As Bernie Threatens, Insurers Respond With More Medicare Benefits

[Uncle Joe]

Undaunted by threats to implement a single payer form of "Medicare for All" that would put them out of business, health insurance companies are taking advantage of new federal rules to add new Medicare benefits.

(snip)

But U.S. Sen. Bernie Sanders and some Democrats running for the presidency in 2020 are advocating a single payer version of Medicare for All that would replace the private healthcare system.

Sanders and others argue the single payer version of Medicare for All would eliminate co-payments, deductibles and allow Americans to pick the doctors they want free of insurance company restrictions and provider network rules. Sanders plan would cover a “robust set of benefits” including long-term care as Vox pointed out earlier this month and there would be a transition period for Americans to move to government-run Medicare as envisioned by the Vermont Senator.

The arguments of Sanders and supporters of single-payer Medicare are up against a tide of seniors picking private plans and new rules from the Trump administration that have gradually changed regulations to allow private insurers to expand Medicare Advantage and offer more benefits.

(snip)


https://www.forbes.com/sites/brucejapsen/2019/04/28/as-bernie-threatens-insurers-respond-with-more-medicare-benefits/#741f02b33598

This is one way you can tell that Trump and the private for profit "health" insurance industry are worried that Medicare for All is a winning issue for the Democratic Party.

[DURHAM D]

1. I am confused.

So it is a good thing that more people are picking private health insurance companies (Medicare Advantage) and fewer are picking the government plan (Medicare)?

Don't the Medicare Advantage pickers cost the government more than the regular Medicare pickers?

[watoos]

6. The poster is confusing Medicare with

Medicare supplemental plans. When you retire you can opt out of Medicare which I do not suggest. Medicare doesn’t cover all of health care costs so most people buy a supplemental plan to cover the difference. I’m pretty sure that’s what the poster is talking about.

[radical noodle]

10. Very few will pick to opt out of Medicare totally

If you need it later, you'll pay dearly for not having taken it at 65.

Many docs (at least around here) won't take Medicare Advantage.

[DURHAM D]

35. I don't think so.

I believe the hype is about Medicare Advantage plans from private insurance companies.

I have come to realize that most of the seniors who buy Medicare Advantage plans have absolutely no idea that they are being covered by a private company.

OTOH - everyone who has regular Medicare and buys a supplement for meds and the 20% Medicare does cover from a private insurance company knows the difference.

[at140]

54. I am on Humana HMO Medicare plan

I do not have to deal with Medicare rules. It is 100% Humana HMO rules. I see a doctor who is in the Humana system, with zero copay to see the doctor. I get all the coverage or more than what Medicare has. Such as PSA test, Flu vaccines, EKG, colonoscopy etc with same or less cost than if I was on straight Medicare.

[abqtommy]

2. My son and I take advantage of a free prescription support plan within Medicare

but most of the other Medicare Advantage plans are very expensive and a lucrative source of income
for insurers. That's why they all oppose the single-payer/Medicare For All system that I support.

[George II]

5. Is Medicare Advantage a supplemental plan? They all have different names, my plan is called....

...Medicare Complete. It's very affordable, has been between $25 and $30 a month for the six years since I went on Medicare.

[watoos]

7. Yes

[George II]

8. That's what I thought. Maybe the supplemental premium is different in different states, but....

...I live in one of the highest cost of living states in the country.

[still_one]

17. Medicare Advantage Plans are bundled plans that include Part A, Part B, and supplemental, along with

prescriptions, and some also offer dental and vision.

Medicare Plan Part A is included what you have paid into through your Medicare taxes, and doesn't cost additional when you qualify for Medicare. Medicare Plan Part B includes doctor visits etc., and you need to pay a premium for that. Medicare Plan Part D is the prescription plan, and you need to pay a premium for that. In addition, Medigap or supplemental plans will cover what isn't govered under Part A or Part B, and a separate premium is paid for that.

Medicare Advantage Plans are usually more cost effective, but except for emergencies, where you can go is usually limited, as oppossed to Medicare Supplemental Plans.

There are pros and cons of each, but people need to study them carefully to understand their needs

It is my understanding in 2020, they are removing Medicare Supplemental Part F from their offerings. Those who are grandfathered in can keep it, but for those just coming into Medicare they will be offered Medicare Supplemental Part G in place of Part F. The difference between the two is there is no out of pocket expense with Part F, while there will be with Part G, but other than that, the coverage is the same, though the premiums for Part F are more than Part G.

Supplemental F and G give you the best coverage. Other supplemental plans cost less, but you also get less coverage

Medicare Advantage Plans bundles everything together, and is most cost effective, but may not serve everyone's needs

[dflprincess]

24. No. Medicare Advantage takes the place of traditional Medicare

If you go with the traditional plan you get Medicare A at no cost; Medicare B for about $134/month. But Medicare A&B do not cover all your costs. You wind up having to find a supplemental plan that will cover what they do not and in some cases, a second plan that covers prescriptions.

Medicare Advantage plans take the place of all that and, in some cases covers more than traditional Medicare. When you add up all you pay out of pocket for regular Medicare, an Advantage plan may be cheaper. Medicare Advantabe is strictly a private insurer plan but they will arrange to have your premiums taken right out of your Social Security check. If you stick with old plan only Medicare B is taken out of your check and you write checks to your other insurers.

My own opinion is that these Advantage plans are just a sneaky way to privitize Medicare and insurers are willing to sell then at a break even or at a loss to get people to sign on. Once they take over I would expect the cost to skyrocket.


I turned 65 last summer and am not all that impressed with what I've learned about Medicare. I'm still working so my employer's plan is still my primary plan and I only have Medicare A. I was planning to work until 70 but now I wonder about going longer just so I can stay on the group plan. I'm in the unusual situation where, even with what I pay out of each check, plus the potential deductible ($250/a year) and max out of pocket of $2500, my employer's plan is apt to cost me less and cover more than Medicare.

[George II]

29. I hope you enrolled in Medicare during the 65 year old window anyway. You can do that....

...and still not participate or pay premiums. If you enroll after that window (I think it's six months before and three months after your birthday) the premium will be higher should you use it. Doesn't hurt to enroll, you pay nothing until you begin using it.

[dflprincess]

32. I only needed to enroll in Medicare A

as long as I have "credible coverage" (which generally means an employer's plan) I will not be penalized for not enrolling in Part B at age 65. I did confirm that with Social Security, both on line and in a phone call.

What a shock it was when that Medicare card came in the mail. It was just yesterday I was riding the bus to & from the University watching the little old ladies climb on waving their Medicare cards at the driver because back then seniors got to ride for free between 9 AM & 3 PM Monday - Friday (and all day on weekends). Hard to believe I've joined that crowd!

[George II]

36. Yes, that's the one, and Part B is what you enroll in (without penalty) whenever you have no....

....other insurance. My wife didn't retire until two years after me, so we didn't need Part B at the time.

For me, it was a shock that I was officially a "senior citizen"!

[still_one]

34. One has to be careful if they don't initially sign up for Part B when they turn 65 if they are

currently covered by an employer plan, that when they do sign up for Part B, they can only do so during the "special enrollment period", which is like open enrollment, and at that time they have 6 months to enroll in a supplemental plan without being penalized for higher premiums, or acceptance. That 6 months window is critical.

Medicare Advantage Plans may be right for some, and are usually more cost effective premium wise, and many times covers dental and eyeglasses, which standard Medicare doesn't, but one can lose flexibility with such plans, so people need to determine what there needs are.

I am not refuting anything you said, just wanting to put emphasis on the fact that once someone does sign-up for Part B, they need to be aware that they have 6 months to choose a supplemental plan, or they can run into an unexpected surprise

[dflprincess]

47. What Social Security told me was

as long as I have been covered by an employer's plan I can sign up for B whenever I decide to retire. The person I spoke to told me that, ideally, you give them 3 months notice of when you'll be switching from the employer plan to Medicare just so the transition goes smoothly. I will also be able to sign up for a supplement at the same time regardless of the time of year. My employer will have to fill out a form verifying that I have been covered but, from what HR tells me, that's something they know all about.

Medicare Advantage does have lower premiums and covers more, but it also tends to have very narrow networks. Again, I think it's a backdoor way to privatize the whole system.

[still_one]

52. That is exactly right, as long as you are covered under an employer or spouse plan. Once you sign

up for part B though, you have 6 months to sign up for a supplemental,

The rules are complicated, but no doubt you know exacatly what’s up

Thanks

[DURHAM D]

38. There are two ways to be covered after 65.

One - regular Medicare (gov) and supplemental plans to cover meds and the 20% of costs not covered by regular Medicare. There are multiple different plans at multiple different cost points. The most popular is Plan F.

Two - Medicare Advantage - there are like a thousand different programs from multiple private insurers.

If you stay on regular Medicare the government subtracts $135.50 from your SS check and shifts it to the Medicare program.

If you enroll in a Medicare Advantage plan the government takes $135.50 from your SS check and immediately gives it to your private carrier like Humana, Blue Cross Blue Shield, State Farm, etc.

[George II]

3. I see no correlation between Sanders' "threats" (which he has no authority to carry out)....

....and insurance companies adding new benefits.

I've been on Medicare with a supplemental plan for six years, and each year benefits have been added, long before any of these "threats". In fact, during two of the six years both my Medicare and supplemental plan premiums were reduced with additional benefits, and since the first year I've been on Medicare my combined premium has changed by less than $10 / month (they're now about $150 / month combined)

Also, some of my copays, especially prescription drugs, have gone DOWN and they now have an offer to eliminate copays for three of the four prescription drugs that we're using.

[watoos]

9. I have been on Medicare for 7 years

And the premiums have never gone down.

[still_one]

20. I suspect it is because you are not under an advantage plan, which bundles things together, and is

more cost effective, though it may limit your choices verses standard Medicare Part A/B plus supplemental

[George II]

26. I don't know which years they were, but there was at least one year that it went down, maybe two....

...but it was only about a dollar or two. In the six years I've been on Medicare it's stayed between $120 and $130 per month. The thing is that it hasn't changed dramatically over the years. Same thing with my supplement, it too has gone up and down, but never below $25 nor above $30.

I hemmed and hawed about retiring because I didn't think I could afford healthcare insurance, I had no idea how affordable Medicare and the supplement would be. At the time I was on my wife's insurance - we were spoiled. She worked for a hospital, insurance for both of us including dental insurance was only $19 per week!

[yaesu]

4. I believe this is how AARP has made a fortune, they pushed for Medicare donut holes & profited

greatly by pushing united healthcare insurance.

[watoos]

11. AARP is a supplemental plan.

[Honeycombe8]

22. AARP is not an insurer. It's the facilitator. Like a broker, I guess?

I asked United Healthcare about that. UNH has a business agreement with AARP. AARP will handle the initial paperwork, send out the ins. cards and such. In return, UNH puts AARP's logo on the paperwork. Something like that.

But AARP can't sell insurance because it's not an insurer, UNH told me.

I bought such a plan. I pay UNH, and my account is on UNH's website.

[still_one]

23. Not quite. They offer supplemental plans through United Healthcare, but you can be a member of AARP

which is a 501C non-profit, and advocate for seniors, and buy your supplemental insurance through blue cross and blue shield elsewhere

[radical noodle]

13. Are you talking about Medicare Part D?

because I don't see any other donut holes.

[George II]

15. AARP is a non-profit organization.

[DURHAM D]

41. Ok, that made me smile

because so is the NRA.

[Honeycombe8]

21. AARP pushed for filling in the donut hole for prescriptions. Part D. nt

[LongtimeAZDem]

12. The weather was beautiful today; I'm so glad Bernie Sanders made that happen

[highplainsdem]

43. I hope he'll make the sun rise tomorrow. Maybe if we all feel the Bern it will happen again.

[highplainsdem]

14. Even that short excerpt refers 3 times to Sanders AND OTHERS -- somehow the others didn't make the

subject line.

Curious, that omission...

[George II]

27. And so it goes.....

[highplainsdem]

33. Yep. Predictably so...

[NurseJackie]

49. OMG! That's funny! 😂🤣😃😄😁

[Hoyt]

16. I think the OP is totally misreading the article. Insurers aren't doing this BECAUSE of Sanders,

they are doing it to compete with each other.

I do think healthcare is a winning issue for Democrats, but not wild assed promises of covering everyone (which should be the goal); removing deductibles and copays; adding dental, hearing and vision coverage; etc., at no additional cost to anyone.

If he can do that, Medicare Advantage would be obsolete. If he can't do that -- quickly -- then he (or his supporters, who got trump elected BTW), then bashing Medicare Advantage is going to tick off the 30% of Medicare Beneficiaries who voluntarily choose Medicare Advantage over paying for a supplemental policy and drug coverage.

[watoos]

18. Ok I read the link

The article is combining Medicare and Medicare advantage plans to muddy the water
Medicare pays about 80% so people buy a 2nd plan to make up the 20%. Medicare for all will not be free and won’t cover everything. Single payer health care is more what Bernie is talking about.
The government administers our health care and everything basically is covered with no need for a second insurance.

[Uncle Joe]

31. Trump changed the regulations in an attempt to tilt the field toward Medicare Advantage

to benefit private health insurers and weaken Medicare.

The arguments of Sanders and supporters of single-payer Medicare are up against a tide of seniors picking private plans and new rules from the Trump administration that have gradually changed regulations to allow private insurers to expand Medicare Advantage and offer more benefits.

Make maximum bucks before the death knell of the for profit "health" insurance industry.

[George II]

39. The so-called "for profit" private health insurance companies will never go away. I wonder....

...if the Senator or his followers understand how Medicare is administered. If they did they would understand why private insurance companies are necessary.

[Uncle Joe]

42. What purpose does the for profit "health" insurance industry

serve toward actual health care?

Can you name any redeeming qualities or virtues of the industry?

[George II]

44. Insurance companies don't provide health care, doctors and hospital do.

[Uncle Joe]

45. What purpose do they serve other than to make money for themselves?

[George II]

46. If they didn't serve any purpose other than making money for themselves, they wouldn't exist.

[Uncle Joe]

48. Then please share it with me/us, other than making money what is it?

[George II]

53. Where would many Americans be if they didn't have coverage by private insurance companies?

Even further, where would seniors covered by Medicare be if it weren't for the private insurance companies?

The fact is, people would be very surprised if they ever looked into the profit margin of healthcare insurance companies.

[Uncle Joe]

55. They would be in Medicare for All with much better coverage than existing Medicare and

lower administration costs to run the system than the for profit "health" insurance industry provides.

[George II]

56. No they wouldn't, Medicare for All doesn't exist....

....And the efficient, cost effective Medicare program is such because it's administered by, you guessed it......the "for profit" private insurance companies.

Now, if only Sanders and his supporters would only research the existing Medicare program.

[Uncle Joe]

57. Medicare for All can be run with the same administrative efficiency as Medicare without

the profit margins of private for profit "health" insurance.

[George II]

58. The "administrative efficiencies" of Medicare is BECAUSE of the for profit insurance companies!

[George II]

59. Bingo! That's exactly my point - a big part of the administration of Medicare today.............

.....is by "private for profit health (no quotes) insurance companies"! I wonder if Sanders and the proponents of "Medicare for All" have dug deeply enough into this to realize that private insurance companies are very much involved in the efficiency of the administration of the existing Medicare program.

By doing away with private insurance companies the current, existing Medicare program would have to be drastically overhauled in order to administer it.

[Uncle Joe]

60. Medicare is administered by the Centers for Medicare and Medicaid Services;

a division of the U.S. Department of Health and Human Services, that's why the cost to administer is less.

That's the general umbrella that Medicare for All would fall under, the government not the for profit private "health" (quotes included) insurance industry which has a higher administrative rate not to mention profits being siphoned away from the people's precious health care dollars.

[BlueFlorida]

19. ...

[Honeycombe8]

25. We can't get Medicare for All passed with a Republican Senate.

Is there any chance of getting the majority in the Senate?

[InAbLuEsTaTe]

28. tRumpy's definitely running scared of Bernie... it's understandable!!

Bernie & Elizabeth 2020!!!
Welcome to the revolution!!!

[George II]

40. No he isn't, he's just ITCHING to run against BS.

[NurseJackie]

51. BS would be an easy takedown for Trump.

So very easy.

[highplainsdem]

50. LOL!!! You really think they're trying to paint all Dems as socialists because they're afraid of

running against a self-described socialist?

Sanders is the opponent they're hoping to run against.

[WeekiWater]

30. So Sanders is increasing the Republicans attempt to help private insurers...

And it’s a win for Medicare for All?

[bahrbearian]

37. " it shall never come to pass"