Medicare Part C

[Klukie]

I have been reading up on Medicare recently because I didn't understand the system and it seems to me that the private health insurance industry has a lot to gain from the upcoming baby boomer enrollment. Please correct me if I am misunderstanding the way the system operates (I mean that sincerely), but it seems as if Medicare part C or Medicare Advantage plans insert the private health insurers into the mix and it is paid for out of Medicare funds. Medicare advantage plans offer HMOS, PPOS, and POS options. Part C now accounts for about 24% of Medicare spending. Did the insurance companies obtain a way to re-route the Medicare system funds while still offering the same crappy plans? Do they see the potential for huge profits with a system that is about to see a huge influx of subscribers. Any thoughts, info, corrections?

[OmmmSweetOmmm]

1. It was a giveaway to insurance companies. According to Obama, there seems to be

no difference in the care between regular Medicare and Medicare C, and this is where there will be cuts to save money.

[Klukie]

3. hey thanks for the info.....

I didn't know that this is what he was going to cut. Smart move. Maybe this is part of the reason that the insurance companies are trying to scare the bejesus out of seniors.

[OmmmSweetOmmm]

4. Your welcome. Obama mentioned it in one of his town halls. It might have been his first.

[OmmmSweetOmmm]

5. From the transcript

http://www.kaiserhealthnews.org/Daily-Reports/2009/July/01/Transcript-Obama-Town-Hall.aspx

And I'll just give you one example. We spend right now about -- over the next 10 years, we will spend $177 billion -- $177 billion over the next decade -- in unwarranted subsidies to insurance companies under something called Medicaid Advantage -- Medicare Advantage. Now, this does not make seniors healthier. People who are signed up for this private insurance subsidized program don't get any better care than those who aren’t. The subsidies don't go to the patients; they go to the insurance companies. Now, think if we took that $177 billion and helped families so that they could have insurance, and that we could have preventive care.

[Old Codger]

2. From my experience

These are supposed "supplements" to medicare, also referred to as "medigap" policies. I have tried several times to get a decent one but first they have a lock on most areas, what is available for me in southern Oregon is provided by blue cross, and only blue cross. I'm not exactly sure how this all works but I "think" that if you sign up for one, you pay them X amount (in my case 160 a month) that is above what is taken out of my SS check each month, you are required to keep your part B medicare paid up along with paying them also. I found overall that I ended up paying more for office visits and small things like most normal 6 month blood tests than without it. this is only my personal experience so not sure how accurate this is for others. I do know that when I look at what is available in other areas they seem to be much more comprehensive than what if offered here, with plans from several different companies being offered rather than only one as it is here....

[DURHAM D]

6. Medicare is not the "public" plan that most people think it is.

Through Medicare Advantage or Medigap supplemental policies the private insurers are high-fiving themselves and their congressmen at their progress in turning Medicare into a public/private federal plan. Costs for the "private" portion for seniors is increasing rapidly and no end in sight.

The privatizing of Medicare is why seniors are upset - however, they are unable to articulate it in a few brief words.

The majority of seniors are on a fixed income and have a little money saved. But they are seeing their monthly premiums for both Medicare Part B (doctors visits, tests, outpatient procedures) that they must pay to the federal government and Part D (prescription coverage) increasing over time. But the real boogieman is the supplementals (private insurance) they must buy in order to cover their 20% responsibility for everything, procedures and needs not covered by Medicare at all, and their Medicare deductibles.

Older seniors for the most part don't have a way to increase their monthly income so they are totally screwed. And, early boomers will begin to discover in January of 2010 when the first batch hits 65 that being on Medicare doesn't mean they will be paying much lower insurance premiums - it won't be much different then what they are paying at 64. For this reason many early boomers will decide to keep working. This is not what we need at a time of high unemployment.

My main point - Medicare has been privatized. Privatized means high premiums for seniors.

[pinto]

7. A side note. Senior advocates, health care advocates in general, encourage

Medicare recipients to be pro-active and assertive in requesting "assignment" from a health care provider. That means the provider agrees to accept Medicare's payment as payment in full. If the answer is no, look for another provider.

In my experience, I've *always* gotten assignment approvals, even with specialists. The only exception - lab work. It's hard to pin down someone "in charge" at a lab to accept assignment, especially if samples are being sent out to specialty labs.

[OmmmSweetOmmm]

8. According to Obama (see transcript in my above post), this is one area that will be

taken into account to save money to pay for a public option.

[DURHAM D]

9. That reference is a distraction. Yibber jabbish.

Medicare Advantage is just one program. Its just one way seniors buy private insurance.

Focus on "Medicare Advantage" and you miss the forest.