Medicare and Healthcare Concerns Rising As Congress and President Debate What to Do Next

Category: Health Issues

Update March 18 – We just provided an update on how the new TrumpCare replacement will affect people age 50 – 64 – “Obamacare Replacement Will Hammer Pre-Retirees

March 1, 2017 — Judging by the number of Comments and questions we are seeing on this Blog, baby boomers are uneasy about what might happen to their healthcare insurance under Medicare, Medicaid, or the Affordable Care Act (ACA – Obamacare). Given all the headlines and conflicting plans and positions, those concerns seem to be well founded. In this article we will air some of the most frequent questions and concerns aired on the Topretirements.com Blog. In some cases we provide answers provided by other Members. We also have some good resources to recommend where you can research this topic in greater detail.

First, a little update on where we stand
The President, the Republican controlled Congress, and the new Secretary of the Health, Education and Welfare have all said they are going to repeal and replace the Affordable Care Act (ACA – Obamacare). Democrats, on the other hand, favor improvement/repair rather than repeal. The subject is confusing: according to one poll, one-third of Americans don’t realize that the ACA and Obamacare are the same thing. Republicans have floated at least one replacement plan in rough form, but they appear to have no consensus among themselves, in fact conservative Republicans say they won’t go along with many of the provisions in that plan. What will happen, and how long it will take for the changes to take place, is anyone’s guess. The President, who has promised to replace it with “something terrific”, seemed to acknowledge the difficulties this week when he met with governors and health executives, after which he commented that “Nobody knew health care could be so complicated”. To the President’s credit (in our view), his new budget plan reportedly has no cuts to Medicare or Social Security. It will be interesting to see how this plays out.

Changes to all 3 health insurance programs promised
Proposed changes to health insurance will probably affect all 3 major federal programs: The ACA, Medicaid, and Medicare. The ACA extended coverage to roughly 20 million Americans. About half of the newly covered got insurance coverage from the new exchanges created by the ACA (many of whom got tax credits based on on their incomes up to 400% of the Federal Poverty Level – FPL). The other half got it from Medicaid expansion in the states that agreed to do that (most of whom have incomes under 138% of the FPL).

Insurance under the health exchanges and Medicaid programs were tied together in many ways by the ACA. Repeal of the ACA would, depending on what it might be replaced with, almost certainly change many aspects of both programs, and reduce the number of people insured.

The third federal program, Medicare, which provides medical insurance to most people over 65, is separate from the ACA. But that does not mean it is immune to change – Speaker Paul Ryan and other Republicans have proposed replacing it with fixed amounts per recipient. Critics are concerned that a voucher program could mean coverage limits.

Now for those questions (We hope you’ll add yours in the Comments section!)
In many cases here we have provided answers provided by our Members in the Comments section. There are many more interesting questions and responses in the Comments sections to our other Medicare and Obamacare articles (see Further Reading at end of article).

1. Can someone who is Medicare age eligible apply for coverage even though that person is eligible for health insurance coverage through their employer? (Staci)

(This is BeckyN’s answer)
Staci, you might want to check with your employer’s benefits department on your employer-provided plan. Some plans may require you to sign up for at least the “premium–free” Medicare Part A at 65 (providing you qualify for it).

The employer plan may state Medicare Part A then becomes your primary, with employer-provided insurance covering what Part A does not cover as secondary insurance plan. Also this provision will probably be completely separate and different from what they require for Part B of Medicare (which requires a premium paid by you).

But if you’re still working and your employer coverage is a high-deductible plan with a health savings account (HSA), be careful. Under IRS rules, you cannot contribute to an HSA in any month that you are enrolled in Medicare (A or B).

So, when making a decision on whether to sign up for either Medicare Part A (or B) at 65 there are multiple factors to consider: 1) whether you qualify for Medicare A with or without a premium, 2) whether you have a HSA with your employer, 3) what are the stipulations in your employer’s plan when you turn 65 and 4) the Medicare rules on signing up for Part A during your initial enrollment period.

It is probably best to get information from your employer directly. Always lots to think about-never simple.——

(Kate’s response to BeckyN) – Very good advice! I checked and my employer’s plan is one that requires me to apply for Medicare at 65. At that point Medicare is primary and my employer’s health care is secondary—
See also: Is it worth keeping Medicare if I’m covered by my new employer? , a recent article on the PBS News site. (Thanks to JoannL for this excellent link).

2. If the government pays for your Medicare and prescriptions because your income is $15,000 are you allowed to have savings? My friend will be very low income but she came into a small inheritance. I would think that would be considered to make her ineligible for assistance.
by Louise —

Answer: This question is referring to Medicare’s program of extra help with prescription drug payments for lower income individuals. To be eligible you cannot own more than $13,820 for an individual or $27,600 for a married in stocks, cash, etc. But your primary home, vehicles, life insurance, etc. do not count against that total.
See this Social Security Publication

3. Medigap Insurance. Can anyone from SE Florida tell me what it cost for Medicare part F and D plan along with a good donut hole coverage plan? Trying to figure out a retirement budget regarding these expenses. We plan on moving to Delray in late 2017 from Texas. (Skip from Texas)

Answer. Medigap insurance generates a tremendous amount of questions and confusion, mainly because there are so many alternatives. Medigap basically covers whatever your Medicare Parts A, B, or (if you have it) Medicare Advantage plans won’t cover. Florence’s suggestion to Skip was: “You need to investigate on line. The cost in each state is different. See Medicare- What is Medigap

3. There is much confusion between Medicare, Medicaid, and the Affordable Care Act health exchanges.
Medicare coverage has nothing to do with ACA. Obamacare and the Affordable Care Act Act are the same thing.

Medicare Part A is hospital coverage 65 and older and covered by the Fed govt. Part B is office visits, labs, etc., and your premium is dependent on what your income is. Medicare pays 80% the rest is up to you. Therefore many people buy a supplemental plan from an insurance company (medigap) – the plans are alphabetized. Each state’s premium for a particular plan is different depending upon the plan you choose. You also pay for a Part D plan (drugs) through the same insurance company. All of this is traditional Medicare, it has nothing to do with Medicare Advantage Plans nor the ACA. (B. Pentony)

4. Where do we go from here?
In a Comment on Topretirements.com Brian summed up the problem that baby boomers face, now that we have had the election and the new Administration is in place: “So, really isn’t it essentially impossible to provide any concrete advice for 2018 and beyond that can be relied upon until after we learn what changes are going to be made to healthcare coverage for those who retire before 65 and even for many already using Medicare?” Brian, we are afraid you are correct.

That being said, there are some steps you can take:
– If you are working and have health insurance, don’t quit or retire! The phenomenon is called “job lock”, and the NY Times has an interesting article on it: “If Obamacare Exits, So Could Your Chances of Retiring Early“.
– If you do not have health insurance and are under age 65, do your best to get coverage so you don’t have a gap in coverage. Open enrollment for Obamacare ended Jan. 31, 2017 for this year. But you can still apply any time: 1) If you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, or having a baby. Or 2), If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
– Be informed about what proposals are coming from the government, and let your representatives know how you might be affected by it.

Comments? What are you doing to protect your health care insurance? What questions do you have about Medicare or other health coverage? Please share your thoughts in the Comments section below.

For further reading
So You Are Turning 65 – Your Medicare Guide 101 95 Comments
How to Solve the Health Care Puzzle If you Are Not Yet 65 94 comments (Note: If Obamacare is repealed much of this article becomes outdated)
AARP Raises Concerns About Future of Medicare 79 Comments
Medicare.gov
Healthcare.gov


Posted by Admin on February 28th, 2017

50 Comments »

  1. Implications for Medicare of repealing ACA
    http://kff.org/health-reform/issue-brief/what-are-the-implications-of-repealing-the-affordable-care-act-for-medicare-spending-and-beneficiaries/

    Compare the options for replacing ACA
    http://kff.org/interactive/proposals-to-replace-the-affordable-care-act/

    by Kay — March 1, 2017

  2. What happens with the donut-hole if they do away with ACA? This could cost seniors thousands of dollars with rising drug prices.

    by John Valentine — March 1, 2017

  3. I am certain we can do better than Obamacare. Although I am glad one can get insurance with a pre-existing condition, I am furious and disheartened that we were lied to. My insurance stared out at $155.00 per month in 2014 and has gone up to $375.00 per month in 2017 and my income has not changed. I have changed insurance providers twice, because now there are only two providers in our state. (DE) We need interstate availability for competitive rates We need rates that don’t keep going up.
    The Affordable Care Act is no longer affordable and long ago I had to give up the insurance I wanted. President Obama may have meant well, but things are not working out for the middle class affording insurance.

    by Carla — March 1, 2017

  4. As a former nurse, who had a supervisory position in an Internists office before leaving medicine altogether, I have seen people call in a panic before a scheduled office visit because they had a $5,000 deductible, could not afford expensive medications, or were not sure what lab tests would be covered under a “free” annual physical. It was a nightmare. The high deductibles prevent people from coming in to see a doctor and one must be sure that their doctor is in network at all times–even at hospitals to make sure they are covered or look out for a big bill! The stress of the financial situations on both sides from the patients and the doctors–they have to be able to pay their bills and staff–made me rethink my future in the business. I worked in surgery for twelve and a half years prior to the Internist’s office but that was also stressful in a different way. I am getting older and decided I did not need the daily worries and so I switched gears and now work for a Church.

    by Jennifer — March 2, 2017

  5. Whatever the Republicans offer to replace the ACA I can’t imagine that it would include Government subsidies like it does now. I don’t see the cost going anywhere but up.

    by Jim C — March 2, 2017

  6. For the people who were not happy with their insurance rates increasing to help pay for the needy….well perhaps you need to move to a state that offers more options. For example, California offers you many to choose from and if I was still working my premiums would have stayed the same because I was earning $31000 yearly. I don’t have any faith that when they repeal and replace that the costs will be lowered…..

    by mary11 — March 2, 2017

  7. Just to put the cost of insurance under Obamacare into perspective, I still work for a Fortune 500 and my monthly payment for solo insurance is over $400 month (not counting vision and dental, but it does include prescription coverage). I have a $5,000 deductible. I hear people complaining about the cost of insurance under the ACA, but they have to realize that insurance is expensive for everyone. They are guaranteed the ability to buy insurance and have some subsidies…but they aren’t guaranteed to be immune from increases in cost that have affected all Americans. I am hoping that ACA is still available when I get laid off or leave work before age 66. I’ve been told that my COBRA cost would be in excess of $1,000 per month if I have to continue my existing coverage.

    by Kate . — March 3, 2017

  8. Kate, I have 16 more months till Medicare and holding my breath I can transition from ACA to Medicare without a giant bump in the road with repeal and replace. I am hoping if they replace ACA it takes some time for it to actually happen. I don’t have a good feeling about the future of ACA. I am very thankful we have/had it. My Hub had major surgery last October and what we paid above and beyond our policy was doable and didn’t break the bank. He is now on Medicare and Plan F so hopefully, no more bills for future issues for him.

    by Louise — March 3, 2017

  9. The ACA has saved many Americans from losing their insurance, My wife had high blood pressure and when she changed jobs they tried to deny her coverage until the ACA was put into effect. Also the ACA lifted the arbitrary cost cap which discontinued your insurance after you reached a certain expenditure.

    by Ron — March 3, 2017

  10. Darn spell check. I meant “hear.”

    by Caps — March 3, 2017

  11. Carla, are you on Medicare? Where in the world do you get health insurance for 370 a month? My premiums were around a thousand dollars a month for just me for years. My medicare A and B , D, and F is about 500 per month, and I consider that huge bargain.

    by MaryNB — March 3, 2017

  12. Perhaps was feeling the bite that the ACA is increasing in cost more than any retirees received in
    COLA increases-after the first year! Whether this an aberration or a trend that would continue, no one knows, but the laws of economics says with more insurance companie pulling out of the ACA, less competition =higher prices. The President’s address this past week included the ability to purchase insurance across state lines, which should increase competition. The increases:
    http://www.thefiscaltimes.com/2016/11/01/Here-s-How-Much-Obamacare-Premiums-Are-Rising-All-50-States

    by HughC — March 5, 2017

  13. There needs to be competition and availability of all available health plans across all state borders and all health care plan companies, including Medicare, must be able to openly solicit price bids and contracts for drugs and drug prices across all suppliers, including foreign ones.
    The current attempts of the major health plan companies to merge together might help them but it won’t help the recipients, for then we will soon have a huge monopoly that will start raising costs to people to suit their own self-serving greed.
    People should be able to get their medications at cost from Mexico or Canada if they are too expensive here. If low prices work offshore, they can work here in competition with the offshore health facilities and manufacturers. What we have now is a mass “health tourism” industry because so few can afford to get treated in the US. But we still have to participate in Medicare here even if we do not choose to use it.
    Another angle is that discounts should be given to those who consciously continue living in a healthy manner, who take the responsibility to keep themselves healthy. Those who choose to use drugs, cigarettes and alcohol should have to bear the higher costs of the eventual negative results of their own choices.
    Those with genetic propensities toward certain diseases should be given discounts as long as they are actively living in a manner that allows them to prevent early onset of their “future” predicted disease possibilities.
    The biggest worry is that the changes in social security will negatively impact those who live on little more than their social security checks which are insufficient to live off of today due to the pay levels of their past years being much less than those pay levels available today. What will they use to buy food and rent if their entire social security check gets consumed for their medicare deductions, which is where the current congressional planning seems to be going by making seniors pay up to support the “absent youth and poor people’s” health care? They should just allow the retirees in that situation to drop out of medicare and just take their chances going across the border for their much cheaper health care. Now, one is not allowed to drop out of medicare even if one is not using it..
    For retirees to be hit with a bill to underwrite costs lost by the ACA, retirees would have to be expected to return to work just so that they can pay for their medicare. For that to be successful, the government would have to pass AND ENFORCE laws preventing age discrimination and firing or “retiring” those over 50 early to get rid of the expense of keeping them on payroll. The many in the process of losing their jobs after they reach the 50-55 age group shows that no or little enforcement is currently taking place.
    Retirees who elect to return to work find that they will end up paying much of it back in taxes, their medicare costs go way up, their social security taxes go way up, plus state and local taxes if any, so whatever is left goes toward the increased health care costs that will be jacked up every year. Who wants to spend the rest of their life working for nothing, unless one is so well off that none of these possibilities would put a dent in meeting their basic needs for living?
    People in that category can easily be expected to pay more, for they don’t really need most of their high incomes to live on. Statistics nowadays show that many retirees are NOT in that happy situation.
    This whole issue begets the thoughts we had about the original version of the ACA and its “death panels” type legislation, dressed in the subtle legal speak of unintelligible verbosity hidden deep in a tome so over-sized that no one in Congress even bothered to read it before signing off and voting on it. If we are not careful, this one could be even worse, as they refuse to deal with any of the real underlying insights and problems that will be very hard to solve when redoing this law. Will the elderly be the next class of people to be demolished as the middle class has been?

    by K. Magee — March 14, 2017

  14. If this thing passes it will just force low income people to depend again on the emergency rooms. Where is that saving money for the government?? Most retirees who are only living off of their social security will need to figure out is food or health insurance more important. ….

    by lela1955 — March 15, 2017

  15. Medicare is not required by law as you state. You can decline to sign up and you can also terminate your enrollment but face penalties to re-enroll at a later date.

    by Larry Scanlan — March 15, 2017

  16. To Lela,
    Do you realize that even on SS if you are single and take in 1200 and have no savings medicare is cheaper than when you were working? Plus given the above circumstances you will be able to qualify for sup SS and prescription benefits? If you are married and together take in no more than 30k w/o savings the same applies. And if you decide to go the way of a HMO it is even cheaper. The prices for meds are going up as sup and drug coverage but it is still a better deal than Obamacare or the plan being proposed now.

    by LMB — March 15, 2017

  17. Larry, I believe Part A is automatic which is hospitalization which is fantastic. I cannot imagine anyone turning that one down. In fact I do agree with socialized medicine but I can see myself supporting a Part A type of medicare for every citizen. To me that is the area that can really put someone in the poorhouse.

    by LMB — March 15, 2017

  18. LMB, Part A is great and free (for most people) but if you go to the hospital and they put you under observation status, Part A pays little and you are stuck with the bill. http://khn.org/news/observation-care-faq/

    Hospitals will do anything rather than to admit you. They want you to be there under Observation status because Medicare scrutinizes the bills and penalizes the hospitals.

    by Louise — March 15, 2017

  19. I hope we can get back to making our own decisions regarding our health care, allowing for more free market options. Having the Federal government knowing everything about us, reminds me of Nazi Germany. Very troublesome indeed.
    The government doesn’t have any of it’s own money…..it has to take it from us taxpayer’s first, or print it without backing, causing ever higher deficits. This should all be relegated to each state, instead.

    by Caps — March 15, 2017

  20. LMB, sorry but my comment was for the 62 to 64 yr old retirees like myself. I do plan on choosing Medicare when I turn 65. I will be earning less than $10000 yearly on SS with an inheritance of $165000 , so getting any assistance from the govt, if it is still available, might limit me unless I invest it all into a home.

    by lela1955 — March 16, 2017

  21. Thanks Louise for sharing on this “observation” status thing. I had no idea and now that I am on Medicare I will keep this is mind.

    by BeckyN. — March 16, 2017

  22. I am very concerned that the current Republican Congress and President do not have the best interest of seniors in mind.
    If the current Trumpcare bill is any example it appears this congress has its sites set on eliminating Social Security and also Medicare and Medicaide. This would be disastrous for me personally and I fear for many many more seniors who rely on this valuable service.
    Tax credits and tax voucher are a scam and never work. We have seen these no work with schools and it won’t work for us. Please notify your local congressmen and tell them Hand Off of a system that works quite well. Many seniors rely on their Social Security check for a living allowance pitiful as it may seem. I read many of you in the same situation as I. I did not vote for these people who want to end my life neither should you. Vote for people that actually demonstrate they have seniors in mind not on a death list.

    by Ron — March 16, 2017

  23. BeckyN, The troubling thing is when you are sick you have no choice when you need help and then they put you in observation status, you are screwed. You can rant and rave you want to be put on admitted status but probably will do you no good. I don’t even think the doctors have much clout in swaying the hospital to admit you. Yes, you can get crabby and say you are not going to stay but where are you going to go? However, they will send you home in 24 hours anyway so you do not get the 3 midnights overnight stay. I find this beyond dispicable and evil to send people home when they have not diagnosed issues and the person is sent home sick as a dog. Hahaha, Marcus Welby where are you???

    by Louise — March 16, 2017

  24. Ron, Social security is not going anywhere in your lifetime and neither is medicare. This is just hype that those on the left like to do to scare older folks. They have been doing this for the last 45 years. The truth is no matter the left or the right adjustments have to be made because the government has been continually extending both programs to entitle every situation. There are true situations where our citizens need help and we should help them but I can personally tell you I was laid off around 6 years ago and was barraged with emails trying to get me to get ss based on a disability which had yet to be determined. Thank God, I have no disability. I can tell you that these people should be locked up and fined for this is one example of draining our ss system and medicare as you are entitled to ss medicare if you are disabled. Not only do these scams hurt those who truly are disable and those in the future who may need they drain the system. There will be changes this is the price one pays for so call progress and the high cost of living. So please do not buy into the scare tactic, and read all sites not just those that present one point of view to get you to vote their way.

    by LMB — March 17, 2017

  25. Louise, you are so right that is why it is so important that someone is with the person in the ER who is not afraid to demand to be admitted and not observed or call the doctor. I just went through this same scenario I asked two times to make sure my husband was being admitted because if he was only going to be observed I would take him home. One must stand their ground otherwise as you say the hospital does not care. I do not know your situation but if you drove the person there, you can drive them home. Do not let them bully you. The only time I have learned that they can bully you is once a patient is admitted and the care is less than efficient you best not complain because they do retaliate. They did with my Mom and I will never ever forget it. For many the job is just a pay check and they did not enter the profession for their love of people. They entered it for the money period.

    by LMB — March 17, 2017

  26. Lela, if you are getting a inheritance of 165k and your ss is less than 10k per year you are correct you are not entitled to supp unless you put all the money in a house. I think it sounds as though what you need is a good financial advisor as how many at age 66 will receive 165k inheritance? Good luck.

    by LMB — March 17, 2017

  27. Lela, again retirees who have to decide on whether to eat or pay insurance most likely qualify for additional ss supplements and do not have a 165k inheritance.

    by LMB — March 17, 2017

  28. Ron, could you help me find the reference in the DRAFT of the new proposed American Care Act (referenced by you as Trumpcare bill) that states Congress plans on eliminating Social Security, Medicare and Medicaid? I could not find it, but perhaps I am not reading the same document you are? I would like to stay informed with REAL facts.

    by BeckyN. — March 17, 2017

  29. LMB, thanks. Yes, I know my inheritance will assist me in my retirement years so I won’t need too much help from the govt. I’d prefer to buy a smaller and less expensive home and invest the rest. My hubs is 10 yrs younger so need some of the inheritance to get by until he can collect his SS….

    by lela1955 — March 17, 2017

  30. In support of Ron’s comment. In my previous home, i lived next door to someone who had a mental disability. It was being treated properly, and this person functioned on a very high level. S/he entertained friends and family continually. The family constantly took trips and the demands of planning, packing, and scheduling were always met. I knew this person well, we were friends; so i did know what was going on ‘inside’ the family.
    One spouse earned well over $100,000 annually; but not only the disabled spouse, but their two children received a check every month!
    THIS IS NOT WHAT SOCIAL SECURITY WAS MEANT FOR!

    by ella — March 18, 2017

  31. Read your quarterly Medicare statements carefully! My mom passed away in Nov. and I just received her last statement in which Medicare was still being billed for equipment and services after her death. By the way, I called SS and Medicare the day that she passed! And yes they still paid the phony charges! No wonder it is in such a financial mess…yesterday I called the providers and let them know that I would be reporting them to Medicare and they assured me that they would reimburse the money. RIGHT…

    by SandyZ — March 18, 2017

  32. Ron did not state that Trumpcare (the American Health Care Act being supported by Speaker Ryan and the Republican leadership) contained provisions that indicate plans to eliminate Social Security and Medicare. He said that, from what is in Trumpcare, it appears many in Congress who support Trumpcare have THEIR SIGHTS SET on weakening Social Security, Medicare and Medicaid. However, Trumpcare will definitely affect Medicaid recipients negatively and eliminate it for many. The nonpartisan Office of the Management and Budget (OMB), has statistically determined that under Trumpcare over 12 million people will lose or fail to receive their Medicaid coverage sometime before or after 2020. And the OMB is currently headed by a Republican appointed by a Republican Congress.

    by Clyde — March 18, 2017

  33. Ron, I can’t find anything in the health care proposal that indicates any intent to do away with Medicare and Social Security. Am I missing something?

    by MaryNB — March 18, 2017

  34. MaryNB
    I think you need to check out the news today. There are talks in Washington of reducing Medicaid. The Philadelphia Inquirer had an article on that very subject this AM.

    by Staci — March 18, 2017

  35. Ella: My spouse did receive disability benefits, as did our kids – and I earned what you would view as a big salary. In high-cost states we probably would have been middle-class, but you probably would have thought we were wealthy before my spouse began his battle with early onset Alzheimers. My spouse’s disability check went to his medical bills and caregivers, not to frivolous spending. My “big bucks” went to keep the family in the same home, since my spouse would not have been able to handle a move to another house or neighborhood and the kids’ (youngest only 10) were already being impacted by their Dad’s illness. The kids’ benefits until 18 helped to replace their Dad’s support. And yes, they did get part-time jobs but they also helped care for their Dad. When my spouse eventually no longer understood language, was aggressive, incontinent, began to wander, would not sleep, and other issues, we were forced to admit him to a nursing home for skilled care. My salary did not begin to cover those expenses, and a lifetime of marital savings were then spent down to the nursing home including retirement savings and savings for the kids’ education in 529 accounts, before becoming Medicaid eligible for nursing home assistance in our state. We had both paid the maximum social security taxes through most of our careers, so these were benefits that my husband had absolutely earned and was entitled to receive. Disability benefits were a lifesaver through the years of his deterioration. By the way, no one who chatted with him at the beginning or who just looked at him would have guessed about his illness, or what we were dealing with behind closed doors. The law did not require that the family be completely destitute before my spouse could get the benefit he had paid for. You may think that you know what’s going on in your neighbor’s house. I respectfully submit that no one ever knows everything about anyone else’s situation, and we shouldn’t judge so harshly. If one person takes advantage, that doesn’t mean that everyone else is abusing the sytem.

    We should all pay close attention to the changes in law that could negatively affect our benefits, and pay attention to budgets that eliminate everything from women’s subsidized health care, meals on wheels, etc. Even if you don’t think you or your family members need those programs and you think that the people using them should just work harder or be more self-sufficient, I KNOW from personal experience that we are just a crisis away from needing the safety net ourselves.

    by Kate . — March 19, 2017

  36. Kate,
    I am sorry for all the heartaches you went through. You shouldn’t have to try to explain to anyone how you spent disability money. The system has strict rules and when it comes to Medicaid and getting a loved one into a nursing home it is brutal. My Mom ran out of SS money to pay for her rehab at a nursing home. She was going to have to self pay at $12,000 a month. That will wipe anyone out in a heartbeat. My Mom didn’t live long enough for her to self pay.

    This has nothing to do with Medicaid but in our area, several ‘injured’ cops (medically retired) were investigated by private investigators and one was photographed snow skiing and lost his benefits, another was photographed water skiing. He lost his benefits too. Also, my neighbor won a lawsuit for an injury from years ago. A private investigator called my house to try to question me on what I knew about this man. He also did all kinds of physical stuff in his yard. But I just told the investigator I didn’t really know the guy which I didn’t. He died about 6 months later of cancer. So, there are tons of people who scam the system and then there are people like your husband who played by all the rules and received money legitimately.

    Now here is a story that will either make you shake your head OR make you laugh. My husband worked with this guy years ago when they when they were in their late 20’s. There used to be this chain restaurant that offered all the shrimp you could eat. Well this guy decided he was going to get a law suit against this chain and his scam was buying his own shrimp and leaving it out of the fridge for several days to get ripe. He and his wife went to the restaurant and got some shrimp on their plates. This guy gobbled up his ‘rotten’ shrimp he brought from home and waited for it to take effect He planned to get sick right at the table and I assume be taken to the hospital by ambulance. Well, they sat there for the longest time and nothing happened. His wife was freaking out scared and nervous. She finally dragged him out to the car. In the parking lot he got sick and he wanted her to go in and get someone to ‘see’ that the shrimp make him sick. She said the heck with that and threw him in the car and drove him home! No lawsuit!

    by Louise — March 19, 2017

  37. Just to clarify, I’m not objecting to using our savings for my husband’s care before he became eligible for Medicaid. I understand that was our responsibility (although it was heartbreaking to see 20 years of savings for the kids’ college money m their 529 accounts be counted too). I just take exception (1) to the attitude that some people should be eligible for the same government-promised benefits that they have spent their working lives paying for like everyone else; and (2) that anyone should be judging their neighbors. I hate the we-vs-them resentment, whether it’s from people who judge other people’s spending or lifestyle, or by the people who assume that poorer people just didn’t work hard enough or made smart enough life decisions. Ultimately we all benefited during our lifetimes from farm workers toiling for hours in a field so we can order a salad in a restaurant, having doctors available for emergency surgery, the truck driver delivering goods to our WalMarts and Costcos, being able to call a plumber when our toilets back up, the accountant who works weekends to keep a company afloat, etc. And we all deserve access to a safety net, and respect.

    by Kate . — March 19, 2017

  38. Well said, Kate. I will investigate what might happen to the 529 college savings accounts we have for our grandchildren, and thank you for your thoughtful response.

    by Marianne — March 19, 2017

  39. I heard nothing about eliminating or even effect Medicare and Social Security. It is only Medicaid that will be effected.

    by Barbara O. — March 19, 2017

  40. I have mentioned this book before. It is called How to Protect your Family’s Assests from Devastating Nursing Home Costs-Medicaid Secrets. The book I have is the Eighth Edition and is 2014. He reprints a new version each year. The book is written by Attorney K. Gabriel Heiser. You may be able to get this book at the library. I purchased my copy. It gives you a good insight into how you can prepare financially if you/spouse are going to need Medicaid. It also tells you what is legal to do to spend down your assets. It tells you that you may buy a larger more expensive home, a new car, carpeting, siding, flooring, furniture, all kinds of home improvements like a new roof. You may also pay for certain prepaid funeral expenses. The idea is to invest the money into for your needs and your home before Medicaid takes it. The book also says NOT to hide your assets. According to page 5 in this book every technique and option discussed in this book is 100% legal. Hiding your money is not an option!

    Plus, it mentions an annuity called a SPIA (Single Premium Immediate Annuity). It allows the healthy, at home spouse, to put assets into an annuity. This article explains more: http://www.lifehealthpro.com/2013/04/23/medicaid-planning-spias

    This book is very infomative and doesn’t replace going to an attorney. From what I have read, you need to get a very specific SPIA which an Elder Law Attorney would be familiar with. Picking the wrong one will disqualify you.

    I am in no way affiliated with this book or author although the book is an informative read, going to an attorney is the best advice. However, reading this book or one like it will educate you immensely.

    by Louise — March 19, 2017

  41. Referencing Clyde’s comment “it appears many in Congress who support Trumpcare have THEIR SIGHTS SET on weakening Social Security, Medicare and Medicaid. Conjecture and I feel that depends on which news station you listen to. As a member of the silent majority, I will hold out to see what actually get voted into law and what is provided in the NEW BUDGET (both Federal and what the States will then have to do) and choose not to react to scare tactics. Those that are worried, should contact their Senators.

    Another comment – “However, Trumpcare will definitely affect Medicaid recipients negatively and eliminate it for many.” CORRECT – that is part of the “Repeal” process and again I choose to wait for the “Replace” legislation and what the new (and hopefully improved) plan offers. Just about anything they come up with has got to be better than the provisions in Obamacare. And, all of this will take time – give it a chance. The nation gave Obamacare a chance and we saw the disastrous results.

    by BeckyN — March 19, 2017

  42. Becky, Thank you and I agree with you about the wait and see what happens. Thank you also for the info on the book. My husband has Parkinsons and I have already informed my daughter that I did not want Dad to go into a nursing home but now I am learning it does not matter, there is no way he could afford a nursing home. I know we both will feel better knowing we have made the best possible plans.

    by LMB — March 20, 2017

  43. Had it not been for Obamacare, my family and I would have been without health insurance from 2014 on. Had there been a serious illness or injury, we easily could have faced catastrophic hospital costs, financial ruin, even bankruptcy. There are millions upon millions like my family who are able to obtain insurance through Obamacare, who otherwise (especially because of pre-existing conditions) would be facing unbearable situations. In no way do those benefited by Obamacare consider it “disastrous.” In fact, it has been a Godsend.

    by Clyde — March 20, 2017

  44. Clyde, My Hub retired 2 years ago and we went on Obamacare. About a year after he retired, he had a serious illness which required surgery. That surgery and all that went with it was close to $100,000. If not for Obamacare this surgery could have broken the bank. We have been very happy with it and what it has paid for. I wish that they would take their time and find fixes for Obamacare rather than kill it. The only way this insurance will work is if everyone paricipates in it like any other type of insurance. Car insurance, house insurance, Social Security. Not to mention school taxes. We all pay into it and basically no one wants to use it because either you are sick, you have wrecked your car, your house burned down. But if you need it, the insurance is there if you have paid into it. Rushing to get this thing passed is either going to blow up in their faces or it will pass and we will be stuck with an expensive health plan that will not help those who need it most. The sick!

    by Louise — March 20, 2017

  45. Thank you Clyde. ….after being layed off at the age of 58 I would not have been able to afford health care…Obama care has been a godsend for my family. We qualified for the medicaid expansion. I am a caregiver to my 89 yr old mother and receive only $760 from social security so if trump care passes I won’t be able to afford any healthcare!! I understand how unhappy some policy holders with the higher premiums may feel it was unfair but having people go without or having to use emergency rooms again is not a better choice either……

    by lela1955 — March 20, 2017

  46. Clyde and others – I apologize for my use of “disastrous” in my earlier comments. I obviously should have used a softer word. It was not my intention to give the impression that Obamacare was not good from the stance of providing medical care for you.and others My focus was that it was not financially good and I believe, as others do; it is not able to sustain itself. That is my focus in supporting its repeal and replacement and wish for a better plan to provide for and meet the medical needs of ALL and be financial solvent. My second point is don’t condemn its replacement until we know what it will be and it has been given a chance. And, while I am at it, that goes for Congressional actions on Social Security, Medicare and Medicaid and President Trump’s ability to execute on positive, good and necessary changes for all Americans.

    by BeckyN — March 20, 2017

  47. Help! Just moved to Fla from another state where we have Cigna Healthspring…they are unavailable in Fla and I am searching for a trustworthy medicare plan. Who do we go with? We are not on a lot of prescriptions. Thank you. WE are in Santa Rosa County…is there someone I can call that represents all the medicare plans and will give me honest answers and not just someone pushing their plan?

    by Brenda — March 21, 2017

  48. You can find assistance through your state’s SHIP office. Find your office here: http://www.seniorsresourceguide.com/directories/National/SHIP/

    by LS — March 21, 2017

  49. Brenda – Most insurance agents who sell Medicare policies have knowledge and access to all plans in a county. They are paid the same for each policy signed up, so they have no incentive to sell you a policy with a particular company. They should be looking out for your best interests and specific needs. Call whoever you have car, homeowners or renters insurance with and ask if they sell Medicare policies. If they don’t, ask them to refer a good Medicare agent. And don’t forget to ask about Medicare Advantage plans. They may work well for you and are very competitively priced.

    by Clyde — March 21, 2017

  50. Just read an article on Medicare Part A. There is a deductible of $1,316 but you can be charged that amount up to 6 times per year. Once you’ve been out of the hospital for 60 days, you start a new benefit period if you need to be admitted again, even if it’s for the same illness or injury that took you there before. And with each new period, you get the same benefits and pay the same set of charges, according to how long you need hospital care. This includes paying the Part A deductible again, unless you have a medigap policy that covers it. In the worst case scenario, you may be required to pay the deductible up to 6 times per year, for a total out-of-pocket cost of $7,896. My husband has Plan F that covers the deductible. Not sure what other plans cover the deductible but some of you might want to check into it. I thought the $1,316 was a once per YEAR deductible but the benefit period is every 60 days. Probably not too many people will be hospitalized 6 times in one year but who knows! Oh, and Plan F is being phased out to new buyers in the year 2020 so if you buy in before that then you will be grandfathered and can keep it. Who knows what the prices will be though. In CT Plan F thru United Health Care is $241.50 per month. Not cheap and I checked some other states and it is much lower than CT.

    by louise — August 17, 2017

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