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Author: TwoCybers Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 19224  
Subject: Re: Medicare for mother. Big Picture needed. Date: 12/5/2012 8:44 PM
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There are two broad sides of Medicare -- the Advantage Plans and traditional Medicare. You pick one or the other. At this point I do not know if you can switch or how to do that. To find out if you can switch, start by calling Medicare. If you have not established legal authority with Medicare to act for your mother, she will have to be on the phone and answer questions before you can get any patient specific information. (As an aside to obtain authority to act on behalf of your mother, I expect a physician will have to say your mother can't do it - the usual reason is something like diminished capacity - which can be mental or physical as in a stroke victim. We have such authority for a friend. It is possible as a son you will not need the authority, but get it you can. Note: A Power of Attorney specifically will not be recognized by Medicare.)

The Medicare care Plan A, B, etc. you mention are private insurance plans which cover things not covered by Medicare. The cost of these varies with age, the plan chosen and to some extent the insurance company.

I am very biased against Advantage Plans - currently they do offer the lowest out of pocket costs. But that is because currently Traditional Medicare is paying a capitation to all Advantage plans. This capitation rate is the roughly $718 billion that was called a Medicare Plan cut or whatever during the recent election fight. The capitation was a part of the Advantage plans because when passed under President Bush these plans were not financially viable - i.e. no insurance company would offer an Advantage plan without the capitation.

My bias is very simply based - there used to be HMO plans back in the 90s. These eventually all went bust. The Advantage plans are really HMO type plans with a different name. If the capitations are reduced or cut, the only options for the insurance companies will be ration care, raise premiums, restrict physician choices, etc. Just what the HMOs did in the 90s before they threw in the towels.

The no charge Advantage plans, as I understand it -- I am not very knowledgeable will have copays and deductibles. My guess in your previous $100/month plan had none of minimal ones. (In either case if you go beyond generic drugs expect to pay something.) The reason the plans currently cost consumers nothing is a combination of two payments to the insurance companies. The Capitation I have mentioned and another transfer which as I understand it is the Medicare Part A average cost or premium.

Gordon
Atlanta
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