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lib2DaBone Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 05:51 PM
Original message
I'm Still confused about Medicare and HCR ?
I'm reading all the sumnmaries on line.. but all they say is that Medicare is going to be reduced by 21% starting right away.... and in 2011 Medicare Advantage payments will be frozen. This means Seniors will have a hard time finding a doctor to treat them.

Tonight, NBC Nightly News says that in 2014.. medicare taxes will be increased by 30%?

So what is the bottom line.. are they trying to say that Seniors should switch over to the private insurance pool? Or will seniors remain on Medicare as they are today? I'm not sure what they are saying..

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Motown_Johnny Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 05:59 PM
Response to Original message
1. Medicare advantage is being phased out, not Medicare itself. Other cuts are
focused on endind some of the fraud, waste and other abuses in the system. Nobody's Medicare is being cut or frozen.
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RKP5637 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:02 PM
Response to Original message
2. Here is a summary from another post, maybe this helps some. It mentions Medicare some.
FACTBOX: US healthcare bill will provide immediate benefits

WITHIN THE FIRST YEAR OF ENACTMENT

*Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.

*Insurers will be barred from excluding children for coverage because of pre-existing conditions.

*Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

*A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

*Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

*A tax credit becomes available for some small businesses to help provide coverage for workers.

*A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

WHAT HAPPENS IN 2011

*Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.

*Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

*A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.

*Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.

*Employers are required to disclose the value of health benefits on employees' W-2 tax forms.

*An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.

WHAT HAPPENS IN 2012

*Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.

*An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.

*The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.

WHAT HAPPENS IN 2013

*A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.

*The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.

*The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.

*A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

WHAT HAPPENS IN 2014

*State health insurance exchanges for small businesses and individuals open.

*Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.

*Health plans no longer can exclude people from coverage due to pre-existing conditions.

*Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.

*Health insurance companies begin paying a fee based on their market share.

WHAT HAPPENS IN 2015

*Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.

WHAT HAPPENS IN 2018

*An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions.
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lib2DaBone Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:17 PM
Response to Reply #2
6. Thanx.. that is helpful.. I hadnt seen that post....
I had read that employers were going to form a pool for early reitrees 55-64.. but that won't help people who are laid off or unemployed.

It also sounds encouraging about what Bernie Sanders described as Regional Health Care clinics for people that fall through the cracks and don't fit into other categories.

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RKP5637 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:20 PM
Response to Reply #6
7. I like Bernie Sanders, I trust him. I think he's one of the good guys in the world. n/t
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DURHAM D Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:03 PM
Response to Original message
3. Seniors have to go on Medicare at 65.
And because it is only 80% coverage with a 20% co-pay and has deductibles to be met most seniors buy a private insurer's medicare supplemental. Medicare "advantage" is a type of coverage for the 20% and it looks like that is being phased out and the seniors that have medicare "advantage" will need to switch to a medicare "supplemental".

I don't know what the 21% medicare thingie starting immediately is.
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quiller4 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 07:00 PM
Response to Reply #3
15. No Medicare Advantage is NOT a Medicare supplement. It replaces
regular Medicare. I don't know many seniors who bother with a supplement. The deductible is small and unless you have unusually high medical expenses, the cost of a supplement exceeds paying the deductible and co-pay out of pocket.

My spouse is 64 and we've been looking at supplements and comparing that to out of pocket expenses. We figure we are almost $3,000 better off foregoing any suppplement.
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DURHAM D Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 11:17 PM
Response to Reply #15
20. I don't know anyone over 65 who does not have a supplemental.
Maybe its just the people I know but the 20% cost of one hospital stay for a major procedure would far exceed the cost of a supplemental.
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Statistical Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 08:15 AM
Response to Reply #20
24. Well if that were true insurance companies would go broke.
:)

Generally speaking insurance companies collect more in premiums than they pay out on the supplement.
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Fire1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 07:13 PM
Response to Reply #3
16. Seniors are NOT REQUIRED to buy into Medicare. n/t
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DURHAM D Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 11:22 PM
Response to Reply #16
21. If they want coverage after 65 they can not stay with
their regular private insurer except under very unusual circumstances.
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Fire1 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 08:24 AM
Response to Reply #21
25. Not true.I have a couple of elderly relatives well beyond 65
who have NEVER had medicare. We all have Blue Cross Blue Shield and I don't plan on paying for medicare, either.
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laughingliberal Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:05 PM
Response to Original message
4. Medicare will go on as before
The only thing changing is the MA programs will no longer get subsidies from the government. They are cutting out the 1.33 billion MA companies have been getting from the government. The companies make profits far and above what they get from the government and should have no problem surviving without the subsidies.

The Medicare tax is only being increased on those who make over $250,000 per year.

In addition to the cutting of the MA subsidies, there is about 330 billion being cut from Medicare which the government believes they can save by routing out waste, fraud, and abuse and by instituting best practices. I'm skeptical about that but I don't think most will notice a change in their Medicare benefits any time soon.
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lib2DaBone Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:21 PM
Response to Reply #4
8. Thanks.. that makes it a lttle clearer. It doesnt sound too bad....
There is so much dis-information out there.. and of course the news networks have been zero help in finding information.
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laughingliberal Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:33 PM
Response to Reply #8
11. You're welcome. I expect to see some attempts to privatize Medicare
in the recommendations which come out of the deficit commission but nothing in the current bill should affect current recipients and I don't expect the deficit commission to recommend anything that will affect the current recipients, either.
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patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 11:01 PM
Response to Reply #11
18. I think those are going to be elective partnerships between private and public money
at minimum in Elder Care.
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RKP5637 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:16 PM
Response to Original message
5. Just FYI. I use a Medicare supplemental plan, it works exceptionally well. I never
used Medicare Advantage because when I researched all of this many told me Medicare Advantage was not as good as a Medicare supplemental plan. The Medicare supplemental plan I have pays all of the remaining balance due after Medicare pays. The whole thing works extremely well.
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lib2DaBone Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:23 PM
Response to Reply #5
9. Wow.. that is great. I guess that would be the same supplemental as thru AARP..
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RKP5637 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:33 PM
Response to Reply #9
10. Yes, basically the same. I don't know if AARP is the best, you need to
check what is available in your area. Here BCBS is excellent, but then I hear in other parts of the country that is not so. But yes, AARP supplemental would be the same. Watch out though because the plans vary a lot, don't take them at face value, check them out.
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buttercupmammie Donating Member (1 posts) Send PM | Profile | Ignore Mon Mar-22-10 06:47 PM
Response to Reply #10
12. medicare/medicaid
I had medicare and medicaid since 2001 due to a disability. I am widowed and survive on ss-benefits and a$250.00 per month pension. In 2009 they took my medicaid away because i was $11.00 over the qualifying amount. Now i have medical bills piling up...my children have to help me with my everyday bills (and they are borderline poverty level). I have never understood anything about insurance. I didn't realize how much help medicaid was till i became responsible for the 20 percent that medicare doesn't cover. I am one of those older people who has more money going out to medical bills than money coming in. I don't understand what advantage programs are. Can anyone explain how this is going to help me or not help me, this new insurance change.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:56 PM
Response to Reply #12
13. Do you have an Area Agency for the Aging in your area?
If so, you can ask them these questions (look in the blue pages in your phone book). Also, consider contacting AARP. I'm sure they can help direct you, if not answer your questions. Or go on their website, since you are already on the Internet, obviously.

Good luck. I hope this helps...
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RKP5637 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 06:59 PM
Response to Reply #12
14. I notice you posted this within this posting. Just as an idea you might get
a lot more information if you posted your question as a new Post under General Discussion because your Post would get more visibility. I don't know enough myself about medicaid to be of much help, but I bet there are others in DU that can help.
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cynatnite Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 11:08 PM
Response to Reply #5
19. Most of the retired in my family have supplemental insurance...they love it. n/t
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patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-22-10 08:31 PM
Response to Original message
17. Before he decided to support the bill, Senator Bernie Sanders said that he & some others would not
allow that to happen. You can trust him.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 02:47 AM
Response to Reply #17
22. Why? He and the other progressives in congress rolled over and played dead
No public option
No overturning the anti-trust exemption
No ERISA waiver
Tax on benefits
No regulatory body as proposed by Feinstein
Sellout of reproductive rights and care for LGBT people
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patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 08:08 AM
Response to Reply #22
23. And I should trust the motives & agenda of some anonymous person, make that digits, on the internet
more than I trust a guy who has an ACTUAL history on the issues and whom I have been listening to almost every Friday for about 5 years?

:rofl:

Simplistic false dichotomies are obsolete and promoting division is questionable to say the least. Now, just go ahead and prove this last statement true.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 04:29 PM
Response to Reply #23
27. You might try shitcanning the very notion of "trust" entirely
--and just evaluate the arguments as they are presented. Or you can continue to be a sheep bleating "But Famous Name says it, so it MUST be true."
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leeroysphitz Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-23-10 08:29 AM
Response to Original message
26. All I know is that my 5 yr old son, who was born with disabilities, will now cost 2-4 times what
a non-disabled child for premiums, co-pay and deductible even for care that has nothing to do with his disability.

Also, since the craniofacial surgeon we fought so hard to get access to may have to stop seeing him if she can't get paid we may have no choice but stop seeing one of the best craniofacial repair surgeons in the country and take him down to the local money grubbing, for profit, bottom line driven corporate approved plastic surgeon at the boob-job clinic.

So, in other words, the years of surgeries scheduled to reconstruct my sons face will, if we can afford it at all, most likely be done by some hack plastic surgeon who specializes in boob-jobs and sucking the fat out of rich womens asses instead of the world class team of specialists and facial reconstruction surgeons that have been with him planning his recovery for five years.

I'm glad you rah rah rah fuckers got your big fucking win and I hope you fucking CHOKE on it.
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