There is an old saying that goes like this: “Be Careful What You Ask For”.
Currently, we see a multitude of people talking about Medicare for All, which sounds great until you review what that entails. So, we must be careful what we ask for.
Currently, if you work for 10 years (40 quarters) legally in the United States, you receive Medicare Part A at zero cost, and you are entitled to get Part B, which you buy from the government for $135/mo. As an agent, I often hear people say that in general Medicare covers about 80% of your medical care and a supplement will be needed to cover the rest. Listed here is how that 80% works for Medicare, in general:
Part A = Hospital Services in General
Part B = Typically everything outside of the hospital, such as doctor visits, outpatient services, labs, X-Rays, MRIs.
Part D = Prescription Drug Insurance. This is offered by private insurance companies, not the government. You can get this by contacting me (click here).
Part A has a $1,365 deductible for a hospital stay per period (60 days). Then there is a co-insurance and some copays. There is more to it, but to keep it simple in this article – this is a good general description of the Part A Deductible.
Part B has a $185 calendar year deductible, then typically there would be a co-insurance amount.
Part D: We help people enroll in Part D plans (click here) and these can range in premium from around $15 to over $100. A plan is selected depending on the type of prescriptions that have been prescribed by a doctor.
A good supplemental plan for someone turning 65 would cost around $130 / mo. We help people enroll in these plans (click here).
Part C = Medicare Advantage Prescription Drug plans take over for Medicare. These plans are offered by private insurance companies. Here at Oak Crest Insurance, we help people enroll in these plans as well (click here). Part C plans (the private insurance companies) do all the administrative work; therefore, Medicare does not have to. These plans range in premium from Zero dollars to overs $200. Part C plans have a different set of deductibles and co-pays when compared to someone that is on straight Medicare Parts A & B.
If Medicare was offered to all people, I believe that we would experience some changes to the structure which would have major changes compared to how Medicare works today. Keep in mind that for the 12,000 people that are turning 65 every day here in the United States, they have been paying into the Medicare system for over 30 years without receiving any benefits. This is how Medicare is funded currently.
If Medicare were offered to everyone, I believe we would see these kinds of changes.
· Part A deductible would go up. This is determined by Congress.
· Part A co-insurance would go up. This is determined by Congress.
· Part B deductible would go up significantly. This is determined by Congress.
· Part B co-insurance would go up. This is determined by Congress.
· Part B premium of $135 would go up significantly. This is determined by Congress.
Additionally, since Medicare deductibles would go up, the MediGAP plans offered by individual insurance companies would experience higher premiums; however, since these plans are offered by private insurance companies, there would be some stability in the premiums. Those that could afford them will purchase them. If you are interested in a MediGap plan, click here to inquire.
Advantage plans offered by private insurance companies (which receive anywhere from $900 / mo to $2,000 / mo from Medicare to administer these plans) will undergo benefit changes and a change in premiums. It would be difficult to see how the premiums would change since these plans do receive funds from Medicare as I mentioned. With private insurance companies competing for the business, premiums would have some stability.
The big question is: where will the money come from to pay for the $900/mo to $2,000/mo that Medicare pays private insurance companies for those beneficiaries that choose to enroll in Part C Advantage plans? Current topics among politicians agree that the Health Care Reform Act is experiencing some funding problems. It is reasonable to see that a “Medicare for all” solution would experience the same problem.
Most doctors accept Medicare Assignment, but not all doctors accept the Part C Advantage plans (PPOs & HMOs) that are offered by private insurance companies.
For some people on Medicare Disability (under age 65), they do have an opportunity to purchase a MediGAP plan; however, the premiums for age 64 and younger differ from someone turning 65. Here’s an example:
· MediGAP Plan C under 65 $333 / mo (female). $356/mo (males).
· MediGAP Plan C age 65 $149 / mo (female). $160/mo (males).
So even when you have Medicare for all, you still have supplemental plans that would be purchased by the individual. Those that can afford pricier supplement plans would have more choices; whereas, those on limited budgets, would not have as many choices, limiting medicals services at their disposal – which is what we have right now without Medicare for all.
Therefore, it is this writer’s opinion that a “Medicare Solution for All” would have the same funding problems that we are currently experiencing with the Health Care Reform Act that was passed in March, 2010.
At our agency, Oak Crest Insurance Solutions, we strive to provide people with a benefit package that fits their needs with a low premium. To contact an agent for an insurance review, contact David Banet
Because we represent many private insurance carriers, we can create an insurance solution that meets benefit needs and budgetary concerns.
About the Author: David Banet is a Licensed Insurance Counselor (Health & Life) and licensed in life, property and casualty insurance that helps people and small businesses with their health, life, business and retirement needs with insurance products. He has written over 100 articles on insurance. David is a family man residing in southeast Michigan, and is licensed in Michigan, Ohio, Florida, Illinois, Indiana, Pennsylvania and Tennessee.
He is an independent broker which means that he represents many insurance carriers. There is no charge to enroll in a health insurance plan for his services.
David has given several educational seminars on Medicare Basics in the neighboring community.
