Showcase Listing

Cresswind Charleston is Charleston-area's BEST active adult lifestyle community. Cresswind inspires active adults to live life to the ful...

Image
Showcase Listing

Traditions of America is excited to bring the 55+ Live Better lifestyle to Bethlehem with its latest community - Traditions of America at...

Image
Showcase Listing

Bon Ayre is a 55+ active adult, manufactured home land lease community located in Smyrna, Delaware, a town which was recently ranked 31st...

Image
Showcase Listing

Few towns in the Southeast offer more gracious charm than Aiken, South Carolina.  Take a relaxing stroll through Aiken's tree-lined ...

Image
Showcase Listing

Set amidst the picturesque, quintessential landscape of Lancaster County, Traditions of America is excited to introduce Traditions of Ame...

Image

AARP Report Raises Concerns About Future of Medicare

Category: Health and Wellness Issues

January 22, 2017 — The AARP is a solid defender of Medicare and Social Security, as you might imagine. In their most recent Special Report the organization highlights some of the issues and dangers that Medicare faces as the Trump administration and Republican controlled Congress take over. We recommend reading the entire AARP Special Medicare Report – it raises important issues that every retiree, and every American, needs to be informed on. We certainly know the issue resonates with Topretirements members, who from our surveys say they like Medicare.

Conflict between the new President and conservative Republicans – and surprising potential allies
Trump promised on the campaign trail in New Hampshire that he would protect Medicare: “Every Republican wants to do a big number on Social Security. They want to do it on Medicare. They want to do it on Medicaid. And we can’t do that. It’s not fair to the people who have been paying in for years.”

With the inauguration behind us the battle lines are a bit murkier. Speaker of the House Ryan has proposed that Medicare as we know it would be replaced by fixed payments with which beneficiaries would be able to buy private insurance. His plan would also delay coverage from age 65 to age 67. The effect would be to change the popular program used by 57 million people from a “defined benefit” to a “defined contribution” program. Trump’s pick to head the Department of Health and Human Services, Tom Price (R-Ga.), is seen as an advocate of Ryan’s Medicare approach, which critics label as a “voucher system” (supporters call it “premium support”).

If Trump sticks with his campaign promises, that would make him at odds with the Ryan plan. Holding on to that position would, oddly enough, align the new President closer to his natural foes, the Democrats. However, Trump’s website is less definite about his plans for Medicare. According to the AARP, the site says he wants to “modernize Medicare,” which many people interpret as supportive of Ryan-type approaches. Meanwhile, over at the reformulated Whitehouse.gov site neither Medicare or Social Security are listed as “Top Issues”, nor could we find any information about either issue there.

The impact of Obamacare repeal
Republicans and President Trump have a clear goal to repeal the Affordable Care Act (ACA) known as Obamacare. The problem is that they haven’t decided how to replace it, and given their divisions, might not actually be able to to that without garnering widespread Democratic support. That puts the future of the ACA’s many provisions affecting Medicare into doubt. If they cannot replace all of the popular Medicare components, such as free prevention services and coverage of the “doughnut hole” for prescription drugs, Medicare beneficiaries could be severely impacted.

Retirees who are not yet eligible for Medicare could be impacted even more severely, depending on what happens with Obamacare replacement.

What to do
The Medicare landscape has the potential to change very fast as the government tries to control its costs and deal with the repeal of Obamacare. We recommend that you stay informed on this issue as well as on Social Security, which faces similar challenges. Whether you like the direction you see or not, it is important that you let your elected representatives know your position in clear terms. All it takes is a phone call or email (your reps all have websites with their contact information) and at least you will have been heard!

To find out more about the fiscal health of Medicare see the annual Trustees Report, which finds among other things that the Medicare Part A trust fund will be exhausted in 2028, at which point only 87% of costs can be paid. So something has to be done – the question is what.

Stay tuned!

For further reading:
Topretirements Members Love Medicare
First Salvo Fired in Social Security Reform



Posted by Admin on January 21st, 2017

79 Comments »

  1. Want to protect Social Security and Medicare? Vote out anyone who trys to tamper with it!

    (Note from Editor: we edited out some statements made here that seemed too partisan. )

    Regarding this topic. Please try to keep your comments polite and avoid name-calling. We will keep this thread live as long as everybody can remain civil and fact-based. If necessary we will edit out inflammatory statements or disallow comments. Please help us remember that we are a friendly, respectful, and kind website! Thanks.

    by Ron — January 22, 2017

  2. There is little doubt about it January 2017 report concerning the future of healthcare outlines some scary and important stuff for those planning for their retirement in this decade and in future decades. Your healthcare looks like it will become a major (perhaps the major) item to consider. Another important article also came out in January 2017 in Consumer Reports entitled “The New Retirement–rules, tools and attitudes you need now, whether you’re in your 20s,40s, or 60s.” You just might want to scout these articles up at your local library. Some people may want to consider expating to a different country for their living and healthcare arrangements. There is a large and growing number of countries where healthcare is superior, efficient and much more cost effective in the United States. Several of these countries are in Latin America as well as other sections of the world. If you don’t want to travel that far there is Puerto Rico which is closer, uses the U.S.dollar. You can ex;plore some of these options in publications like Live and Invest Overseas or International Living. There is a wealth of information about each of these options and they note healthcare as an important consideration. OPther people are exploring the possibility of becoming “minimalists” to help them cope with their current and future needs and to consider their own viewpoint about life. A good website to explore minimalism is called The Minimalists. No matter what we do, healthcare and future needs for care needs to be front and center as we look at planning our futures. No doubt about it things will be different and maybe radically different. Do some wide reading this is important!!!

    by David Lane — January 22, 2017

  3. AARP lost all their credibility,in my opinion, with their original endorsement of ACA and the resulting windfall profits they made as a direct result. I immediately cancelled my membership as I believe their motives were to simply enrich their organization rather than represent the “interests” of the over 55 citizenry. I believe it is grossly misleading to think Social Security and Medicare can survive financially without structural change.

    by Robert — January 22, 2017

  4. We agree Robert.
    Don’t get me wrong ; I really enjoy TR, yet even your topics seem to favor the progressive mantra when it concerns government (taxpayer cost) spending.
    We need to think big picture. Insurance companies need to make a profit in order to provide for catastrophic care. Face it: Decent health care is expensive. SOMEONE has to pay. What is fair?
    We planned for a $40k per year retirement budget, and now our health premiums, deductibles and expenses are costing nearly half our budget. We feel like we (and others in our situation) are paying for those who get their care for “free!” It’s NOT FREE!

    by Caps — January 22, 2017

  5. Well its no longer going to be free for Anyone… Lets be more compassionate to the people who won’t be able to afford any medical coverage.

    by toula1955 — January 22, 2017

  6. My concern is that the insurance marketplace will only raise prices (after all, they need to cover claims and make a profit). If they get too many claims, prices will go up. If they have to cover preexisting conditions, prices will go up. If hospitals increase prices, premiums will go up. If their subscribers are older, prices will go up. If an area (such as a state in which retirees tend to migrate) has too many claims, they may choose not to sell insurance in that location. A voucher program will only help to set off rising costs a little, but that presumes that private insurance is going to be available and there will be enough carriers competing for customers.

    IMO, health care reform is a complex issue that requires insurance regulation, tort law reform, pharmaceutical industry reform, etc. across all of the costs of health care in this country. Health care reform can’t happen overnight or in a vacuum. There needs to be an examination of the reasons why costs are so high, and assessment of how those reasons can be controlled hand-in-hand with insurance reform. Otherwise, medical coverage is just going to go up & up (or become completely unavailable) under any proposed system because costs will continue to rise. If people can’t afford coverage or it simply isn’t available, we all suffer financially. Either the health care system charges the paying customers more, or we pay more in taxes to pay for medical payments made through Medicaid programs. People will obviously get sick or die. Any way you look at it, this is a lose-lose situation. (In the interests of full disclosure, some of my thoughts come from discussions with a kid who has a degree in health care administration, and other kids with medical professions.)

    by Kate . — January 23, 2017

  7. Hi Kate:

    I am a former nurse and I definitely feel that the insurance and pharmaceutical industries must be regulated. If other countries do it, we can do it. Healthcare is a right in my opinion and if someone gets sick, they cannot be left to die because they cannot afford treatment. With health insurance companies raising not only premiums, but deductibles, they are still making huge profits. Very few people feel like they have insurance with a 5,000 to 10,000 deductible to satisfy first. I saw this first hand in an Internal medicine practice where I worked–people wanted to know all costs first or they would not even come in for a yearly physical. (Lab work is not always covered in an annual physical.) It was awful for everyone involved–except the insurance companies. When I worked as a surgical nurse, people called us al the time because they got to a pharmacy to pick up their prescriptions–often for pain relief or antibiotics and said they could not afford the bill and to prescribe something else. (Doctors have NO CLUE what a prescription costs a patient–I was even married to a surgeon and it was a shock to him to see what was charged). I advocate Medicare for all with a requirement that all doctors must participate as a requirement for licensure. It is already working for most seniors and could be tweaked to include younger participants–the insurance coding system is based on what Medicare pays–so why reinvent the wheel??? How many paths are we going to go down before we have healthcare available to all citizens in the USA?

    by Jennifer — January 23, 2017

  8. Jennifer – I totally agree with you after working for years in the pharmaceutical industry and going through breast cancer treatments.

    http://www.fiercehealthcare.com/payer/health-insurance-ceo-pay-at-big-five-tops-out-at-17-3m-2015

    by JoannL — January 23, 2017

  9. Jennifer, I have been saying Medicare for all for a long time! The program is in place and exactly like you said why reinvent the wheel? If they incorporated the VA into it too, perhaps it could make it more cost effective. They each could have branches. Medicare for Senior Citizens, Medicare for those not 65 and Medicare VA for Veterans. There are far too many programs from state to state. Time to consolidate.

    by Louise — January 23, 2017

  10. Jennifer, I too have worked in health care my professional life and totally agree with you. I don’t understand how insurance and drug companies get away with constantly raising prices. There needs to be some control. Unfortunately this country is more about profit than people especially in the present political climate. Hopefully this will change. I think we all need to be vigilant and let our elected leaders know how we feel. Change comes slowly but it does come.

    by Stacey — January 23, 2017

  11. SS, Medicare and Medicaid most likely will be impacted fairly soon. Woe to double and triple dipper retirees from tax money. It seems we’ll need to get used to paying more to get less.

    The younger generations will be conditioned to this new norm because these changes will not immediately impact the vast majority of them. They will endorse it and vote for it so that it can prevent their way of life from deteriorating even further because of the financial drag from the expensive non-working “old”. But, we, the Baby Boomer generation, will be immediately impacted. Woe is us to this inevitable new norm.

    by Colorado Living — January 23, 2017

  12. At 65 I’m retiring this year. I read in an AARP email the I will pay Medicare Part B premiums of $134 per month! Someone please tell me I missunderstood that please?

    by Karen — January 23, 2017

  13. @Karen: Yes, you will have to pay a premium for Medicare Part B. It’s based on your income. All of us on Medicare pay this premium. The Part A premium was covered by your payments during your working years.

    As for AARP, I quit paying them dues years and years ago. You don’t need to belong to AARP to get senior citizen discounts and they are all about making money for AARP and selling you stuff.

    by Linda — January 23, 2017

  14. A good part of the problem with ACA (besides that it was called Obama care) was because young people found it more affordable to pay the penalty for not having health insurance. When we are young we think we are strong and healthy. We don’t think we will step off the curb and get hit by a bus, fall off a mountain bike or acquire a disease. And without premiums from the young and healthy, guess who pays for them when they need health care – all of us do anyway. So they need to pay their way just as we all do and have done. As has been said above, there is already a system in place and we need to use it. This country has no excuse for not providing us all with decent and affordable coverage and prescription drugs. We don’t need to invent the wheel. We need to tell Congress what we need and expect. And good luck with that.

    by Carol Dugan — January 23, 2017

  15. Yes, Carol, you are right. We have a system in place. Why destroy it when it can be tweaked and improved. Any government program needs adjustment once the flaws are discovered. Paul Ryan is hell bent to kill it and not fix it. Makes no sense. They can’t seem to come up with a plan at all. If drugs are too pricey in ACA fix it. Think of the millions of dollars spent to develop ACA and all in vain. Tons of jobs will be lost too. What part of FIX do they not understand? DUH, if you buy a new car and an airbag needs replacing you don’t normally just get rid of the car because of it.

    Yes, young people are in a bubble and think they will never get sick or hurt. That is what insurance is all about. We hope we never have to use it but if we do, we have it.

    by Louise — January 23, 2017

  16. We need to get cracking and write our representatives here in Washington, DC . They need to know what we want and we need to write to those representatives who feel as we do. Bernie Sanders is one. No one will see what we have written here–but they will see how we feel when we write to them, Medicare for all!

    by Jennifer — January 23, 2017

  17. Blaming Medicare problems on the young not being covered is simplistic. I personally have two young adult children, who both have and pay for their coverage under ACA. Health insurance, to many young adults, is more important than you may imagine. Even for those who cannot afford payment under the ACA, Medicaid is available. I’m just glad that both my husband and I are already on Medicare. I have younger friends, almost retirement age, who may be postponing their retirement, just to see how this mess plays out.

    by Staci — January 24, 2017

  18. Karen – Yes, $134. is the new cost but not set in stone for all new people https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html As said here, the amount varies based on your income. You should make an appt. with SS & talk to someone they will work up the get/take for you. Also check with your local Council on Aging (or the like) ours run a class & gives all this type of info & they also offer one on one in helping with finding a secondary insurance designed on your needs. I retired from State gov. & carried my insurance with me, I pay extra each month to cover my husband in the event I die first he can still have the ins. at a reasonable cost, for both I pay $155 monthly which includes the prescriptions plus each of us has to pay medicare. Not to knock AARP (we also dropped subscription) but they will also keep trying to sell you another ins. do your homework & remember in most cases you can change each year during open enrollment if not happy (I can’t since it is part of my gov. retirement, drop for another can’t pick back up – homework done ahead was needed) Once you sign up you won’t believe the “info” coming to your mailbox! Good Luck..

    by Sue M — January 24, 2017

  19. The elderly in this country are being disrespected and getting a raw deal……..time to step up seniors. Time for seniors to STAND UP and be heard. It makes me ill reading all these statements from people like myself that can no longer afford the basics of living

    * QUESTION: I do not have Medicare part B since I elected to keep Blue Cross/ Shield Federal. The problem is this: I asked BC if I could pick up a supplemental. They told me I could not. I could have Medicare part B, and then pick up a supplemental from BC/Shield. I did not want to do this…as there are many physicians that will not accept Medicare patients, or only accept them on a limited basis.

    I broke my wrist in 2015 and the balance from surgery, therapy etc that I was responsible for was several thousand dollars. I still have a balance of almost $1,000.00 that I am still paying on.

    Is there anyone out there that likewise may have BC/Shield…and have you found a solution for the need of supplemental coverage?

    by Roberta — January 24, 2017

  20. Might we get more cooperation and a sympathetic ear from our dearly elected representatives in state capitals and Washington if we insist that they must rely on Social Security and Medicare upon their retirement ?? And deny them access to their posh retirement plans and secure healthcare. Then they may well be more understanding and amenable to change.

    by Jim Zimmer — January 24, 2017

  21. Roberta, My Mother had State of CT insurance on top of Medicare Part A & B (no additional supplement). She had tons of medical problems and Medicare paid 80% (I believe) and the State of CT retiree health insurance plan paid the rest (Medicare always pays first). She basically never got a bill. It was amazing! She had many, many illnesses, hospitalized for weeks at a time, and was treated several rounds of chemo. I bet over the years a million dollars was spent on her healthcare and she rarely got a bill that I recall. She had to pay copay for prescriptions and that was part of the State of CT insurance. Her Rx copays were $3 and $5. You may not need a supplement if you pay for Medicare Part B to work in conjunction with Blue Cross/Blue Shield Federal. From what I have read if you delay taking Part B you are penalized and it costs more than if you took it when initially offered. You might contact your BC/BS provider for more help. The State of CT was very helpful to my Mother and guided her a few times.

    by Louise — January 24, 2017

  22. Jim, I firmly believe that anyone in Congress and the Senate should be the first ones placed on the healthcare plans that they advocate for everyone else. They are removed from the “real” world once they get here to Washington, DC. I have seen it time and time again. Where else can you give yourself a raise at will? Get great healthcare for a great price FREE!

    by Jennifer — January 24, 2017

  23. Jim and Jennifer: Congress members and their staffs obtain their health care from the Affordable Care Act Exchange set up by the District of Columbia for small businesses. The coverage is not FREE. They are also able to obtain their coverage through their spouse’s employer as does my senator, Ted Cruz.

    Jim: Members of Congress must serve a minimum of 5 years before they are eligible for a the bare minimum retirement annuity under the Federal Employees Retirement System (FERS), to which they contribute during their service. I don’t believe you would get many qualified people to serve in Congress if we insisted that they lead a life of poverty after their years of service to our country.

    by LS — January 25, 2017

  24. Thank you Louise, Yes I am aware that I can use part B Medicare and a supplement of some kind that would give me better coverage….HOWEVER many physicians will not see Medicare patients, and if they do they treat Medicare patients very differently…Medicare generally does not pay the physicians very much for services…and the physicians either only see the Medicare patients on a limited basis, do not see them at all, or spend very little time with a medicare patient. Such an injustice that at the time of life that seniors should be getting the BEST care….we are getting the worst care.

    I should call BC/Shield AGAIN to double check…but what they have told me is I can not get a supplemental with the B/C Shield primary coverage….I can only get BC/ Shield as a supplemental if I have Medicare part B. Do not want to opt out of the BC/Shield Federal program as you can not go back once you opt out.

    Basically, I am trying to keep the level of care I am accustomed to……but acquire a supplement to cover more if not all of what is not covered by my B/C Shield primary.

    Any Federal retirees out there with the same dilemma?????

    by Roberta — January 25, 2017

  25. Jennifer…great idea……the Senators and Congressmen should have to live with the health plans they advocate for us!

    Stand up seniors…..remember THEY work for US !

    by Roberta — January 25, 2017

  26. Linda…Not a member of AARP….have not found them to be helpful for me.

    by Roberta — January 25, 2017

  27. Roberta, Not sure where you live but when my mother was sick, she had many, many doctors/specialists and was hospitalized many times. She was never refused care nor given less care than anyone else. She was never turned away for being on Medicare. She was treated with respect and never thrown to the bottom of the barrel.

    by Louise — January 25, 2017

  28. I had my MIL on BC/BS medigap switch to AARP, and switch back in one year to BC/BS medigap because it cost less and MIL has better health care. It is my understanding Medicare pays first then BC/BS pays second, and then MIL pays the co pays.

    by DeyErmand — January 25, 2017

  29. https://democracy.io/#/ is an easy site on which to write your Congessperson and both Senators. You do not even have to know how they are, the site looks them up from your address. They do not put you on an email list, though your representative might do so. I have use it for a year plus, with no problems.

    by Tony Hodlofski — January 25, 2017

  30. I question how much AARP cares. Last year Congress slashed a Social Security provision that allowed spousal Social Security. I contacted AARP to see what they were doing to keep it from happening and didn’t even get a reply. That change cost my wife and me $60,000 over the four years we could have collected it.

    by Ron Manuel — January 25, 2017

  31. I think the answer to many of the fiscal problems our country faces would be solved with term limits for the senate and the congress. People are living longer and working longer. Raising the age from 65 to 67 or 68 makes fiscal sense. The problem is that these people fear not being elected or relelected. Trump said that he would not change SS or Medicare which is not very smart (unless you want to be sure to get the senior vote). Now that he is elected, he will hopefully do what is right. If he gets reelected, he cannot run again and then is when we may most likely see changes to SS and Medicare.

    by Tracy Bachtell — January 25, 2017

  32. Well- to me Louise on 1/24/17 got it perfectly right. I was really surprised that AARP is fighting to keep it all the same. SHAME!! We know there has to be some tweaks to keep it going, They should make suggestions as opposed to asking support that will take the programs down.

    by Ron F — January 25, 2017

  33. Tony H, Thanks. I will use it. Come on everyone, make your voice heard.

    by DeyErmand — January 25, 2017

  34. I gave up my AARP membership at the beginning of ACA. When they decided it more important to join with the SEIU union I knew it was time to go. I have no regretted it since.

    by art — January 25, 2017

  35. Agree with the comment above. AARP lost all credibility with me when they allowed the Medicare program to be raided to pay for the ACA. A voucher program? Get serious. Many seniors live on Social Security alone. For that group, the burden would shift from Medicare to Medicaid. Any voucher issue without premium protection for Seniors would make health care unaffordable for many. AARP has long since abandoned representation of Seniors. Cancelled my membership the day that they endorsed paying for the ACA by reducing Medicare benefits

    by Lauren — January 25, 2017

  36. In my opinion our troubles are not with healthcare insurance but with the outrageous prices being charged for healthcare itself. I recently had a heart procedure (cryoablation) and was in the hospital overnight. The bill was $158,000! Medicare paid only $37,000 and my portion was about $1600. The rest was @forgiven.” That was just hospital fees. Nothing they did had that kind of value! If something isn’t done about these unrealistic fees no one will be able to afford to be sick.

    by Joe Mann — January 25, 2017

  37. The cap on contributing into Social Security is around $ 116,000. What ever you make above this you do not contribute into the system. Just raise the cap.

    by Charles — January 25, 2017

  38. Roberta, maybe I am misunderstanding your insurance issues or you are misunderstanding what I said.

    Basically I believe all you need to do is sign up for Medicare B. That is it, nothing else.

    Medicare A & B will be your primary health insurance and will pay 80%

    Your Federal BC/BS should pay for the 20% Medicare doesn’t pay.

    You should NOT need any supplemental insurance. Your Federal BC/BC should be considered your supplemental insurance. If your BC/BS doesn’t cover prescription drugs you might need Part D supplemental insurance.

    I am not an insurance agent so I could be all wrong but this is the way the State Insurance worked for my Mother. Medicare paid first and 80%. The State paid the rest at 20%.

    I guess you have your druthers on Medicare but as far as I know any retiree who gets retiree health insurance from a former employer works this way. Medicare is the primary insurance and the retiree insurance is the secondary.

    I think you can survey people here and find out if they have been treated fairly on Medicare. Veterans are another story. They have been treated very badly and I have heard they have made strides to improve things. I hope so.

    by Louise — January 25, 2017

  39. I know for a fact in this area Doctors are telling people when they go on Medicare they will no longer be treating them. I read people saying Medicare is the solution but for the past two years Medicare patients have been getting turned away. Many physicians aren’t even accepting new patients. It’s a mess. For years I worked in a social service position. The poor were getting free treatment but the social workers driving them to the appointments could even afford their own needs. I’m not saying people should not be treated I’m saying this system has been a mess for years. We all know the problem and the solution doesn’t get votes.

    by Kate — January 25, 2017

  40. Neither my husband nor I have had any issues with Medicare. I have not had difficulty in finding doctors or specialists. When I discussed turning 65 with my primary physician and my apprehension about Medicare she said, “Don’t be afraid of Medicare.” She told me she actually prefers it as they almost always approve tests and procedures as opposed to
    the “Advantage Plans” which are more likely to deny coverage. So far, a year in, we have been pleased.

    by Florence — January 25, 2017

  41. We are 70 y.o. retirees on Medicare A&B&D and Aetna supplemental. Cost here in SE Penna is about $540 per month all in with $600 deductible each, but it will go up each year. It has been wonderful and we feel secure because we can afford it. I understand many folks cannot. The problem is that neither can our country. Our entitlement costs are rising far faster than the national income as we all know. Simply saying that we should cut out the insurance companies and put everyone on Medicare won’t work, because Medicare reimbursement rates are so low we would all need supplemental policies which would be priced too high for most. Especially if we want millions spent on end of life care to give us an extra couple of years (at someone else’s expense).

    So what can we do? Well, it would help if we baby boomers were all to “check out” within a dozen years of retirement, but not many of us are willing to “take that one for the team.” So, the alternatives are 1) just keep taxing the employees or borrowing money to feed the system aka “We’ll have fun, fun, fun till Daddy takes the T-bird away.” That’s what we are doing now.

    2) ration healthcare by
    a)using govermnment fiat to give everyone a base policy of specified treatments at what the government can afford (welcome to Medicaid) with ups and extras to be purchased by the consumer through private insurance or out-of-pocket. Bye-bye hip replacements, transplants, prompt treatment, and fancy drugs for the bottom half of our economic order. They get the “VA treatment.”
    and/or
    b). price controls on insurance companies, hospital conglomerates, trial lawyers, drug companies, and medical providers.

    In effect, our politicians are lying to us about solving the medical care cost crisis if they say it can be resolved painlessly by cost shifting to someone other than ourselves There will be pain and suffering even for us comfortable boomers as the solutions evolve.

    by Ed Blomstedt — January 25, 2017

  42. to Caps: I’m sorry your health insurance rose so much. Ours went down greatly, because we were finally able to get into a group (our state exchange). Before that, we were being charged $1800 per month for $5,000 deductible, family rate, because we were a self-employed “group of one” and had a child with a pre-existing condition (that’s $21,600 of premiums in 2014). We were SO happy to have our rate drop under ACA to $1,113 per month (this year–it started at $700 per month in 2015), even though my husband now also pays for Medicare parts A, B, and D. It’s still cheaper than what United Healthcare was charging us.

    No one can tell us that they needed that much money from us. All we used it for was well childcare, because the therapists did not take ins. anyway. We adults were terrified of getting a checkup and possibly finding out that we now had a “pre-existing” condition as well! In two years, we have been able to pay off our $50,000 charge card because our deductible is lower and more things are covered.

    I always asked first what the charge was going to be before taking my child to anyone. I have been known to leave a prescription at the window because the pharmacist claimed he could not tell me the cost without putting in the order and through the ins. Now I try to stick to the $2 or $4 generic formularies at the various big box pharmacies. In fact, my sister just spent 2 hours saving herself hundreds of dollars for her cataract surgery medications because I told her about the $4 generics on Medicare. She is wondering what will happen when she is older and not able to hunt down the bargain meds like she just did (three meds at three different pharmacies).

    In two years, I will be on Medicare myself if nothing changes, and my daughter will have to find insurance on her own (she’s 22 and still in school). Her sister was kicked off our coverage at midnight on the day she graduated by the ins. co. It took her years to find affordable coverage, and meanwhile, she limped through with the nurse practitioner at Walgreen’s. I can assure you that she really wanted (group) insurance.

    by Sandra — January 25, 2017

  43. Mostly we are all assuming healthcare models need to stay the way they are. There are many great ideas coming from those now advising the new President such as hospitals being required to list their procedures and costs for all to see. What other consumer product do you buy and never get to know the cost before you accept? You wouldn’t buy a house or a car under those conditions, why do we think we need to accept them for our health care. Also, there are superb new tests for gaining knowledge of the state of our health that are quick and cheap, and they aren’t being used right now by Dr.s and hospitals. Why not? Why are 60-80 year old people paying for reproductive services such as maternity and birth control services? We need to open our minds and close our pocketbooks to “business as usual” in our healthcare. Frankly, I’m sick of paying for free healthcare for drug addicts and layabouts and youngsters who’d rather go to Colorado and smoke dope than work. We need to help those less fortunate, but must draw the line those who’d take advantage of our good nature. I had to submit to drug test for my employment and was happy to do so, why can’t people lining up for our tax dollars do the same.
    I know I seem all over the board here, but there are just so many logical and just things we could do to decrease our healthcare costs I get a little excited about it. We need a new point of view, I think.

    by Laura C — January 25, 2017

  44. I want to know where Florence lives. Maybe that should be my retirement destination!!

    by Kate — January 25, 2017

  45. Roberta, I’ve attended a couple of retirement briefings for federal employees and they both said to make sure to sign up for Medicare and keep your federal insurance. It’s like the others have said, if you have Medicare A & B and your insurance, it’s unlikely you’ll have to pay anything out of pocket. Since you didn’t sign up for Medicare when originally eligible you’ll have to pay the penalty. If that’s the what you decide to do, be sure to sign up for it now because the penalty will increase each year you delay.

    by Tessa — January 25, 2017

  46. The cap on contributing into Social Security is around $ 116,000. What ever you make above this you do not contribute into the system. Just raise the cap.

    by Charles — January 25, 2017

    I sort of agree on this but…maybe they should also adjust what the person who pays extra should get from SS when they retire. I was never in that earnings wage level but if they are paying more, maybe they should also get more. Not tons of more money but some fair amount.

    by Louise — January 25, 2017

  47. LS

    I am well aware that the staff of any congressman has health benefits under the ACA.I live in Washington, DC. We treated many of them in the Internal Medical Practice that I worked for nearly three years. Believe me the Congressmen themselves have better benefits than their staff does. Our lawmakers need to be subject to the same laws that they put over on their constituents. If anyone feels that Congress would live in poverty without posh benefits then what does that say for the rest of us that live normally???

    The best thing is to write your representatives, by law they must answer letters they receive within a certain number of days.

    by Jennifer — January 26, 2017

  48. Roberta, as several others have said I believe most State/Federal retirees follow the same – no matter what Medicare MUST be your primary insurance once you retiree & you will need some type of secondary ins. As a State retiree I presently have BC/BS covering myself & hubby but that could change if the State decides to go out to bid. But I also believe first medicare pays up to 80% then secondary pays 80% of left over & normally what is not paid is forgiven. I’ve not seen where the secondary pays everything left over. Both my husband & myself are cancer survivors & neither of us is/have paid anything for procedures. What I would like to see is Medicare to pay for eye care/glasses & hearing aids (most ‘older’ people end up needing), my State does pay $100. every 2 yrs. towards eye care – big deal but yes every bit helps. Also as former AARP members we never got any discounts that our AAA plus didn’t offer & same percentage & if you were able to keep your fed. id I’m sure that brought you the same. The bottom line is do your homework, use the info folks supply here & sign up for Medicare when you reach eligible age regardless if you are retired (only starts once retired).

    by Sue M — January 26, 2017

  49. Kate
    I’m in SE PA. Apparently a good retirement state for more than one reason!!

    by Florence — January 26, 2017

  50. I have been watching some of the hearings going on in DC. Most of the insurance plans I have been hearing about sound just dreadful. And they will be run by the states. They will put some money in HSA’s and then you can pay your copays and such. But how and where to do you find an insurance plan that you can afford? And the states will automatically sign you up. Interesting since they are saying you don’t have to have health insurance. And if you don’t have to have insurance who is going to pay when you do to the ER? We all are. And the plans – they are all high deductible plans. And what is going to make the insurance premiums go down?

    Then there is the plan where you can get a plan which right now is so bad it is illegal. And the plan to put all of the people with pre-existing conditions in a special pool.

    My question is why doesn’t our government start regulating the cost of healthcare itself. Like other countries do. We make drugs right here in the US and every other country can get them cheaper than here. Why is it that other countries have healthcare. I think we are so behind the times.

    I recall President Trump saying that we all deserve access to healthcare. He didn’t say access to health insurance.

    So far our politicians who want to gut the ACA and Medicare, Medicaid and Social Security. And they have no plan to replace any of it. I don’t think too many of them have any idea what is going on with seniors. And of course there are those in congress who think they need raises. They can’t live on $174,000 a year. And the federal minimum wage is $7.25. I for one am very afraid going into retirement.

    by elsie45 — January 26, 2017

  51. I live in Atlanta …and as I said many physicians will not see Medicare patients…or see them on a limited basis. My brother is in Massachusetts, has had two hear attacks. He has recently had to give up his basic insurance for Medicare, as the premiums for him and his wife were in excess of $5,000.00 year. He is still able to see the same internist and cardiologist he saw before, but now they do not spend any time with him. He mentioned to me the other day that if I make the change I can be certain I will not be treated the same. My next door neighbor here in Atlanta has been plagued with many medical problems over the years. She and her husband are now retired and her primary care physician will only see medicare patients on Thursday afternoons. It is common place.I would like to have the best care possible, of course…..and I know I am not going to get that as a Medicare patient.

    *My gyn retired because of this. The last time I saw her ( years ago) she indicated to me that most of her patients were medicare age…and she could not afford to operate her practice on what medicare would allow her ( at that time it was $68.0 for a yearly).

    by Roberta — January 26, 2017

  52. Would like to hear from anyone retired from federal government…and what you have elected to do about Medicare/Insurance.

    My deceased husband passed 32 years ago…that is why I am on BC/Shield Fed……..unfortunately I have met no one retired from the Fed that I can ask about this.

    Would love to hear from some Federal Retirees.

    by Roberta — January 26, 2017

  53. Roberta
    I’m a bit confused. What insurance does your brother have now if he gave up Medicare??

    by Florence — January 26, 2017

  54. I am a retired fed employee and would like to clear-up some info in this thread. First, Medicare is not mandatory for fed retirees…it might be for some state retirees. I kept fed bc/bs and only signed up for Medicare A (because it’s free). Only change in fed bc/bs coverage for over 65 is that payouts are limited to Medicare limits by fed law.

    by Dave — January 26, 2017

  55. Roberta, if you haven’t already received this booklet, it might be helpful:

    https://media.fepblue.org/-/media/C71498FD18624C10836706E8AF9FF545.pdf

    This is the website for the Federal Employee program:

    https://www.fepblue.org/en/benefit-plans/coverage/medicare/

    by Louise — January 26, 2017

  56. Roberta, actually 5,000. Per year for two people is very cheap! I just got onto Medicare and with my part B, D, and F along with dental, I will be paying about 6000. Per year for insurance for myself as opposed to 10,800. Per person that I was paying before I got into a group.

    I have never heard of anyone having a problem in Massachusetts with doctors seeing them because of Medicare. I hope that I don’t because I am a cancer survivor and see specialists.

    by MaryNB — January 26, 2017

  57. Roberta, here is a Government website Medicare.gov that you can put your physician’s name or medical group name to find out if they accept Medicare Assignment. I was curious after all this talk of doctors not accepting Medicare patients and put in my Hubs urologist who he will see for the first time in March after he goes on Medicare. His doctor is listed as accepts Medicare Assignment.

    This is what it says: Medicare assignment
    The clinician accepts the Medicare-approved amount; you won’t be billed for any more than the Medicare deductible and coinsurance.

    Accepts Medicare assignment

    by Louise — January 26, 2017

  58. Oops!

    https://www.medicare.gov/physiciancompare/

    by Louise — January 26, 2017

  59. I spent 30 years in the insurance business, the last twenty as a compliance officer. People are stupid for thinking insurance companies aren’t constantly looking to avoid or simply cheat the state laws concerning coverage. I left the industry because it wanted someone to blame if they got caught–the compliance officer, of course. I went from making a six figure income to $10.50 an hour.

    And people ignorantly believe the “government” will cheat them. It will–when they privatize medicare.

    by Kent — January 26, 2017

  60. https://petitions.whitehouse.gov/petition/keep-insurance-protections-people-pre-existing-conditions-millions-it-really-could-be-life-or-death-0

    Keep Insurance Protections for People with Pre-Existing Conditions: For millions, it really could be life or death.

    I was pointed to this petition and thought to spread the word.

    by JoannL — January 26, 2017

  61. Lots of taxpayer money must be required to subsidize doctors and hospitals based on what people on Medicare and Medicaid say they’re paying, compared to what the procedures actually cost.

    by Caps — January 26, 2017

  62. I use AMAC – the AARP alternative that has no federal government involvement.

    by Liz — January 26, 2017

  63. My sister lives in a “red state” and was complaining about the ACA “Obamacare” and how expensive it was.

    Since each state has different degrees of utiliazing the program, people in her state were really suffering. As a test, I compared similar plans in her state and mine using her age and our rates were significantly lower.

    Same experience with Medicare. If you want good coverage, you have to compare plans in different states if you are concerned about your budget, and that means most of us.

    Furthermore, we all have to get active and write or call our elected State and Federal officials. The one thing they fear is us!

    by Marcia — January 26, 2017

  64. The drug industry needs to be controlled. And everyone should be enrolled in Medicare. The two best programs the USA has are medicare and social security. Are you afraid of socialism … ? We already have it in our best programs. The For-profit model does not serve the best interests of the people. If cuurent doctors don’t like this structured payment arrangement, they are free to do something else. Many thousands of good doctors from other countries would happily take their places.

    by Thomas — January 26, 2017

  65. Legislators are required by law to answer letters in a certain number of days? Evidently most legislators don’t know about this law. I can’t find any link to this.

    by Debra — January 27, 2017

  66. Hi Debra:

    I worked for the Federal government when I moved to DC for one year and eight months. I was amazed that incoming mail needed to be answered within a certain amount of days. We did it. Most Americans have no clue about this and they do not write–but they should.

    I would not worry about what the Insurance pays the doctors, I am a former nurse (RN) and my husband was a surgeon. The fees need to come down in the first place. In many instances the doctors charged too much because the insurance would pay it–much like you see the hospitals doing today when they buy up doctor’s offices. An independent practice used to charge certain fees for services, but when they are purchased say by Johns Hopkins they charge much more these days.

    I have long said that to get a medical license, doctors must be required to accept Medicare patients. It is wrong to treat the elderly as second class citizens when all of us will need Medicare benefits in the future–even the doctors and other practitioners who treat the elderly. In Washington, DC, if you do not already have a working relationship with an Internist, they will not accept new mediare patients. It is very difficult to find a doctor who participates with Medicare and if you do find one–the ratings can be poor on that doctor. Check Healthgrades and Yelp before you make a final decision and no matter who you choose to see, you must always check your final bill. Keep an eye out for any fraud no matter who you see. Hospitals make mistakes in their billing all the time and under the current system this can cost you big money.

    by Jennifer — January 27, 2017

  67. Caps-
    Not necessarily. In PA and several other states doctors are required to accept Medicare payments. Additionally, a section of some supplemental plans covers the “gap” of what Medicare covers and what the doctor’s charge is. I don’t think doctors receive additional government payments, but I could be wrong.

    by Florence — January 27, 2017

  68. There are obviously a lot of questions (and some misunderstandings) about Medicare, as indicated by the comments here. Reading a good book on the subject is an excellent idea. One to start with might be “Medicare for Dummies 2017.” It’s available for $12-20, depending on where you buy it. It and other good books on the subject are likely available at your local library. You can also find much free information on the official Medicare website, medicare.gov

    by Clyde — January 27, 2017

  69. From what I read…..
    Patients were paying $2 – 3k or less per year for coverage, yet having extensive procedures, with no additional payment required of them.
    Where did the money come from to cover the Specialists and the medical facility required? It’s obvious premiums alone aren’t enough.
    The only money Government has, is STILL TAXPAYER money.

    by Caps — January 27, 2017

  70. Caps and Clyde:

    I would love to know which states require doctors to participate with Medicare? Can you provide a list or tell me where to find one? A doctor only is required to accept what Medicare allows if they participate with Medicare. There are various levels of participation a doctor can choose OR they can choose to OPT OUT of the program altogether. If you see a doctor who is totally out of the program then they are not required to file your claim and you will have to pay in full out of pocket for those services. If you worked for the Federal government, (maybe you have Federal BC/BS as an example) and your doctor participates with Medicare on any level, then you cannot be charged any more than Medicare would allow if you are over 65. I live in Washington, DC and my a good part of my life I was a nurse. I am not aware of what other jurisdictions do or require. I am skeptical that a whole state makes their doctors accept Medicare—many doctors would probably leave that state or totally OPT Out of the program as things now stand. However I do believe that as a condition of licensure, that ALL physicians must be required to participate fully with Medicare–otherwise why have insurance at all? It is of no use if you are in a rural area and your doctors won’t see you because you have Medicare. Of course if you have the money–it is not an issue.

    by Jennifer — January 28, 2017

  71. Florence: Sorry…perhaps I was not clear: My brother had to give up his primary insurance as it was just too expensive. He then had to go to Medicare. I do not know what he has for supplemental. This was quite recent. he told me again as recently as this week that he and his wife notice that they are not treated the same by the same physicians they have been using right along. He sees a cardiologist……..and his complaint is that the he cardiologist still sees him, but spends practically no time with him…..physician has a very different attitude.

    My physicians, brother and therapist have encouraged me to keep my BC/ Shield. Everyone else has said to go to Medicare.

    by Roberta — January 28, 2017

  72. Dave: Thank you….likewise for the past 7 years I have opted to stay with the BC/Shield Fed. Curious: Where you able to somehow pick up a supplemental policy ? I have spoken to BC/ Shield and they tell me I can not pick up a supplemental Unless I opt for Medicare B and pick up BC/Shield as the supplemental.

    I have not had a problem until two years ago….because I have not had any serious medical until two years ago. Since I shattered my wrist, had surgery,months of therapy….I was left with thousands of dollars to pay…in fact I am still paying on it. Recently had a diagnosis for a torn meniscus…and here we go again: office visits, medication, therapy, and possibly surgery.

    by Roberta — January 28, 2017

  73. Much thanks to all of your for your comments……very helpful.

    by Roberta — January 28, 2017

  74. Roberta, Take a look at the links posted by Louise on 1/26. One of them lays out what you pay if you sign up for Medicare Part B and keep your fed BC/BS and what you pay if you don’t. I’m a fed, still working and several years away from Medicare. My intent is to keep my insurance when I retire and sign up for Medicare A & B when I’m 65, and then I will keep my insurance along with Medicare.

    This is from our retirement counselors: At age 65, enrollment in Medicare is optional. If enrolled, it becomes your primary and your FEHB plan becomes your secondary provider.

    Louise, Thanks for the info you provided. I haven’t paid much attention to Medicare because it’s not in my immediate future but the brochures were helpful. My plan for Medicare and insurance hasn’t changed, but it was good to see the benefits spelled out.

    by Tessa — January 28, 2017

  75. For Robera…I am a widow of a Federal Worker, so I get his annuity after he passed. As far as health insurance, I decided to switch from standard BCBC to basic, and I now have Medicare A and B. It is very reasonable and pretty much covers all. I used to have the standard BCBS but this year switched over to the other. Hope this helps!! 🙂

    by Loraleea — January 28, 2017

  76. I am a retired federal employee under Medicare Parts A and B. I retained by Federal BC/BS Standard and pay
    $230.00 a month for myself which is now my supplemental as Medicare pays first. Blue Cross covers all of my co-pays and deductible so I have not been out of pocket any money besides my premiums. Federal BC/BS’s prescription plan is good and that is also covered under my premium. There are retired federal employees who feel it is unnecessary to continue their federal insurance and just pay for Part B. However, I feel that the govt plan is just as good or better than any supplement plan. It boils down to how much risk you are willing to take. My husband has been through colon cancer, radiation and chemo and the charges are astronomical if one does not have insurance.

    The decision to keep the federal plan and forego Part B is not a magic formula because of the penalty one has to pay for each twelve months not covered by Part B if one decides to take it later.

    by Joyce — January 29, 2017

  77. Jennifer, I am unaware of any states that require doctors to take Medicare, even though the possibility has been mentioned by others in this discussion. I expect it’s not legally possible for a state to force doctors to take Medicare. If you live in or retire to an area where there are lots of retirees, you will probably find a lot of doctors who take Medicare in that area. Otherwise, they would not have very many patients, and probably couldn’t make a reasonable living. If anyone does know of a state where all doctors are required by law to take Medicare, please comment about it.

    by Clyde — January 29, 2017

  78. Penalty for not taking Part B Medicare: https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html

    by Louise — January 29, 2017

  79. http://www.pbs.org/newshour/making-sense/worth-keeping-medicare-im-covered-new-employer/

    Is it worth keeping Medicare if I’m covered by my new employer?

    Saw this article on the PBS website.

    by JoannL — February 25, 2017

RSS feed for comments on this post. TrackBack URL

Leave a comment