them.

They and I would take your system in a heartbeat, but that’s not reality here.

[Celerity]

59. Hoyt, that's so depressing to hear you (a very intelligent person) frame it in such fatalistic terms

A politics of resignation is not going to win the day.

I am NOT saying you are going get to a Nordic model healthcare system overnight (if ever, or even IF you should strive for that, there are many ways to get to a good place), but to simply capitulate and accept a foundationally flawed structural architecture as 'oh well, it is just the reality we have to accept' is not going to improve things (or even stop the rot from spreading), let alone lay the seeds for positive change from a more comprehensive systemic overhaul.

I hope you understand where I am coming from.

cheers

[Hoyt]

65. Appreciate it. But, it's not fatalistic to oppose screwing up to 42% of Medicare

beneficiaries because one is in opposition to privatization. Provide a viable alternative, rather than screwing people before the alternative is available.

Although small potatoes with no pay, I did a research paper for someone influential in my rube states’ healthcare financing agency and legislative committees in 1981/1982 recommending MediCAID-for-All.

I got a polite, and somewhat apologetic, letter thanking me. It was clear they laughed their asses off, knowing I was at least close to right solution in a fair society lI suspect, that would apply in blue states too.

We’re cool. Truthfully, I think the USA should have stayed with England, especially with respect to healthcare.

[Demsrule86]

86. People have to deal with the here and now. Regular Medicare has ended their best plans and

only those grandfathered in can have them. What remains is expensive and mediocre...you are looking at $300-$400 premiums for a wrap which you must-have unless you qualify for Medicaid help. Otherwise, you will have to pay upfront for any deductibles or copays...this means for many that they would be refused expensive treatment even life-saving treatment unless they paid in advance.

[Celerity]

97. why did this happen?

Regular Medicare has ended their best plans and only those grandfathered in can have them

[Demsrule86]

169. Medi-gap plans are done through private insuerers;they charge large premims, have big deductible and

and huge out-of-pocket costs. Promoting something like taking away Medicare Advantage when there is no f'ing way to replace it or improve Medicare presently is madness and will cost us the midterms...millions depend on Advantage plans.

[leftstreet]

45. +1

[stopdiggin]

70. you haven't answered the question

"what's the alternative?"
And are you (and Rep Porter) ready to provide it?

[Celerity]

72. remove the profit motive

and right now, certainly don't pay the parasitic insurance companies more money

they will manage just fine

if they try and rebel, crack that whip

[stopdiggin]

91. OK. Does this happen in time for

our next open enrollment period? What are MY options going to be for that time frame?

[Celerity]

96. shop around, I am sure you will manage nt

[stopdiggin]

98. have you priced Medicare supplimentals recently?

it's not a matter of 'good shopping' - it's a matter of sheer (and significant) cost differential.

[Demsrule86]

170. I wanted to do regular Medicare and shopped around extensively-$300 or $400 per month

for a mediocre plan...and then add on vision, dental and a pharmacy plan...it just costs too much...and you still have deductibles and out-of-pocket to pay. I say NO.

[Celerity]

178. US healthcare's a scam, EOS, a joke, no one else in the world runs it like the US, for good reason

The sickening (pardon the pun) thing is, I doubt it changes anytime soon, other than for the worse

and it will get worse, as the costs will explode to 7 trillion usd plus per year by 8, 9, 10 years from now

broken system, and a broken political system in terms of sorting it

you will likely always have some Dem wreckers, like Lieberman, Baucus, Manchin, Sinema, etc, to sabotage a public option, and that is if we even control the POTUS/Senate/House all at the same time

the 2024 US Senate map is crazy bad for is Dems too

The Rethugs only defend 10 seats, all in red states (almost all ruby red), Scott in FL is the only remote chance of an upset

whilst we have potentially as many as 14 seats in varying degrees of danger, depending how things shake out

[JoeOtterbein]

30. We need...

...Universal Healthcare in America.

NOW!

[Hortensis]

194. But "now" is literally 1000% impossible. So is anytime soon --

though it, or something very close to, was within reach in 2016.

Not any more.

Thank all those who want universal healthcare but refused to vote for the bad old Democrats. It's costing many of them big time now.

I'm not sure many realize they should be blaming themselves for trumpism and a SCOTUS set to rule all national healthcare programs unconstitutional. But they really should.

[bringthePaine]

32. Rep. Porter is the walking, breathing definition of "servant of the people", a treasure!

[mcar]

101. Really?

Why is she bringing up a sure loser of an idea right before the midterms? Also, if she feels so strongly about it, why isn't she writing legislation?

[Budi]

110. Think we know the answer to that. Good question.

Right before midterms.
Like 'student loans'. 'defund the police'.

I have yet to hear anyone selling M4A actually explain the policy, costs or implementation.
You know, the actual plan beneath the election yr slogan.
None of these are a quick fix & where are the legislative bills written & passed that actually give credibility to the well timed slogans.

Basically, They Have No Policy to speak of.

Let us kmow when M4A actually & finally has a policy plan that improves what we now have.
Until then its just campaign sloganeering.

It's been sloganeered for 6 years. Where's the M4A bill?



Meanwhile, I'm happy with the coverage I have & lemme know when I can read the M4A policy/cost plan.

There isn't one.
6 years later, nothing.

[sheshe2]

119. Change does not come from a slogan alone.

It takes hard work to write a bill and name the cost and benefits for everyone. It takes a group effort to introduce such a bill and yet none of them have.

In my opinion with all these slogans to defund the police,MA and all the student loans do nothing to fix the problem. See, we need to fix the problem and not root to put a band-aid on a hemorrhaging patient.

[Budi]

127. 'Burn it all down' was always the rallying cry.

The hemorrhaging was always the goal, or they would have worked together to advance their cause rather than pounding away on a 6 yr slogan with zero to show for it legislatively

Pitiful isn't it.

[sheshe2]

128. Yes it is pitiful.

[mcar]

138. Somehow my reply to this got lost in the ether

But your points are well taken.

I suspect/fear, after observing midterms under a Democratic president for so many years, that there are those who call themselves "progressives" who really don't want Democrats to win.

I'm not quite there yet, but SO and I are researching options. We won't go for MA because we plan and hope to do a lot of travel. But I have many friends on MA and they love it.

Having worked in healthcare for 16 years, I know there are problems with it. But to even suggest taking away some aspect of Medicare - at the same time that Republicans are actually promising to sunset SS and Medicare - is political suicide.

[Budi]

145. It is that. We have no idea what M4A even is.

6 yrs later & no one can expand on those 3 digits. Easy to remember, say, & key into a soc media reply.
That's it. And we're spose to all be ecstatic about it & all happy with it.

That's a populist ruse.

[mcar]

146. Yep, just like cancel student debt

None of them can explain how it could happen, but, of course, it's Biden's fault.

[Budi]

151. Yup.

When one has zero accomplishments of their own to campaign on, this is what they do.

I believe a big majority would prefer to have the choices we do when it comes to our health care. Like what Biden has since done with improving on ACA, for instance.
People need options & like those options.
We have no idea what ditching it for the 3 digit, 6 yr old campaign slogan would look like.
Apparantly neither do those still pushing the meme.
Nothing yet. Nope

Health care coverage is not a one size fits all kind of policy.
Not with 300 million people.

[halfulglas]

46. My big complaint is that Medicare Advantage gets paid more for their coverage from CMS.

What would happen if they didn't collect that extra amount from the CMS. Their plan drains CMS funds more to produce profit for private companies.

One of the reasons that AARP doesn't complain is that their AARP approved insurance has 2 separate groups a Medicare Medigap plan and tah dah - a Medicare Advantage plan. AARP might be good on some issues, but they make money on these so they are not exactly unbiased.

[NBachers]

48. I'm staying out of this one.

[Samrob]

51. I had an excellent insurance advisor who advised me against using this program. Said it was a scam

and would eliminate some official Medicare coverage. Never looked back and happy with the insurance I opted for.

[Hoyt]

90. Yeah, he probably sold supplemental policies and drug plans.

[Demsrule86]

139. Exactly, I found out after having to shell out 2500 for my sister in laws' surgery that there was

another fun fact is that the regular medicare plan charges $300 or $400 for the first 7 or 9 days in the hospital...so you pay thousands...you don't fork over the money then no treatment. You simply must pick plans with deductibles and copays you can afford even if you are hospitalized or need surgery or even chem...one never knows. And yes the agent made a commission on the useless wrap which cost $150.00 per month.

[keithbvadu2]

58. After reading up on it, MA is more of a HMO and it was less risky to pay the Part B for better cover

After reading up on it, MA is more of a HMO and it was less risky to pay the Part B for better coverage.

[Demsrule86]

84. If you can afford it...many can't. And if you take a bad wraparound...you have to pay the

deductibles before being treated. So, many would effectively have no insurance for hospitalization. My sister-in-law had a broken hip in order for the operation to proceed, my husband and I had to pay $2500. She didn't have the money. But her social security was too high for her to qualify for Medicaid in Ohio. I put her on a low deductible Medicare Advantage plan the next year which includes pharmaceuticals and refunded Medicare part B. There was no premium and the plan included dental, vision, and a gym membership to pretty much any gym around here.

[Hoyt]

92. Exactly. Understand some people don't like "privatization," but why penalize/bash people who can't

afford traditional Medicare?

Besides, most of the critics don't realize Medicare was privatized from day one. Even if one is on traditional Medicare, it's private insurance companies who pay the claims, credential providers, audit providers to keep them from gaming the system, monitor quality (which is monitored much more closely in Advantage Plans), answer your questions, send you notifications, etc. And, almost every service Medicare beneficiaries receive is from private doctors, hospitals, facilities, etc.

[Demsrule86]

141. That is absolutely correct. The medigap policies also come from insurance companies...I

believe they are not advertised as much because they can't complete with Medicare Advantage and most on regular Medicare are either grandfathered into a better plan that is no longer available to new subscribers or can supplement using Medicaid.

[orleans]

62. k&r nt

[Ron Green]

66. One risk pool is a health care system. Multiple risk pools is an investment scheme.

We have enough investment schemes in this country; we need a health care system.

[leftyladyfrommo]

73. I love my Advantage Plus plan.

So far I have gotten great care and it's way cheaper than my friend's Medigap plan

[Demsrule86]

82. I do too . They refund half of part B

[Emile]

74. Many doctors will likely tell you they do not like Medicare Advantage plans because

the private insurance companies make it difficult for them to get paid for the services they provide. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan; if you decide to switch.

[lapucelle]

75. Politicians writing letters that urge a Democratic president to cut medicare funding

right before a midterm election...



--------------------------------------------------------------------------------

Here's what the "government report" referenced by Raw Story actually recommends:

Rebalancing Medicare Advantage benchmark policy
June 15, 2021

The Congress should replace the current Medicare Advantage (MA) benchmark policy that applies:

- a relatively equal blend of per capita local area fee-for-service (FFS) spending with price-standardized per capita national FFS spending;

- a rebate of at least 75 percent;

- a discount rate of at least 2 percent; and

- the Commission’s prior MA benchmark recommendations – using geographic markets as payment areas, using the FFS population with both Part A and Part B in benchmarks, and eliminating the current pre-Affordable Care Act cap on benchmarks.

https://www.medpac.gov/recommendation/rebalancing-medicare-advantage-benchmark-policy-june-2021/

-----------------------------------------------------------------------------------------------------------------

The government report issued by the advisory commission is calling on CONGRESS to fix the problem. I don't think writing letters was what they had in mind.

Wouldn't we all be better served if politicians paid to be legislators actually spent their time writing laws that closed the loopholes and imposed onerous penalties for defrauding consumers and the government, as well as actually implementing the recommendations made by the Congressional advisory commission?

-----------------------------------------------------------------------------------------------------------

The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 (P.L. 105-33) to advise the U.S. Congress on issues affecting the Medicare program. In addition to advising the Congress on payments to private health plans participating in Medicare and providers in Medicare’s traditional fee-for-service program, MedPAC provides information on access to care, quality of care, and other issues affecting Medicare.

https://www.medpac.gov/what-we-do/

-----------------------------------------------------------------------------------------------------------------

Link to the complete MedPac report and its 2022 recommendations for CONGRESSIONAL action to overhaul Medicare Advantage, as well as recommendations to Congress 2016-2021 not yet implemented.

https://www.medpac.gov/wp-content/uploads/2022/03/Mar22_MedPAC_ReportToCongress_SEC.pdf

[Demsrule86]

87. It is fucking insanity...we could lose Congress over this...hope Biden ignores it and only those

promoting it are endangered except for Katie Porter, most are in save Democratic seats...I wish she wouldn't do this, I worry it will cost us the seat.

[lapucelle]

89. Indeed. Who benefits from the narrative that a Democratic president is cutting Medicare funding?

And why engage in publicity campaigns urging the president do something when the report recommends that CONGRESS do something?

Cui bono?

[Cha]

113. I know I trust and respect President

Biden more than those writing a letter instead of getting busy in Congress!

Mahalo for your informative posts, lapucelle!

💙💛

[lapucelle]

115. Facts are our friends.

MAHALO CHA!!!!!!!!!!!!!!!!!!!!!!

[Cha]

116. And you are the best at investigating

those Facts.. shining the light!



💙💛

[Demsrule86]

143. I absolutely agree Cha.

[Cha]

154. I see you do, Dmes..

💙💛

[Demsrule86]

142. I do to...do your job Congress. And please every once in a while remember this is a f'ing

midterm year.

[mcar]

99. This is akin to "defund the police"

Democrats want to take away your Medicare.

[Demsrule86]

77. I like Medicare advantage. Millions do.

[skylucy]

125. +100! I am one of those who is very happy with my Medicare Advantage plan.

[Demsrule86]

130. Me too.

If you are older and have an earlier version of Medicare or if you are eligible for Medicaid help, it may be different. But millions of older people who can't afford regular Medicare would essentially lose health care if they couldn't pay the wrap premiums, pharmaceutical premiums and the better plans also have premiums. In Ohio, if you can't pay your deductible or co-pays, they can and will refuse treatment.

[Demsrule86]

80. Katie Porter endangers her reelection . As many like Medicare advantage,

[Emile]

85. The first year of my retirement I was on an advantage plan. I found out

if you wanted to freely travel you were taking a big risk. The second open enrollment I switched.

[Demsrule86]

88. The one my sis has allow travel...and you have to choose what you can afford. regular medicare ...

those plans not grandfathered in are damned expensive and could mean that those who can't pay for wraps, pharmaceuticals, or deductibles could be essentially shut out from expensive treatment...as most doctors and hospitals ask for money upfront.

[Hoyt]

93. If you buy plans from large insurers, travel is not an issue. People who take a local plan, often

owned by local hospitals and doctors, do have some travel issues, although there are usually ways to work around it.

[Demsrule86]

133. I have a large insurer so no worries.

[Emile]

104. Sure you can, just make sure the doctors, clinics and hospitals are

all covered before going.

[Demsrule86]

132. my Advantage Plan has doctors and hospitals out of area...and I don't think folks don't

here don't get it. If you can't afford the deductibles you will not receive care. Regular Medicare now has high deductibles...and if you try to get rid of Medicare Advantage, we will likely lose the midterms. I can't imagine what those in Congress are thinking. I suppose they don't understand affordability is very important in these matters.

[gulliver]

94. Let's let Biden do the talking from now on. Attacking Medicare Advantage seems foolish to me.

A very close loved one of mine is on Medicare Advantage (which is still Medicare, just wrapped by additional insurance). MA is just fine, thank you. An example major user is the Teachers Retirement System (TRS) of Illinois.

MA saves its customers a lot of money and gets them better care. Importantly, unlike base Medicare and Medigap, Medicare Advantage provides a MOOP (maximum out-of-pocket) benefit. You get a $150K bill for heart surgery one year? Under MA, your cost is your MOOP, probably around $3K-4K. Under Medicare and Medigap, the sky's the limit. You're going to the poor farm.

What we should be doing is promoting MA-like universal national health insurance, not attacking...not attacking really anything at all. We don't need fighters for fighting's sake. We need fighters who win. That means not leading with our chins and not "bravely" punching our opponent's (the Republican Party's) fist with our faces.

[mcar]

100. "Democrats want to take away your Medicare"

This stunt has just given Republicans ammunition for the midterms. Akin to "defund the police." What are these pols thinking?

[Cuthbert Allgood]

102. We spend too much time worrying about what the Republicans will say and not doing what's right.

Know how much the Republicans care about what Dems think? Fucking nothing. They blocked Garlin. Didn't hurt them fuck all because we didn't do/say things because it might offend Republicans.

[mcar]

103. that's because the Republicans control the media

It wouldn't be what the Republicans will say, it will be what the media says. CNN, MSNBC, NYTimes, WaPo would all be reporting how the Democrats are hurting their chances because Republicans claim x, y, z.

[lapucelle]

106. Why are you concerned with "offending Republicans"?

No one mentioned that concern.



------------------------------------------------------------------------------------------------------------------------

Here are some concerns that were mentioned

Because a significant percentage of seniors like and rely on Medicare Advantage, the CMS's funding recommendations should be met.

Biden cutting medicare funding will hand Republicans and the media a narrative that will damage Democrats in November.

Politicians are busy writing letters and then publicly releasing them when they should be busy doing their jobs: working on the CONGRESSIONAL fixes that the report actually recommends.

Politicians who decry fraud and loopholes should work harder at writing legislation to remedy those problems. Underfunding a popular program does nothing to address that issue.

https://www.cms.gov/newsroom/fact-sheets/2023-medicare-advantage-and-part-d-rate-announcement

https://www.medpac.gov/wp-content/uploads/2022/03/Mar22_MedPAC_ReportToCongress_SEC.pdf

[Cuthbert Allgood]

107. Well, the post I replied to said:

This stunt has just given Republicans ammunition for the midterms.

So there's that. I would think that replying to a post would indicate what I'm replying to.

[lapucelle]

111. What does that have to do with offending Republicans?

Concern about handing a damaging narrative to the media and opposition is not the same as concern about "offending" anyone.

---------------------------------------------------------------------------

And if the goal is "to do what's right", then Medicare Advantage should be fully funded as per the CMS findings in its rate announcement, and politicians should stop writing letters and start getting busy working on the six year backlog of Medicare Payment Advisory Commission recommendations concerning Medicare Advantage that Congress has not yet implemented.

https://www.cms.gov/medicarehealth-plansmedicareadvtgspecratestatsannouncements-and-documents/2023

https://www.medpac.gov/wp-content/uploads/2022/03/Mar22_MedPAC_ReportToCongress_SEC.pdf

[mcar]

140. I stand by my statement

This stunt will give Republicans ammunition for the midterms.

Why has Rep. Porter waited until now, midterm season, to come up with this "issue?"

[Progressive dog]

105. If you have medicare advantage

as I do, you realize that it provides better coverage for the same cost. You do still pay medicare part B unless you are low income, in which case you wouldn't pay anyway. This year, the same plan that I have had for several stopped charging an additional premium while continuing part D (drug) coverage and adding some vision and dental benefits.
I certainly hope that it remains as an option for those of us who use it. I believe all MA plans also have an out of pocket maximum in any given year.

The Centers for Medicare & Medicaid Services (CMS) announced today that CMS’ aggressive corrective actions led to an estimated $20.72 billion reduction of Medicare Fee-for-Service (FFS) improper payments over seven years.

“CMS is committed to reducing and preventing improper payments,” said Jonathan Blum, CMS Principal Deputy Administrator & Chief Operating Officer. “It is important to understand that only a small fraction of improper payments represent a payment that should not have been made – and an even smaller percentage represent actual cases of fraud.”

The 2021 Medicare FFS estimated improper payment rate (claims processed July 1, 2019 to June 30, 2020) is 6.26% ̶ an historic low. This is the fifth consecutive year the Medicare FFS improper payment rate has been below the 10% threshold for compliance established in the Payment Integrity Information Act of 2019. Due to CMS corrective actions, the agency saw key successes in the following areas:

https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-medicare-fee-service-estimated-improper-payments-decline-over

[Demsrule86]

136. My Advantage plan pays half of Part B.

[Hotler]

108. Hell yeah. Go away JJ Walker and Joe Namath. Shove your "CALL NOW" up your ass.

[XanaDUer2]

109. I'm confused about MA

can't that money be used to make Medicare better and more comprehensive?

[Demsrule86]

144. No, that won't happen. You never get back what you get rid of...and there would be hell

to pay if Democrats touch Medicare Advantage as it is much more reasonable than traditional Medicare. You can make regular Medicare better by offering better wraps and dealing with pharmaceutical plans. And this is going to hurt us in the mid-terms.

[JohnSJ]

120. Guess what Katie Porter, straight Medicare with a Medigap has gone up significantly also,

but the problem is a lot of people cannot afford that on their fixed income, and need the significantly lower cost Medicare Advantage

Instead of throwing the baby out with the bath water, legislation is needed to fix the situation, and until that happens, the funding is needed

Medigap is run by private insurance also, and its premiums have gone up also, and are considerably more expensive than an Advantage Plan

[Budi]

135. We'll be waiting till the dust layers form to hear an actual policy plan.

Cuz there is none now & there never was one.

[JohnSJ]

149. Well said Budi

[Budi]

152. 👍

💙

[Demsrule86]

147. Why would she do this now during a midterm...people fearing the loss of the Advantage

Plan could stay home or not vote for us...I always vote Democratic personally no matter what but not everyone does. Katie Porter has to get reelected also. And I think that was a Gop seat before she won.

[JohnSJ]

153. +++

[Chuuku Davis]

158. Lobbyists win again

[Demsrule86]

159. Maybe Ms Porter should look at how expensive it is for regular Medicare and taking away

an affordable choice while doing nothing to improve regular Medicare is not the answer. Some would no longer be able to afford care. Unless you can pay the deductibles, out of pocket...you will not receive care.

[OnDoutside]

160. Yet again it's the messaging. Rather than offering up an open goal to the GOP, could they not have

targeted the apparent fraud in the system and demanded the Administration beef up the auditing of the charges ?

[Emile]

161. Wouldn't it be better to just dump Medicare

and replace it with a single-payer system?

[Demsrule86]

172. Sure and we have zero chance of doing that. I want a unicorn too...and have as much change of

getting one.

[Emile]

173. That's a big problem with our politicians, they don't represent us! They

have their interests in who gives them the most money!

[Demsrule86]

175. They are representing the millions who want to keep private insurance and don't want

Medicare Advantage eliminated.

[Emile]

176. Oh I thought you agreed with Single Payer, but never mind. . .

[Emile]

171. Never underestimate Katie Porter's brilliance. She knows what

she is talking about!

[Demsrule86]

174. Her seat was Republicans for years...hope all is well there...we need her to be reelected even

though of late, I disagree with her often. Calling for what some might perceive as the end of "Medicare" might cause her electoral difficulties...and for some, it would be the end as they can't afford regular Medicare. I would be paying 300 to 400 per month plus whatever pharmacy costs...add on vision and dental...and Medicare part B and I will be paying around $600 per month and still have Medi-gap deductibles (hospital fees too), and have to pay for Medicare part B which is about $200 as hubs still works or did before his job eliminated his position while he was on sick leave. So, I would be looking at 600 or 700 per month plus out-of-pocket costs.

My Advantage plan returns $100. of Part B to me, every month and there are no premiums...a saving of $1200 per year. It has low deductibles and an out-of-pocket of $2000 total. Why would I choose the more expensive plan? Those Democrats urging Biden to end Medicare Advantage should stop it...we will lose the midterm if they keep it up.

[Emile]

179. I think she will be reelected because she's not afraid to govern like a democrat.

[Demsrule86]

200. I hope so.

[Demsrule86]

218. Sorry I don't see sending Biden notes demanding this or that governing...not in Congress.

I still hope she wins of course...but this sort of thing weakens us and helps the GOP.

[BlueIdaho]

219. "Democrats want to take your Medicare away from you."

No amount of charts and grafts will counter the ads on TV. I have nothing but respect for Katie Porter - but this is a bridge too far.