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Questions about Obama-Care

Discussion in 'Political Discussion' started by cupofjoe1962, Oct 26, 2009.

  1. cupofjoe1962

    cupofjoe1962 Rookie

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    I have not seen any specifics on the Obama public option.

    If anyone knows where I could find the best information available , please post it.

    I am wondering what they would charge for the program.
    I am also wondering if you will need to buy a second medical coverage if
    you go with the Obama public option (If it passes).

    Example... Most seniors need to buy a second medical coverage to go with
    Medicare. I know my parents were paying for additional coverage from
    Blue Cross & Blue Shield.

    Will Obama's program be a one program answer, or will you need additional
    coverage.

    Any updated information would be appreciated.
  2. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

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    #24 Jersey

    It sounds like you're talking about Medicare Advantage which fills in the gaps, that is the big item on the chopping block in the medicare cuts. They'll be paying more.
  3. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #11 Jersey

    No, he's not. Medicare Advantage policies are Medicare plans which are managed by private insurance companies - and they're part of the reason for the rising cost of health care. Many of them are now currently under investigation and many of them have been fined and have been shut down.

    What he's "talking about" is exactly what he said - things like BC/BS secondary health insurance policies which most seniors have - many of them simply continued their coverage thru their work places when they retired. All the big insurers offer them - BC/BS, United, Aetna, GEHA, Carefirst, Anthem.

    What they do is fill in the gap and pay the copays and deductibles for the patient. They don't pay for anything Medicare doesn't already cover, however - if Medicare denies payment the supplemental insurance will deny it as well. (They don't often volunteer that information, either.) It's considered a "supplement" and as such it does exactly what is says, it supplements but it doesn't actually cover.

    Medicare Part B (anything not connected with a hospital) has a $135.00 a year deductible and the patient is responsible for 20% of Medicare-approved amount for services after the patient's met the $135.00 deductible. A supplemental policy will pick up that deductible and the 20% copay.

    For in-hospital related care Medicare Part A pays as follows:

    For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2009 = $1,068) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

    For each benefit period you pay:

    A total of $1,068 for a hospital stay of 1-60 days.
    $267 per day for days 61-90 of a hospital stay.
    $534 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
    All costs for each day beyond 150 days


    Again, a supplemental policy will pick up that payment due from the patient - which, as you can see, is no small amount.

    Medicare premiums and coinsurance rates for 2009

    Here's the tricky part for those people who are disabled and on Medicare - they can't GET supplemental insurance most of the time. They've got a pre-existing condition. (And it's most likely not, as someone in another post said, "drinking beer" for a living.) They're also not working most likely because if they're disabled enough to be eligble for Medicare they're too disabled to work....so what happens to them if they're in the hospital for more than 2 months? Where do they come up with $267.00 a day or $534.00 a day?

    But hey, who cares, right? We got ours.
  4. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

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    #24 Jersey

    It's part of the attempted payoff to insurers, cut or gut Medicare Advantage then people will be forced to buy their "gap insurance".
  5. alvinnf

    alvinnf Rookie

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    Lot's of info and typing and I am sure research. You failed to talk about how Obamacare is gonna help Joe's, Ma and Pa!
  6. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #11 Jersey

    Here's your Medicare Advantage, BelichickFan - people still need "gap insurance" and the only thing it's done is cost Medicare more.

    Under Medicare Advantage, the government contracts with private insurers, which offer policies that cover doctor visits, hospitalization and sometimes prescription medications. Medicare Advantage plans must offer at least the same benefits as traditional Medicare, but many providers include more in a bid to attract customers.

    Such plans were introduced in the 1970s in an effort to cut Medicare costs. However, as the government sought to add coverage in underserved -- often rural -- areas, costs soared. According to the independent Medicare Payment Advisory Commission, Medicare Advantage now costs the government 14 percent more per beneficiary than traditional Medicare.


    As it says, "they add a bit more." What they don't say is "It costs a lot more."

    MEDICARE vs. MEDICARE ADVANTAGE - washingtonpost.com

    And more:

    A week or so ago, the Centers for Medicare and Medicaid Services (CMS) ordered WellCare, the super-aggressive seller of Medicare Advantage plans, to stop selling policies to seniors beginning March 7 until they cleaned up their act and improved their business practices. That hurts the company right now, since seniors have until the end of the month to switch to a different Advantage plan, and the marketing from the competition has been hot and heavy. About one in three seniors who enroll in Medicare’s drug benefit now choose these plans over traditional Medicare because of their low premiums and extra benefits.

    CMS said that WellCare had “demonstrated numerous deficiencies in serving its enrollees.” There were problems with enrollment and disenrollment procedures, appeals and grievances, oversight of its marketing agents and brokers, and responding to consumer requests for help and complaint resolution. From the beginning of January to the beginning of February this year, CMS said the agency received more than 2,500 complaints from seniors with WellCare policies. Almost 800 of those were considered “immediate need” complaints, which means they were supposed to be resolved within two calendar days. CMS said that the carrier had failed to resolve about 300 of these complaints within the required time frame.


    Adieu, Medicare Advantage? : CJR
  7. IcyPatriot

    IcyPatriot ------------- PatsFans.com Supporter

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    #87 Jersey

    Obama was in Boston for a fundraiser for Deval ... the topic of Massachusetts healthcare was avoided like the plague. Things that make you go hmmm.
  8. sdaniels7114

    sdaniels7114 Rookie

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    As I understand it as of now the bill most likely to emerge from the Senate will have a public option. The one that left the finance committee didn't and what's going on in the House is even more complex; but Pelosi says that bill won't have the PO at least as of now. There's no way to know who's going to be affected and how because the law that Obama will eventually sign hasn't been written yet.

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