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Medicare Advantage is a *premium* service seniors can choose to buy--at extra cost.

Romney said it is being cut. This is a lie. What is happening is the govt is no longer supporting Medicare Advantage because it is NOT cost effective (in terms of what the govt gets for its higher premium payment).

Medicare Advantage costs the govt ~14% extra for more services. The problem is simple: There is no significant gain by those who have Medicare Advantage vs regular Medicare. Paying 14% more and not getting more is a waste of taxpayer money and should be cut--per *conservative* logic (LOL).

Nobody is stopping the insurance companies from shifting the premium *allocation* to the consumers who CHOOSE to buy Medicare Advantage. If people do NOT want to buy it at the higher price they will be charged, that makes it a BAD DEAL in the first place (per the actual consumers).

Or don't conservatives want the "free market" to decide? LOL !!!
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"Medicare Advantage is a *premium* service seniors can choose to buy--at extra cost."

I was just looking into this as hitting 65 (and Medicare becomes primary) and was told the MA plan would have zero premiums for me to pay, some co-pays lower than I'm paying now for doctors in the network, a $3900 annual out of pocket limit, dental and optical coverage I don't have now, and drug coverage with sliding co-pays depending on the drug or generic.

I'm told if I ho Traditional A&B, I'll need D as well that I have to pay for, and a Medicare Supplement coverage would also have a monthly cost in addition to the cost of B and still have co-pays for docs and drugs.

What am I missing? Anyone know a terrific site that explains this all?

Ken
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Thanks

Ken
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"...no longer supporting Medicare Advantage..." = it is being cut, as Romney stated.
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"I was just looking into this as hitting 65 (and Medicare becomes primary) and was told the MA plan would have zero premiums for me to pay, some co-pays lower than I'm paying now for doctors in the network, a $3900 annual out of pocket limit, dental and optical coverage I don't have now, and drug coverage with sliding co-pays depending on the drug or generic.

I'm told if I ho Traditional A&B, I'll need D as well that I have to pay for, and a Medicare Supplement coverage would also have a monthly cost in addition to the cost of B and still have co-pays for docs and drugs.

What am I missing? Anyone know a terrific site that explains this all?

Ken"

Exactly. I switched from standard Medicare + medigap last year and now have better coverage with a $3600+/yr savings.
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Donna405 has written some of the best posts about medicare.

Here is one of the latest posts.

http://boards.fool.com/look-what-i-found-30289368.aspx

You could repost your question on that board.

It's my understanding that for MA plans the insurance companies only accept those without expensive pre-existing conditions, but I could be wrong.
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Thanks. I'll look into it. As of now, it looks like MA for me. They (United Health Care AARP branded plan) have my pre-existing conditions records and are telling me no problem (and no additional premium).

Haven't pulled the trigger yet.

Ken
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"...no longer supporting Medicare Advantage..." = it is being cut, as Romney stated.

Correct. But what he was so very careful to omit was the reason the ADVANTAGE part was being cut. LOL !! If Romney was running Medicare as part of Bain Capital, guess what he would do to Medicare Advantage--and why.... What does Ryan do? Cut Medicare--by $700+B. You do NOT see or hear Romney or Ryan mention THAT fact anywhere (do you?).
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There is no significant gain by those who have Medicare Advantage vs regular Medicare. Paying 14% more and not getting more is a waste of taxpayer money and should be cut--per *conservative* logic (LOL).

There is a significant benefit for people who choose to get supplemental insurance through Medicare Advantage.

Medicare Advantage incentivizes participants to stay healthy, helps pay long-term care, and aids with payments not covered by Medicare.

Perhaps the cost to provide Medicare Advantage is high, but seniors for decades (pre-Medicare Advantage it was Medicare C...etc) have depended on Medicare Advantage.

There is significant gain for Medicare Advantage participants.
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Ken .... just to get an idea, throw your zip code into this site

https://www.uhcmedicaresolutions.com/health-plans/medicare-s...

I am in Florida, so it may be different, but the top plan that covers 100% of most things (A,B and Part D + some other stuff) costs $185.00 per month

Not a bad deal for 100% coverage and no up front deductable

(believe that in Fl, hospital has a $1000 up front deductable per year for hospital stays. I remember my mother was in the hospital for a week and the bill for $1000 came in from the hospital. I did my best all american cheer (Whaaaaaaa) because I had to pay $1000 for her when, I dont remember exactly, but the bill was over $20,000)

Bears
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There is a significant benefit for people who choose to get supplemental insurance through Medicare Advantage.

Then you agree they would be willing to pay EXTRA for the extra benefits they receive.

So, the solution is clear and simple.

The feds pay 14% less (i.e. they still pay the basic Medicare subsidy to the insurance companies). That reduction is then ADDED to premium paid by those who CHOOSE to buy Medicare Advantage. You are the one claiming "There is a significant benefit for people who choose to get supplemental insurance through Medicare Advantage.", so the ONLY way this does not work is if your claim is nonsense and people AVOID Medicare Advantage because it is a bad deal. Customers making the determination, NOT the govt. LOL !!
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Then you agree they would be willing to pay EXTRA for the extra benefits they receive.



They already do, they pay (depending on state and plan) up to $250.00 per month to get an independent companies Advantage plan in order to cover the items Medicare does not cover.

Bears
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They already do, they pay (depending on state and plan) up to $250.00 per month to get an independent companies Advantage plan in order to cover the items Medicare does not cover.

The point you carefully omitted is they are being subsidized by the feds by 14% per person per month. So, the feds pay 14% less and the customer picks up the cost instead.

If the Medicare Advantage program actually paid off in terms of benefits to consumers, then the govt could justify putting everyone on Medicare Advantage and drop non-Advantage plans due to the savings.
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The point you carefully omitted is they are being subsidized by the feds by 14% per person per month.

But that ends .... now, 2012-2014 it is cut off

Bears
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But that ends .... now, 2012-2014 it is cut off

Exactly. But Medicare continues unchanged.

Nothing prevents those who still want Medicare Advantage to continue to be offered it--if it really is of value to consumers. And therein lies the rub. If the insurance companies discontinue Medicare Advantage, that means THEY (the insurance companies) do not think it is of value to consumers (because consumers won't pay for it). They could continue to offer it by charging consumers more and the govt less--so the total revenue for the insurance company remains the same--for the same (Medicare Advantage) coverage.
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Then you agree they would be willing to pay EXTRA for the extra benefits they receive.

Yeah, I am sure that the elderly on fixed incomes would be willing to pay EXTRA. Not sure they could afford the EXTRA though.
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Then you agree they would be willing to pay EXTRA for the extra benefits they receive.

Yeah, I am sure that the elderly on fixed incomes would be willing to pay EXTRA. Not sure they could afford the EXTRA though.



Of each Medicare Advantage dollar, 85% ($610 billion) goes to administration and the remaining 15% ($106 billion) goes to extra services such as toenail clippings and four-point canes. Need links?
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"Of each Medicare Advantage dollar, 85% ($610 billion) goes to administration and the remaining 15% ($106 billion) goes to extra services such as toenail clippings and four-point canes. Need links? "

As a soon to be Medicare eligible, and after spending some time looking into it and figuring Medicare Advantage (no additional premium) is the way to go, yes please.

And any other link that meaningfully explains how going for MA is a bad idea. So far, I'm not finding any.

Thanks

Ken
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"Of each Medicare Advantage dollar, 85% ($610 billion) goes to administration and the remaining 15% ($106 billion) goes to extra services such as toenail clippings and four-point canes. Need links? "

As a soon to be Medicare eligible, and after spending some time looking into it and figuring Medicare Advantage (no additional premium) is the way to go, yes please.

And any other link that meaningfully explains how going for MA is a bad idea. So far, I'm not finding any.



Medicare Advantage isn't bad from a patient's standpoint.

The question is about the most efficient use of the tax dollar.


If you're in charge of overseeing the spending of tax dollars on health care, might you see a better use for that $610 billion?
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($106 billion) goes to extra services such as toenail clippings and four-point canes. Need links?

Yes. If you have links that back that up.

Meanwhile I have a mother with Medicare Advantage so I could tell you about real world services.
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Meanwhile I have a mother with Medicare Advantage so I could tell you about real world services.

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


I have good friend on regular old Medicare and he is EXTREMELY happy with it.

AM
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As a soon to be Medicare eligible, and after spending some time looking into it and figuring Medicare Advantage (no additional premium) is the way to go, yes please.

And any other link that meaningfully explains how going for MA is a bad idea. So far, I'm not finding any.


Of course that is your point of view. "Something for nothing" is ALWAYS a great idea (which makes you one of Romney's 47%--per HIM).

Now for the hard question: How much would you be willing to pay out of your own pocket for the "Advantage" portion if it cost you more? Today, the "Advantage" portion is free. In 2014, the feds stop subsidizing Advantage. It goes away unless you are willing to pay extra for it--IF the insurance companies will even offer it. What is it worth to you?
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"Now for the hard question: How much would you be willing to pay out of your own pocket for the "Advantage" portion if it cost you more? Today, the "Advantage" portion is free. In 2014, the feds stop subsidizing Advantage. It goes away unless you are willing to pay extra for it--IF the insurance companies will even offer it. What is it worth to you? "

A lot can happen in two years.

Besides, I can switch over to traditional Medicare/Medigap if it seems worthwhile. Need to look into it then, if I need to look into it at all.

Ken
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"If you're in charge of overseeing the spending of tax dollars on health care, might you see a better use for that $610 billion? "

Ahh and there's the rub... Do you want a handful of technocrats in government deciding OR 330 million people voting with their wallets on what is important to them. This is crux of the progressives' philosophy that has never and will never work. No one person can make those economic decisions has effectively and efficiently as the market.

When deciding what is in the best interest of consumers, the free market wins hands down. This is undisputed fact unless of course you are in denial.
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I have good friend on regular old Medicare and he is EXTREMELY happy with it.

If he doesn't have Medicare Advantage he might have another Medigap program.

I know people who have absolutely no medical insurance and they are EXTREMELY happy without it.

Without Medicare Advantage or some other Medigap product, the elderly are without coverage at critical times of their lives such as long term care facilities.
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Besides, I can switch over to traditional Medicare/Medigap if it seems worthwhile. Need to look into it then, if I need to look into it at all.


Again, the larger issue about Medicare Advantage plans isn't about whether seniors like it, or not - they uniformly like it.

The issue is about the elimination of unnecessary administrative costs, where possible, in order to start to do something about the stratospheric rate of growth of health care costs in this country.

Medicare Advantage was supposed to be at 98% of Medicare fee-for-service rates, but the rolling average has been as high as 117% and is currently 114%.

The thinking is that extra 14% given to insurance companies isn't in taxpayers' interests given only the marginal increase in benefits (gym memberships and free blood pressure machines, etc), and that some of those insurance companies simply ignored their benefit threshold mandate and pocketed too large of a portion of those tax dollars.

This Medicare Payment Advisory Commission (MedPAC) report has the current payment info - it's on page 8 of this pdf file: http://www.medpac.gov/chapters/Jun12DataBookSec9.pdf

So, do we as a society want to give $100+ billion in administrative fees to insurance companies to provide some marginal benefits, or would we rather stick to basic Medicare coverage and use that extra money to get more of our citizens access to health care?

Under the PPACA, you'd give up your free front-wheeled walker and ear wax removal so that the single mom with psoriatic arthritis down the street can get access to treatment.

Using MedPAC's data, here's a well-articulated rationale for ending the overpayments to insurance companies: http://www.cbpp.org/cms/index.cfm?fa=view&id=2917
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"The issue is about the elimination of unnecessary administrative costs, where possible, in order to start to do something about the stratospheric rate of growth of health care costs in this country.
"

A progressive who falsely believes that government can control costs, while efficiently delivering quality services. Another example of progressives' stupidity.
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Without Medicare Advantage or some other Medigap product, the elderly are without coverage at critical times of their lives such as long term care facilities.


True. Non-skilled needs aren't covered by Medicare.
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The thinking is that extra 14% given to insurance companies isn't in taxpayers' interests given only the marginal increase in benefits (gym memberships and free blood pressure machines, etc), and that some of those insurance companies simply ignored their benefit threshold mandate and pocketed too large of a portion of those tax dollars.



to me, the Clue was:

i got a pamphlet in the mail.. something like "Your Guide to Medicare",
published, iirc, BlueCross.

it spent roughly two pages explaining basic Medicare, parts B and D
several pages explaining Medicare Advantage,
one paragraph mentioned Medicare Supplement plans.

i think that implies the ins. companies are making tonnes from their Advantage plans ..apparently coming from gov't
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i think that implies the ins. companies are making tonnes from their Advantage plans ..apparently coming from gov't


The Medicare Advantage plan experiment was HMO Version 2, and now that experiment has run its course.

Next up - Accountable Care Organizations, which, thanks to PPACA now addresses accountability for the first time. No longer just a giveaway to insurers, ACOs have to meet performance standards in order to continue getting the privilege of participation.
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Next up - Accountable Care Organizations, which, thanks to PPACA now addresses accountability for the first time. No longer just a giveaway to insurers, ACOs have to meet performance standards in order to continue getting the privilege of participation.


Then, next up will be a sign on your Drs office counter that says

"Cash Only"

Bears
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Then, next up will be a sign on your Drs office counter that says

"Cash Only"


Depends how much he/she is paying--and for what....
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i think that implies the ins. companies are making tonnes from their Advantage plans ..apparently coming from gov't


======
The Medicare Advantage plan experiment was HMO Version 2, and now that experiment has run its course.


that being the reason i ,personally, didn't go for one -- none of my doctors were members for any of the MA plans i looked at
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