Basically, you have three choices: Original Medicare (just Part A and Part B ), Original Medicare with a Medigap plan (Medicare Supplement) or a Medicare Advantage plan. Original Medicare consists of Medicare Part A coverage (hospitalization, skilled nursing facilities, home health care, and hospice) and Part B (doctors, outpatient care, home health care, and some preventative care). You could also get a standardized medicare supplement, Medigap, plan to help cover those expenses (deductibles and coinsurance) not paid by Medicare. Medicare supplement plans do not cover prescription drugs. So if you want prescription drug coverage you will have to join a Medicare prescription drug plan or Advantage plan. I think the biggest advantages of having original Medicare with a Medigap plan are that you can go to any doctor, hospital, or medical provider that accepts Medicare. Medicare Part C, also know as Medicare Advantage Plans are plans offered by private companies that are approved and under contract with Medicare. Medicare Advantage HMO and PPO plans include Medicare Parts A and B, sometimes D.
Medicare Advantage plans use networks like PPO’s and HMO’s to control costs. It depends on your plan but going to an out of network medical provider will cost probably cost. You may or may not have out of network coverage and could end up with a hefty medical bill. Most Medicare Advantage plans include coverage for your prescription medications but you out of pocket costs, like copayments and deductibles, will vary. Medicare Advantage plans also include extras like meal programs, gym memberships, vision and dental coverage.
Medicare advantage plans do not all work the same way and they will differe not only from company to company but also from state to state. For example Florida Medicare Advantage plans are not the same as Medicare advantage plans in other states. Not only do they have different service areas but also different networks and benefits. Make sure you understand the rules, costs, and why a particular plan fits you best. The only way to insure this is to ask questions. There will be variations in the services covered as well as the costs for those services. Advantage plans have a lot of rules (i.e. referrals and certifications). Since Part C coverage is from private insurers you will also need to be sure your doctors accept the proposed plans. You will also be restricted to enrolling and disenrolling at certain times. You do not need to get a supplement plan if you get a medicare advantage plan. AARP United Healthcare Advantage and Supplement Plans are some of the most popular.
Many people forget to consider travel when choosing a supplement or advantage plan. Since Medicare Supplements don’t use networks you can go to any medical provider that accepts Medicare insurance. Part C Medicare Advantage plans use networks and those networks may have regional restrictions. If you plan on doing a lot of traveling you may want to look into a Medicare Supplement Plan.
Medicare Supplement plans are health insurance plans sold by private health insurance companies to help pay for the gaps in Original Medicare coverage, deductibles, and copays. In other words your share of the costs not covered by Original Medicare. Medigap plans have been designed as a supplement to Original Medicare. When you receive Medicare approved services Medicare will pay its share. Your medigap isurance policy will the help you with your share of the Medicare approved health care costs. Medigap plans do not cover prescriptions drugs.
Find your Congressman click here.
Find your Senators click here.
Of course if your opinion is different and you want a system like the one described below then you should also voice your opinion. After all it is a free country.
Dear Senator or Congressman (Congresswoman),
I have major concerns with the healthcare bill before Congress. I actually have read the bill and am shocked by the brazenness of the government’s proposed involvement in the patient physician relationship. The very idea that the government will dictate and ration patient care is dangerous and certainly not helpful in designing a healthcare system that works for all. Every person I speak with agrees that we need to fix our healthcare system, but the proposed bills currently making their way through congress will be a disaster if passed.
I ask you respectfully and as a patriotic American to look at the following troubling lines that I have read in the bill. You cannot possibly believe that these proposals are in the best interests of the country and our fellow citizens.
Page 22 of the HC Bill: Mandates that the Govt will audit books of all employers that self insure!!
Page 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get.
Page 29 lines 4-16 in the HC bill: YOUR HEALTH CARE IS RATIONED!!!
Page 42 of HC Bill:The Health Choices Commissioner will choose your HC Benefits for you. You have no choice!
Page 50 Section 152 in HC bill: HC will be provided to ALL non US citizens, illegal or otherwise
Page 58 HC Bill: Govt will have real-time access to individuals finances & a National ID Healthcard will be issued!
Page 59 HC Bill lines 21-24: Govt will have direct access to you ur banks accounts for elective funds transfer.
Page 65 Sec 164: is a payoff subsidized plan for retirees and their families in Unions & community organizations: (ACORN).
Page 84 Sec 203 HC bill: Govt mandates ALL benefit packages for private HC plans in the Exchange.
Page 85 Line 7 HC Bill: Specifications for of Benefit Levels for Plans = The Govt will ration your Healthcare!
Page 91 Lines 4-7 HC Bill: Govt mandates linguistic appropriate services. Example - Translation: illegal aliens.
Page 95 HC Bill Lines 8-18: The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan.
Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans. AARP members - your Health care WILL be rationed.
Page 102 Lines 12-18 HC Bill: Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.
Page 124 lines 24-25 HC: No company can sue GOVT on price fixing. No “judicial review” against Govt Monopoly.
Page 127 Lines 1-16 HC Bill: Doctors/ American Medical Association - The Govt will tell YOU what you can make! (salary)
Page 145 Line 15-17: An Employer MUST auto enroll employees into public option plan. NO CHOICE!
Page 126 Lines 22-25: Employers MUST pay for HC for part time employees AND their families.
Page 149 Lines 16-24: ANY Employer with payroll 401k & above who does not provide public option pays 8% tax on all payroll.
Page 150 Lines 9-13: Business’s with payroll btw 251k & 401k who doesn’t provide public option pays 2-6% tax on all payroll.
Page 167 Lines 18-23: ANY individual who doesn’t have acceptable HC according to Govt will be taxed 2.5% of income.
Page 170 Lines 1-3 HC Bill: Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)
Page 195 HC Bill: Officers & employees of HC Admin (GOVT) will have access to ALL Americans finances /personal records.
Page 203 Line 14-15 HC: “The tax imposed under this section shall not be treated as tax” Yes, it says that!
Page 239 Line 14-24 HC Bill: Govt will reduce physician services for Medicaid Seniors, low income and poor are affected.
Page 241 Line 6-8 HC Bill: Doctors, doesn’t matter what specialty you have, you’ll all be paid the same!
Page 253 Line 10-18: Govt sets value of Doctor’s time, proffession, judgment etc. Literally value of humans.
Page 265 Sec 1131: Govt mandates & controls productivity for private HC industries.
Page 268 Sec 1141: Federal Govt regulates rental & purchase of power driven wheelchairs.
Page 272 SEC. 1145: TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
Page 280 Sec 1151: The Govt will penalize hospitals for whatever Govt deems preventable re-admissions.
Page 298 Lines 9-11: Doctors, treat a patient during initial admission that results in a re-admission -Govt will penalize you.
Page 317 L 13-20: PROHIBITION on ownership/investment. Govt tells Doctors what/how much they can own!
Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion- Govt is mandating hospitals cannot expand.
Page 321 2-13: Hospitals have opportunity to apply for exception BUT community input is required. Can u say ACORN?!!
Page 335 L 16-25 Pg 336-339: Govt mandates establishment of outcome based measures. HC the way they want. Rationing.
Page 341 Lines 3-9: Govt has authority to disqualify Medicare Advance Plans, HMOs, etc. Forcing people into Govt plan.
Page 354 Sec 1177: Govt will RESTRICT enrollment of Special needs people! Unbelievable!
Page 379 Sec 1191: Govt creates more bureaucracy - Tele-health Advisory Comittee. Can you say HC by phone?
Page 425 Lines 4-12: Govt mandates Advance Care Planning Consult. Think Senior Citizens end of life patients.
Page 425 Lines 17-19: Govt will instruct & consult regarding living wills, durable powers of attorney. Mandatory!
Page 425 Lines 22-25, 426 Lines 1-3: Govt provides approved list of end of life resources, guiding you in death. (assisted suicide)
Page 427 Lines 15-24: Govt mandates program for orders for end of life. The Govt has a say in how your life ends.
Page 429 Lines 1-9: An “advanced care planning consultant” will be used frequently as patients health deteriorates.
Page 429 Lines 10-12: “advanced care consultation” may include an ORDER for end of life plans. AN ORDER from GOVT!
Page 429 Lines 13-25: The govt will specify which Doctors can write an end of life order.
Page 430 Lines 11-15: The Govt will decide what level of treatment you will have at end of life!
Page 469: Community Based Home Medical Services = Non profit organizations. Hello, ACORN Medical Services here!!?
Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORIGINATION. 1 monthly payment 2 a community-based organization. Like ACORN?
Page 489 Sec 1308: The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage.
Page 494-498: Govt will cover Mental Health Services including defining, creating, rationing those services.
I guarantee that I personally will do everything possible to inform patients and my fellow physicians about the dangers of the proposed bills you and your colleagues are debating.
Furthermore, If you vote for a bill that enforces socialized medicine on the country and destroys the doctor/patient relationship, I will do everything in my power to make sure you lose your job in the next election.
Respectfully,
The following is from one of the newsletters I received from Humana One this month
July 8, 2009
No time to waste
It’s back to work for Congress. Senators and Representatives have returned to Washington after the week-long Fourth of July recess, and health reform tops the agenda. But with just five weeks until Congress breaks again for most of August, many wonder whether lawmakers can meet their initial timetable.
That aggressive original schedule calls for the House and Senate to pass reform legislation before August 8, combine their measures in September, and deliver a health reform bill for the president’s signature by October 1. After that, many believe it will get increasingly difficult to pass health reform, as members of Congress start setting their sights on the 2010 mid-term elections.
All of which means the month of July will be critical. Three committees in the House and two in the Senate are working to advance reform as quickly as possible. Here’s what those committees have planned in the next two weeks:
Three House committees with jurisdiction over health reform – Education and Labor, Energy and Commerce, and Ways and Means – are working together on a single bill. The so-called Tri Committee plans to debate and amend its legislation during markup hearings scheduled for the week of July 13.
The Senate Finance Committee hopes to release its bill sometime in the next week or two. Finance is taking longer than the other Senate committee as Democrats and Republicans continue negotiations aimed at reaching a bipartisan compromise.
The Senate Health, Education, Labor and Pensions Committee (HELP) last week revised its Affordable Health Choices Act – see below – and hopes to complete markup by the end of this week.
The HELP and Finance Committees will combine their bills before bringing them to the floor of the Senate.
Senate HELP revises reform bill
Last week, the Senate HELP Committee unveiled a revised health reform bill that committee Democrats say will cost less and cover more people. But others say those cost estimates don’t tell the whole story.
The Congressional Budget Office (CBO) estimates the revised bill will cost roughly $611 billion over 10 years – far less than the $1 trillion pricetag CBO put on the original bill several weeks ago. CBO also says the bill would cover 21 million of the nation’s 46 million uninsured, but the bill’s sponsors say it would eventually cover 97 percent of all Americans. Download the CBO score.
The difference in cost between the original and revised bills is largely due to so-called “pay or play” penalties that employers would face for not offering health insurance to their workers. The initial payment would be $750 per year for each employee left uncovered. Employers with 25 or fewer employees would be exempt.
But, the CBO’s estimate did not include the cost of administering a government health plan to compete with private insurers, or the cost of expanding Medicaid and increasing physician reimbursements under Medicare – all of which could increase costs considerably.
Wal-Mart backs employer mandate
Meantime, Wal-Mart – the corporation that employs more workers than any other private enterprise – says the government should require employers to provide health insurance.
The retail giant announced its support for a so-called employer mandate in a letter to President Obama. It was signed jointly by the heads of Wal-Mart, the Service Employees International Union (SEIU) and the Center for American Progress.
“Not every business can make the same contribution, but everyone must make some contribution,” the letter reads. “We look forward to working with the Administration and Congress to develop a requirement that is both sensible and equitable.”
Wal-Mart has drawn fire in recent years for restricting the coverage it provides to employees – for example, imposing waiting periods of up to two years, according to the Associated Press. Much of that criticism has come from SEIU.
The move may be an attempt by Wal-Mart to polish its image and head-off more restrictive legislation. Other business groups, including the U.S. Chamber of Commerce, have adamantly opposed an employer mandate, arguing it would make it harder for American companies to compete globally.
Get involved!!!!! https://www.myhealthreform.org/