Talk me down: Many Medicare recipients WILL be hurt by HCR

[Cetacea]

Specifically, low income disabled and senior citizens. As Medicare Advantage Plans, with their expanded coverage fall by the wayside, low income people will have to pay higher deductibles, more out of pocket drug charges, and lose services not covered by Medicare such as dental work.

All of this in exchange for some free preventive programs, which when you think about it, are kind of redundant to people who are either old and/or already disabled...

Talk me down. This looks bad.

[Hawkeye-X]

1. Medicare Advantage is private, not Medicare itself.

It's private insurance.

I'm on Medicare and I refuse Advantage - I don't need their useless crap.

Hawkeye-X

[Cetacea]

2. Yes, but it can be used in place of Medicaire

And many low income people do prefer it.

[merh]

3. and how does the new bill interfere with it?

I don't understand.

[Cetacea]

6. From what I understand, it is being eliminated.

[madokie]

24. Where are you getting your info is what I would like to know

sounds like more of the scare 'm to death bullshit to me.

[karynnj]

25. I don't think it is being eliminated - they are just going to get the same

amount as Medicare, rather than about 14% more. http://www.healthreform.gov/reports/medicare/medicare.pdf

From that link:

The government is overpaying private insurance companies. Part of the recent rise in Medicare
costs – and in premiums for seniors – stems from extra subsidies to private insurance companies.
Medicare Advantage is part of the Medicare program that allows beneficiaries to receive services via
private plans. Policy changes, particularly in 2003, ratcheted up payment levels to private plans. The
federal government pays private insurance companies on average 14 percent more for providing coverage
to Medicare Advantage beneficiaries than it would pay for the same beneficiary in the traditional
Medicare program. This overpayment is as high as 20 percent in certain parts of the country.1

The overpayments do not improve quality. There is no evidence that this extra
payment leads to better quality for Medicare beneficiaries.2 Insurers, not seniors or the Medicare
program, determine how these overpayments are used – and this includes marketing, profits, and
other administraive costs.3 This means that seniors do not always get the full overpayments back in the
form of extra benefits or improved quality care. In fact, because Medicare Advantage plans have
flexibility to determine their own cost-sharing arrangements, seniors can end up spending more
out-of-pocket under a Medicare Advantage plan, not less.4,5

Private plans contend that low-income and minority Medicare beneficiaries disproportionately rely
on Medicare Advantage for benefits and that eliminating the overpayments would hurt them. In
fact, most low-income, minority seniors obtain additional coverage through Medicaid, not Medicare
Advantage. These “dual eligible” beneficiaries receive cost-sharing protection and extra benefits
through the Medicaid program.

All seniors in Medicare subsidize private insurance companies. Overpayments to Medicare
Advantage plans are a burden for all of America’s seniors. All Medicare beneficiaries pay the price
of these excessive overpayments through higher premiums – even the 78 percent of seniors who
are not enrolled in a Medicare Advantage plan.7 In fact, these subsidies will add $3.60 per month
to premiums for all Medicare beneficiaries in 2010.8 This means that a typical couple in traditional
Medicare will pay on average nearly $90 more next year to subsidize private insurance companies
that do not provide their Medicare benefits.

If you look at the reasons, you can see that here, standard medicare is like "single payer", while Medicare Advantage is "for profit insurance".

[elleng]

7. IN PLACE of FREE medicare,

preferred by low income people?

[Cetacea]

9. Medicaire costs $97 per month plus deductables

And no dental coverage.

[elleng]

10. And Advantage?

(learning here; medicare-eligible.)

[Cetacea]

11. It's the same amount, just more benefits.

The argument is that free preventive services will be a good alternative to actual, useful benefits, such as dental coverage.

[Bryn]

15. How about Plan D (Prescription Drug)?

I have Medicare plus Windsor Medicare Extra Advantage that doesn't cost me anything. It includes prescription drug plan, basic vision, basic dental, etc. It has done me good. I suppose that with this new HCR bill, I probably will lose Windsor Medicare Extra then I'd have to pay for Plan D, right?

I already got BlueCare for dental for 26.70 per month. I think it depends on where you live. Arkansas is pretty good even though it's a very red State.

[Cetacea]

18. I don't know. It's possible that you could be elegible for medicaid

under the new thresholds, and medicaid does provide dental and free prescriptions.

[goclark]

4. I have Medicare and Medicare Advantage

Last year Advantage was first and Medicare was Second
now it is reversed.

I;m just so glad that I have Insurance, I'm not complaining about anything.

[elleng]

8. 'First' and 'second' meaning what?

[goclark]

12. It is billed through Advantage but sent to Medicare

for payment.

So far so good.

[Bryn]

17. Same here

So far so good.

[Warren Stupidity]

5. low income disabled and senior citizens generally

cannot afford medicare advantage plans. They will however directly benefit from the elimination of the prescription benefit donut hole.

[Frances]

13. Medicare Advantage was created by Republicans

to allow the insurance companies to reap some of the Medicare money. It was the same with student loans. When I had a loan, it came directly from the government and I had a fixed interest rate of 3%. Then the Republicans decided to let banks take some of the money that could have gone to students. The banks charged money for making the loans, but if a student defaulted, the government paid the loan.

[Cetacea]

14. True, and (ironically enough) wound up helping low income people

[Bryn]

19. In Arkansas Medicare Advantage is paid by the state

at no charge to me. Pretty good plan.

[Cetacea]

16. Perhaps it will be offset with the expanded medicaid program?

The people likely to be most impacted would qualify for medicaid under the expanded medicaid eligibility rules.

[pnwmom]

20. Medicare Advantage is a private program that has turned out not to be as cost effective

as regular Medicaid. So why should we continue to subsidize it?

[Zhade]

21. kick

kick

[Bitwit1234]

22. The bill fixes the drug charges and gives any senior who had

to pay because of the donut hole $250 dollars to start. They are going to allow bargains for cheaper prescriptions. The reason Medicare is falling down is because bush and company tried to privatize it, which the Democrats and some republicans stopped. The Advantage Plans were too expensive for Medicare to pay out, the insurance companies got all the money.

A lot of seniors would have saved money if they had gotten their prescriptions from WalMart for $4 for a generic one. I have prescription insurance and get them for $5 for 45 days, but if it is a generic and WalMart has it on the list the price is dropped to $4. A life saver for a lot of seniors.

[Dappleganger]

35. That's one good thing about Walmart, Target...

and Publix down here: the cheap generic drugs have been a lifesaver for my dh who has diabetes and high blood pressure. That stuff really adds up!

[spinbaby]

23. Medicare Advantage has problems

My mother, who lives in a retirement community, tells me she refuses to sign on for it because too often she's talked to people who have had Medicare Advantage turn down claims. She says Medicare never does that and that people where she lives are all going back to straight Medicare.

[cornermouse]

26. Don't forget the tax credits.

which you can't use to help pay the rent, buy food, or keep the water and electricity on.

It is bad.

[Cetacea]

29. Yes. Tax credits are useless to low incomers

[izzybeans]

27. The bill was the largest expansion of aid for the elderly since Medicare.

google CLASS Act.

It appears the elderly made out better than anyone in this bill.

[Cetacea]

28. CLASS Act is potentially great. When does it go into effect?

http://www.kaiserhealthnews.org/Columns/2009/November/113009Gleckman.aspx

[Dappleganger]

30. Wow, I had no idea that was in there!

Finally, long-term care is being taken seriously!

[Cetacea]

32. I always liked the acronym. It's good that it's received scant attention.

[izzybeans]

36. January according to AAHSA

Can't find the link at the moment.

[Cetacea]

37. That is good news. Thank you for posting it.

[katmondoo]

31. Get out of Medicare Advantage, It is a thieving HMO

Manage your own Medicare.

[Cetacea]

33. Also: I'd imagine expanded medicaid will cover any lost benefits

The way it is set up now, many living at or below the poverty level make too much money to receive full medicaid in certain states. I'd imagine that this will soon be a thing of the past.

[Dappleganger]

34. Let's hope so. nt