ajc, I'm a retired federal employee and have the med insurance that all employees have.We are given a list during open season in dec and jan and have a choice. Offers are different in different states. The government pays 2/3 of the premium and we pay a third. HMOs are almost non-existant anymore. The premium is usuall very high. blue cross/blue shield is probably the major carrier. I had them for years until this year. I changed to a company that has same coverage, less deductibles, less cost. doesn't matter who the carrier is, we still pay 10% of major medical
cost to hospitals and surgeons. co-pays are low. $10.00 office call and $5.00 for meds.
Its really not as good as some think it. There's a $300.00 a year deductible and then insurance kicks in. pre-existings problems are ok. This is all negoiated by "uncle sugar" with the insurance companies.
Do you expect the government option to give you better terms?
Yes. My husband and I each pay Medicare Part B. We have no co-pays plus an annual physical complete with all testing . Our meds only cost us $3 for 3 months of generic or $9 for 3 months for non-generic. You have to admit, that's very good terms---amd it is all government health.
So you don't think that selling to a group makes it possible to reduce the premium? Well, I don't really know but as I said, I suspect there is a good deal because it is government.
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One must wonder what quality of student Harvard graduated with that class of 95% A's and B's.
But the way their professors and at least one graduate act, the conclusions should not be hard to reach.
Well I don't know what Ins. or coverage any of you have, aside Moon, but I also have Govt. Insurance. I pay for nothing, and can go to any Dr or Hosp. I want.
The VA hospital kept my hubby alive for many more years than was expected. I have nothing but praise for these Govt. run Hosp.
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I've learned that the people you care most about in life are taken from you too soon and
all the less important ones just never go away.
And the real pains in the ass are permanent.
Evidently veterans are expecting their costs to increase under the Obama plan. My son (active duty) came home from work today and stated that the email campaigns have begun by veterans against Obama's plans. They are encouraging all military to start contacting representatives and senators to vote against Obamacare.
Evidently veterans are expecting their costs to increase under the Obama plan. My son (active duty) came home from work today and stated that the email campaigns have begun by veterans against Obama's plans. They are encouraging all military to start contacting representatives and senators to vote against Obamacare.
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Do they give any specific reasons why? [or have they been receiving the same deceptive crap that you first posted on this subject?]
My daughter and son-in-law are supporting your mislabeled "obamacare" plan. And, of course, as you already know, he is active duty Air Force.
Funny being one that IS covered I haven't heard a word. But maybe your son has some insight that the DAV doesn't have? You think?
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I've learned that the people you care most about in life are taken from you too soon and
all the less important ones just never go away.
And the real pains in the ass are permanent.
Insurance premiums are a;lways based on experioence ratings. the more an insurance company pays out, the more the prioems go up.
It is always based on risk. If they insure a group that is prone to have cancer, they are charging premioums according to the number of people who developed cancer during the last year according to their experience.
They also adjust their premiums according to their own expenses.
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One must wonder what quality of student Harvard graduated with that class of 95% A's and B's.
But the way their professors and at least one graduate act, the conclusions should not be hard to reach.
But you still haven't answered my question, potsy. Do you know of any insurance comapny that gives all the benefits I have for only the cost of Medicare Part B?
Yes. My husband and I each pay Medicare Part B. We have no co-pays plus an annual physical complete with all testing . Our meds only cost us $3 for 3 months of generic or $9 for 3 months for non-generic. You have to admit, that's very good terms---amd it is all government health.
Medicare Part B has nothing to do with prescription drugs. On page 38 of your Medicare & You 2009 it states Medicare does NOT cover
Physical exams (routine or yearly). Medicare will cover a onetime ¡ö¡öphysical exam. See page 33. Prescription drugs (with few exceptions). ¡ö¡öSee page 34. See pages 63¨C71 for information about Medicare prescription drug coverage (Part D).
I think you have a supplemental plan to your Medicare Plan, Secure Horizons, perhaps?
This message has been edited by BaconGrease on Aug 6, 2009 2:00 PM
All co-pays are covered under "government" health insurance. I have no Part D and I only pay $3 for 3 months of generic and $9 for 3 months of non-generic plus I only pay Medicare part B.
Potsy hasn't yet posted that a private insurance company can match that.
Funny being one that IS covered I haven't heard a word. But maybe your son has some insight that the DAV doesn't have? You think
Evidently you aren't on their mailing lists. Their concerns were co-pays, premiums for dependents, and other provisions where they did not want to be lumped in with the general public. Their lobbying evidently worked as Obama has backed down.
"...All co-pays are covered under "government" health insurance. I have no Part D and I only pay $3 for 3 months of generic and $9 for 3 months of non-generic plus I only pay Medicare part B..."
I don't know much about this but.... did you answer potsy's question about have a supplemental program?
*****
We'll be friends until we're old and senile. Then we'll be new friends.
-Anon.
I am a federal government retiree and I had to choose to go with an HMO because the fee for service plans were too expensive and the deductibles varied and were too high for me. The HMO works as long as you watch which doctor you choose for your primary care provider. I had earlier (while still working) chosen and they were so often unavailable as they were only part time. I have had to see others that I would not send my dog to and therefore I refuse to see them.
My father is retired military so my parents have both VA and Medicare Part B (which was made mandatory to help cut VA costs). He has received correspondence that there were things in the works to increase the costs even when bush was in office. There is no need for them to purchase Part D (prescription coverage) as the military drug prescription plan is as good or better than what Part D offers. This option is TRUE FOR ANYONE if they have a prescription plan that is as good or better than Part D Medicare.
I myself had elected other fee for service plans in the past and Blue Cross was one of my earlier selections. When there was a problem with doctors not being paid on a timely basis and my doctors had told me I would have to pay the full bill and then be reimbursed from Blue Cross I had enough and left them. That was a number of years ago though. Maybe they are better now.
I always had a difficult time understanding why some of the premiums were so high when large group plans were supposed to result in more reasonable premiums. I worked for a government contractor for awhile and had no premiums to cover my husband and 6 kids! Of course the government was paying for that as it was a cost included in the contract! I also worked for a private company and had a very reasonable premium on the fee for service plan they offered employees.
I also believe there should be a bigger division in premium amounts for families with one parent and one child. The cost should not be the same for a single parent raising a child as it is for a couple with numerous children. That boils down to the smaller household subsidizing the cost of the large household for insurance. Some companies do that...most don't.
In addition, there are many companies now who have already canceled health insurance for family coverage and even the employees nowadays. I do personally know individuals that this has happened to.
You think so? Got any examples? I have not seen any plan that costs $96.40 a month--and covers anything near what I have.
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Isn't the $96.40 you pay monthly only 25% of the total cost for your Part B Medicare coverage? If the government wasn't paying the other 75%, you'd be paying around $400/month for only the things covered by Part B, right?
All co-pays are covered under "government" health insurance. I have no Part D and I only pay $3 for 3 months of generic and $9 for 3 months of non-generic plus I only pay Medicare part B.
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Since you are a retired military family, I'm assuming your primary coverage is via Tri-Care? And, you signed up for Medicare Part B as your supplemental?
I'm getting ready to leave shortly, but I'd like to continue this conversation, maybe tomorrow, Moonie.
I'm interested in knowing how much, if anything, you pay monthly for TriCare and if it covers 100%, 90%, or less, of hospitalization, doctors visits, etc.. Also, did you sign up, when age eligible, for Medicare Part B so you could avoid the 10% increase each year that you hadn't signed up? Did you really need Part B, now, when Tricare might alreadycover what you get with Part B? I'll admit up front I don't know much about Tricare, and I don't expect you to speak to questions that might infringe on your personal situation if you don't want to, but it would help if one could know exactly how much your total healthcare costs are per month, for all coverages you/husband have.
Since TriCare covers the larger percent of the cost, it's not surprising that Medicare could handle the leftover portion.
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Agreed. But, Medicare Part B is, to me, is a supplemental for Part A. I'm still learning about this, though. Not because I need it yet, but because it helps me understand and investigate universal health insurance as proposed in Obamacare.
TriCare is funded by the DOD budget. And, the DOD has been, and is, trying to deal with rising costs of healthcare, too. Their healthcare costs are around $25B last I looked for the number of military covered. I'm not sure how many retirees are on TriCare, and I'd like to know how much, on average and if anything, they pay as a monthly premium. Please understand that I am NOT complaining about coverage for ANY military person or their spouse, I'm just trying to get a grip on some rational figures to determine the cost and how many are covered.
If we move 47 million Americans to 'some' plan, it has to be paid for. How, how much and by whom it's paid for, is still up in the air. I'm looking for details. Know where I can find some real, accurate, non-fuzzy, non-govt estimates it will cost the taxpayers? Oh, the CBO. Yeah, but we're not supposed to look at their numbers.
Sorry, my parents have both Tri-care and VA eligibility. My dad does not use the VA though because it takes so long to get an appointment. They are quite fortunate to have both Tri-care and Medicare which covers what Moon is talking about.
The law changed in 2001 regarding the mandatory Part B coverage for Tri-care to pay the medical bills.
Medicare-eligible uniformed services retirees, their spouses, and survivors who are age 65 and over are entitled to expanded health care benefits, including coverage under TRICARE and pharmacy coverage.
TRICARE beneficiaries who turned 65 before April 1, 2001, may use the pharmacy benefit without being enrolled in Medicare Part B. Those who reached age 65 on or after April 1, 2001, must be enrolled in Medicare Part B to use the pharmacy benefit.
Effective October 1, 2001, under the new law, eligible beneficiaries who continue to receive medical care from their current Medicare providers will have TRICARE as their second payer. TRICARE will pay their out-of-pocket costs for services covered under Medicare and TRICARE. In addition, they have access to TRICARE benefits that may not be covered under Medicare. To continue using TRICARE after age 65, Medicare-eligible beneficiaries must be enrolled in Medicare Part B.
Carolyn: Their concerns were co-pays, premiums for dependents, and other provisions where they did not want to be lumped in with the general public. Their lobbying evidently worked as Obama has backed down.
This is nothing new. This is a constant concern about higher co-pays, higher premiums and so on. It seems to come up in every congress but it has been overcomed each time.
But you still haven't answered my question, potsy. Do you know of any insurance comapny that gives all the benefits I have for only the cost of Medicare Part B?
So do your believe that the universal health care will be the same when everyone is covered by the single payer policy of Obamacare?
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One must wonder what quality of student Harvard graduated with that class of 95% A's and B's.
But the way their professors and at least one graduate act, the conclusions should not be hard to reach.
hmmmmmm......potsy do you have the scoop on what universal health care coverage would be? Countries who DO have systems in place are all different from what I have read. So do tell your secrets pots!
Moniker:Okay, let me understand this in light of your Tricare and Medicare coverage.
Tricare covers most of your prescription requirements and Medicare covers the rest for a $3 co-pay? First of all, even though I have a Medicare card, I never show it. I just produce my Family Health card. Family Health handles all the payments. Sometimes I do need a referral, which is automatic. My medications are under the DOD, not Medicare. The co-pays I mentioned are the only cost we have for our health care other than Medicare Part B.
Are you in a Medicare program designed for low income families? Do you know what the name is for the health care for low income families is called? But I digress--One could hardly call us low income --as my old friends on this board can attest to.
Obviously, you are not up on the many health programs which are under the Federal government.
Grease: Medicare Part B has nothing to do with prescription drugs. On page 38 of your Medicare & You 2009 it states Medicare does NOT cover. I did not say that our prescriptions were under part B.
Physical exams (routine or yearly). Medicare will cover a onetime ¡ö¡öphysical exam. See page 33. Again, I did not say that our annual physicals were under Medicare. Prescription drugs (with few exceptions). ¡ö¡öSee page 34. See pages 63¨C71 for information about Medicare prescription drug coverage (Part D).
I think you have a supplemental plan to your Medicare Plan, Secure Horizons, perhaps? Again, I do not pay for any supplementql plan. An arm of the the federal government picks up the co-pays.
As usual, you are not reading what I am posting. Since I worked in the field of adovcacy for the disabled for a number of years, I am well versed in payments for health care. There are many programs. The bulk of the state programs are heavily financed by the feds.
potsy: So do your believe that the universal health care will be the same when everyone is covered by the single payer policy of Obamacare?
I believe we need universal health care coverage, but I have not said I favore a single payer only policy. I think that should be clear enough, even for you.
You have great coverage moon and as a family of a veteran you are entitled to it. However, do you really believe our country can financially sustain the type of coverage you have for all citizens?
You have great coverage moon and as a family of a veteran you are entitled to it. However, do you really believe our country can financially sustain the type of coverage you have for all citizens?
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Why should we not have that kind of coverage?
Thank god you are not in charge of "O2" ... we'd all suffocate.
Typical liberal response. Why not just guarantee equal employment, housing, transportation, education for all too? You'd like to see us all just sign over our assets to government and then let them dole out what we "need."
Carolyn: You have great coverage moon and as a family of a veteran you are entitled to it. However, do you really believe our country can financially sustain the type of coverage you have for all citizens?
I personally believe that all citizens should have health care coverage and access to good health care. Do you believe that only some citizens should have this?
The fact is that the cost of health care is increasing whether we do nothing or not. We have to find a way to have good coverage as well as finding a way to keep the costs from going up so rapidly.
Typical liberal response. Why not just guarantee equal employment, housing, transportation, education for all too? You'd like to see us all just sign over our assets to government and then let them dole out what we "need."
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Do you even pay attention to what you are saying? How does your second sentence logically lead to your third?
However, it is coming to a point that even 12 years of schooling doesn't prepare students today for jobs. Community colleges are filling much of that need now. And did you forget that public universities and community colleges are heavily supported by local, state and federal government.
I know exactly what I'm saying and I know exactly what you are. I want no part of it. I see how you treat people who think differently than you. No wonder you identify with the people running the AARP meeting.
Typical liberal response. Why not just guarantee equal employment, housing, transportation, education for all too? You'd like to see us all just sign over our assets to government and then let them dole out what we "need."
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Do you even pay attention to what you are saying? How does your second sentence logically lead to your third?
Jim...
#########
easy...it is addressed to liberals
logically leading to a question of the end result of socialism...which is the result of liberalism
They were asking questions ... not making statements. AARP chose not to answer them. Why not just hand out their propaganda and walk away. That's what they did anyhow.
I noticed that many of the people at the town hall meetings seem to be senior citizens I wonder how many of the have Medicare--probably nearly all of them.
More seniors think reform law would be harmful, not beneficial, to them
by Lydia Saad
PRINCETON, NJ -- Seniors are the least likely of all age groups in the U.S. to say that healthcare reform will benefit their personal healthcare situation. By a margin of three to one, 36% to 12%, adults 65 and older are more likely to believe healthcare reform will reduce rather than expand their access to healthcare. And by 39% to 20%, they are more likely to say their own medical care will worsen rather than improve.
If I was older and I was getting $3 and $9 copays from a government program intended to help the less-well-off, and was wealthy, I would definitely feel like I was gaming the system.
I definitely feel like the taxes I'm paying for Medicare aren't going to help the needy.
*****
We'll be friends until we're old and senile. Then we'll be new friends.
-Anon.
Seniors are most always concerned about losing health care or Social Security. It has been a successful ploy by the politicans on both sides of the aisle.
The AARP is supposedly an advocate organization for them and they walked out on them. Why shouldn't seniors be scared? They can't trust the people elected to serve them and they are pushed aside by AARP. Who can they trust?
If I was older and I was getting $3 and $9 copays from a government program intended to help the less-well-off, and was wealthy, I would definitely feel like I was gaming the system. Again, this is Not a low income program. It is NOT income based.
I definitely feel like the taxes I'm paying for Medicare aren't going to help the needy. Medicare taxes are going for Medicare. Medicare is a government health insurance program for people 65 years and older or for people who are disabled and received Social Security disability because they are unable to work.
There is another program for low income individuals and families. Surely you know the name of that program!!!
I have been the payee rep for our disabled daughter for nearly 20 years. She was in her second year of residency when she sustained a severe head injury. She is on Medicare and several state programs because her medical care is expensive. Again, these are government programs. She hit her million dollar limit with Blue Cross PPO about the time she came off of cobra in 1990.
However, do you really believe our country can financially sustain the type of coverage you have for all citizens?
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I don't see anyone answering that all important question, Carolyn. What I see is people saying everyone should have the same, great coverage that TriCare and Medicare Part B offers, but no one is discussing how, how much, and by whom the costs will be covered. That is what I've been trying to get answered, so far unsuccessfully in my research and through dialog with forum members, here and elsewhere.
I am not completely opposed to a govt healthcare option yet. But, I fail to see how people can be pro govt option when they haven't, and can't, put a pencil to paper to determine how it will affect them, personally. For instance, and this is just a throw-out number, what if you pay nothing today for your major medical, or you pay a portion of the costs via payroll deductions (employer paying the rest) but your taxes go up hundreds per month to cover all the uninsured? Or, you will be required to pay far higher monthly healthcare premiums, script costs and co-pays to cover the uninsured? Or, your current services covered are changed, requiring you to pay for services not covered? Etc..
In order to pay for health insurance for 47M uninsured, and that number is questionable, there will have to be changes to your current financial situation. There's no way that the costs can be covered by the few reforms proposed, and without running huge deficits, imo.
Specifics are not being addressed in legislation. Deliberately, imo. And, as I've said before, the left forums I visit are gung ho on just getting something, anything passed and they're counting on amending the hell out of it later. Why not just do it right the first time...and take the time necessary to do it right? Lay out another website offering people a calculator where one can calculate the impact. One similar to that calculator used to calculate the tax cuts under McCain or Obama. Put in your current coverage/premium/family or individual, then compare it to the proposed plan. Until they're willing to do that, they're just baffling people with bullshit to meet a presidential campaign promise and/or avoid a 'waterloo'.
Do you expect the government option to give you better terms?
Yes. My husband and I each pay Medicare Part B. We have no co-pays plus an annual physical complete with all testing . Our meds only cost us $3 for 3 months of generic or $9 for 3 months for non-generic. You have to admit, that's very good terms---amd it is all government health.
------------
Moonie, with all due respect, I think some of your initial comments could lead a reader to believe that your $96.40 per person per month was providing the full coverage that is, in fact, covered by your TriCare plan. And, that is why I asked about your 'other' coverage since Medicare Part B is required coverage you must pay based on TriCare rules. You kept saying 'I only pay $96.40 per month', then you brought in the low script info, giving the impression that you got all this coverage for $96.40/month, without mentioning your TriCare plan. Others you've chatted with over the years may have know this, but the rest of us, I'll assume, did not. I just thought your not mentioning your major plan was being somewhat disingenuous when throwing out the $96.40 per month info.
And, the way I'm reading your comments in this thread, you don't show your Medicare card, only your US Health Plan card. You don't need Medicare Part B, but you have it anyway...because TriCare requires you to have it. So, in essence, your $96.40/month/person is being paid by you and your husband into a pool, of sorts, for other people's use, since you say you don't use Medicare Part B services. Will you be fine with a substantial increase in that, and/or if your taxes are raised considerably to cover the uninsured? Say, to the tune of a throw out number of $500/month more?
inka: I don't see anyone answering that all important question, Carolyn. What I see is people saying everyone should have the same, great coverage that TriCare and Medicare Part B offers, but no one is discussing how, how much, and by whom the costs will be covered. That is what I've been trying to get answered, so far unsuccessfully in my research and through dialog with forum members, here and elsewhere. That is where the debate is. You also left out the "cadillac" health plans which many employees pay for the executives of their companies.
I am not completely opposed to a govt healthcare option yet. But, I fail to see how people can be pro govt option when they haven't, and can't, put a pencil to paper to determine how it will affect them, personally. For instance, and this is just a throw-out number, what if you pay nothing today for your major medical, or you pay a portion of the costs via payroll deductions (employer paying the rest) but your taxes go up hundreds per month to cover all the uninsured? Or, you will be required to pay far higher monthly healthcare premiums, script costs and co-pays to cover the uninsured? Or, your current services covered are changed, requiring you to pay for services not covered? Etc.. The premiums and co-pays will continue to go up because the cost of the current health system is spiraling upwards. That is the reason for this debate. It is trying to find a solution to get coverage for all citizens while slowing down the rate on increase spending. Don't remember the specifics off the top of my head, especially with only one cup of coffee so far this morning-- but considerable amount of money and time is spent in the administration of insurance companies (whom, inccidently are racking up high profits) and doctors offices trying to meet their paperwork demands . Also the word "rationing" scares the bejibbers out of people, but we already have it----if you have dealt with a health insurance company for other than common types of needs, you will understand how they deny and hope a patient wither quit trying to get covereage or they die. They employ case managers who constantly review cases trying to shut them down--even against what the doctor has ordered. People get concerned about having someone between their doctor and them--it already exists.
In order to pay for health insurance for 47M uninsured, and that number is questionable, there will have to be changes to your current financial situation. There's no way that the costs can be covered by the few reforms proposed, and without running huge deficits, imo. I guess the question is do we let the system remain as it is or do we continue to find a way to help. And the cost of uninsured or under insured people is already costing us---in higher hospital fees, higher insurance payments and higher costs in programs for low income people.
Specifics are not being addressed in legislation. Deliberately, imo. And, as I've said before, the left forums I visit are gung ho on just getting something, anything passed and they're counting on amending the hell out of it later. Why not just do it right the first time...and take the time necessary to do it right? Lay out another website offering people a calculator where one can calculate the impact. One similar to that calculator used to calculate the tax cuts under McCain or Obama. Put in your current coverage/premium/family or individual, then compare it to the proposed plan. Until they're willing to do that, they're just baffling people with bullshit to meet a presidential campaign promise and/or avoid a 'waterloo'. Specifics are hard to predict. This situation has been around for a very long time and the last time there were big changes was when Medicare was passed. Dispite all the doom and gloom about that program and some of the problems that occurr in it, overall it is still a good program for all us.
I don't have any anwers but I have had experience with military health programs at military bases in my younger years--including Champus, I have had experience working with private health insurance and with various government programs. The most problems that I dealt with was with private insurance. My personal impression is that this industry has lots of money and will fight to keep the status quo because it benefits them. Somehow we have to come to some compromise. No matter what, health care costs will continue to increase mainly do to the aging population.
I see your reply to me, but I'll have to get back to you later. My grandson spent the night and just awakened, so I have to attend to him for most of the day. Later...and thanks for replying.
Do you expect the government option to give you better terms?
Yes. My husband and I each pay Medicare Part B. We have no co-pays plus an annual physical complete with all testing . Our meds only cost us $3 for 3 months of generic or $9 for 3 months for non-generic. You have to admit, that's very good terms---amd it is all government health.
------------
Moonie, with all due respect, I think some of your initial comments could lead a reader to believe that your $96.40 per person per month was providing the full coverage that is, in fact, covered by your TriCare plan. And, that is why I asked about your 'other' coverage since Medicare Part B is required coverage you must pay based on TriCare rules. You kept saying 'I only pay $96.40 per month', then you brought in the low script info, giving the impression that you got all this coverage for $96.40/month, without mentioning your TriCare plan. Others you've chatted with over the years may have know this, but the rest of us, I'll assume, did not. I just thought your not mentioning your major plan was being somewhat disingenuous when throwing out the $96.40 per month info. Tricare is a government program--a continuation of promised services when my husband signed up for a 25 year career, stating in 1964. I thought most people knew that my husband was a career Air Force officer. I thought most people were aware of the trials and tribulations I have had dealing with health insurance companies because of my disabled daughter--who was an MD in her second year of residendcy when she became disabled. Because of that I worked as an advocate for services for the disabled. I come from a family of physicians and nurses. (BTW--the doctors are financially doing very well despite of their complaints about low payments and their liability insurance costs.)
And, the way I'm reading your comments in this thread, you don't show your Medicare card, only your US Health Plan card. You don't need Medicare Part B, but you have it anyway...because TriCare requires you to have it. Yes, it is a requirement and has been for many years. Before the military hospital system was downsized, Medicare did not pay them for the cost of care for their senior officers and spouses. So, in essence, your $96.40/month/person is being paid by you and your husband into a pool, of sorts, for other people's use, since you say you don't use Medicare Part B services. Will you be fine with a substantial increase in that, and/or if your taxes are raised considerably to cover the uninsured? Say, to the tune of a throw out number of $500/month more? None of us--not you or me or anyone else on this board would like to see a high jump in premiums but they are and will continue to go up. I don't see how we can get around that. But what we need to find is ways to get good coverage and keep the costs from rising so quickly. Hence, the emotional reaction, also fueled by companies who like the status quo and the knee jerk people are really not aware of all this.
If I had the answer, you bet I would be in DC now. But I don't. We have to start somewhere---and sometime. It is here and now.
