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Wed Oct 30, 2013, 10:47 PM

does anyone know if seniors are eligible for ACA.

i'm on medicare and so is my friend in ny. some of her docs won't take medicare and she's hearing rumors that more docs are opting out. IMO it should be against the law for a doc to opt out. it's discrimination against seniors.

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Reply does anyone know if seniors are eligible for ACA. (Original post)
DesertFlower Oct 2013 OP
tritsofme Oct 2013 #1
Tx4obama Oct 2013 #7
Chuuku Davis Oct 2013 #2
DesertFlower Oct 2013 #5
elleng Oct 2013 #26
leftynyc Oct 2013 #49
Jeff In Milwaukee Oct 2013 #59
Tx4obama Oct 2013 #3
sabrina 1 Oct 2013 #23
DesertFlower Oct 2013 #25
ChiciB1 Oct 2013 #43
DesertFlower Oct 2013 #63
ChiciB1 Oct 2013 #65
DesertFlower Oct 2013 #68
ChiciB1 Nov 2013 #69
DesertFlower Nov 2013 #70
RebelOne Oct 2013 #50
Sgent Oct 2013 #66
Systematic Chaos Oct 2013 #32
B Calm Oct 2013 #39
sabrina 1 Oct 2013 #40
DesertFlower Oct 2013 #64
pnwmom Oct 2013 #35
sabrina 1 Oct 2013 #41
pnwmom Oct 2013 #58
Recursion Oct 2013 #37
sabrina 1 Oct 2013 #42
CreekDog Oct 2013 #46
sabrina 1 Oct 2013 #62
babylonsister Oct 2013 #4
DesertFlower Oct 2013 #8
Hoyt Oct 2013 #10
lunasun Oct 2013 #12
DesertFlower Oct 2013 #9
lunasun Oct 2013 #11
indie9197 Oct 2013 #15
lunasun Oct 2013 #17
DesertFlower Oct 2013 #16
DesertFlower Oct 2013 #20
CreekDog Oct 2013 #47
DesertFlower Oct 2013 #60
ChiciB1 Oct 2013 #44
The Velveteen Ocelot Oct 2013 #6
enough Oct 2013 #13
Lifelong Dem Oct 2013 #14
DesertFlower Oct 2013 #18
lunasun Oct 2013 #19
Recursion Oct 2013 #38
Sgent Oct 2013 #67
Historic NY Oct 2013 #21
Raine1967 Oct 2013 #22
kestrel91316 Oct 2013 #24
DesertFlower Oct 2013 #27
tritsofme Oct 2013 #28
DesertFlower Oct 2013 #29
Kaleva Oct 2013 #31
kestrel91316 Oct 2013 #51
pnwmom Oct 2013 #34
kestrel91316 Oct 2013 #52
CreekDog Oct 2013 #48
kestrel91316 Oct 2013 #53
CreekDog Oct 2013 #54
kestrel91316 Oct 2013 #56
CreekDog Oct 2013 #57
kestrel91316 Oct 2013 #61
gopiscrap Oct 2013 #30
chillfactor Oct 2013 #33
DesertFlower Oct 2013 #36
Puzzledtraveller Oct 2013 #45
spartan61 Oct 2013 #55

Response to DesertFlower (Original post)

Wed Oct 30, 2013, 10:53 PM

1. My assumption would be that having Medicare would make you uneligible to partcipate

in an ACA exchange.

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Response to tritsofme (Reply #1)

Wed Oct 30, 2013, 10:59 PM

7. See comment #3

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 10:54 PM

2. I am a salaried MD in a low income clinic

Do you actually want to see a doc that is forced to see you against her will

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Response to Chuuku Davis (Reply #2)

Wed Oct 30, 2013, 10:56 PM

5. i don't, but my friend just got medicare

a few months ago and several of her long time docs won't take it.

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Response to Chuuku Davis (Reply #2)

Thu Oct 31, 2013, 12:59 AM

26. Are you suggesting that a doc that is 'forced' to take medicare patients

will not provide proper care for them?

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Response to Chuuku Davis (Reply #2)

Thu Oct 31, 2013, 01:14 PM

49. Would a doctor risk

a malpractice suit just to be petty?

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Response to Chuuku Davis (Reply #2)

Thu Oct 31, 2013, 02:45 PM

59. No, you're not... (nt)

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 10:56 PM

3. Here's an excerpt from an article about Sebelius, ACA, and Medicare - AND a FAQ PDF



See this one here first...




AND below is a from an article on Politifact.com

-snip-

Employer insurance vs. Medicare

We went right to the source on this one, asking the Department of Health and Human Services if Sebelius misspoke. It turns out she did.

Individuals who have health insurance through their employer can sign up for the online marketplaces, it’s just not financially beneficial for most to do so. If an individual forgoes affordable insurance through work, he or she won’t qualify for subsidies to help pay for insurance on the government-run marketplaces. And plans purchased through an employer are typically cheaper because the company is paying a portion of the costs.

A spokeswoman for the department said Sebelius meant to say, "Marketplace plans cannot be sold to a Medicare enrollee, and the secretary is a Medicare enrollee."

While Sebelius receives health benefits from her government job, as of May, she is also 65 years old and therefore eligible for free Medicare Part A, which covers hospital visits. She can couple those benefits with her employer insurance, but according to guidelines released Oct. 4 by the Center for Medicare & Medicaid Services, "it is illegal to knowingly sell or issue a Qualified Health Plan to a Medicare beneficiary" on the government-run insurance marketplaces.

That hasn’t always been clear, said David Lipschutz, a policy attorney at the Center for Medicare Advocacy. Nothing in the Affordable Care Act mentions whether Medicare enrollees are eligible for the health insurance marketplaces, he said, but the administration lately has cited a section of the Social Security Act also known as the Medicare Anti-Duplication provision that bars private insurance companies from offering coverage to Medicare enrollees.

There are some exceptions. A small fraction of individuals who are not eligible for free Medicare Part A and those with end stage renal disease can still buy insurance on the exchanges and receive federal subsidies. Neither of those situations apply to Sebelius.

Hypothetically, Sebelius could abandon her government health care plan and get out of Medicare Part A. But that would require her to revoke and forfeit her Social Security benefits for the rest of her life, something we can’t envision anyone volunteering to do.

"It’s really not going to be an option to drop it in order to get into an exchange," said Andrea Callow, also a policy attorney with the Center for Medicare Advocacy.

-snip-

http://www.politifact.com/truth-o-meter/statements/2013/oct/30/kathleen-sebelius/sebelius-says-she-not-eligible-exchange-because-i-/




Hope that helps

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Response to Tx4obama (Reply #3)

Thu Oct 31, 2013, 12:28 AM

23. So iow, poor seniors are screwed. Nothing for them. As far as I know from helping two elderly

relatives with their health issues, anyone over 65 whose only coverage is medicare A, which is free airc, has virtually no coverage, other than a hospital visit. Most Medicare recipients have to buy supplemental insurance in order to take care of their health needs.

This sure is discrimination against the most vulnerable citizens. They were simply left out altogether, no doubt to save the Insurance Corps money because older people need health care more than the very young.

How clever, to force young, healthy people to buy from a Private Insurance Corp, knowing they won't need it and to give no option to the poorest of the elderly, because they would use it.

This alone demonstrates what many Dems were most concerned about, that this was not about concern for the sick especially the poor, it was meant to bail out the HC Ins Corps which it will.

No wonder they never talking about this. I doubt too many people know this, I assumed that the elderly were included in all this. I wonder what the % of the 44,000 who die each year are elderly and poor?

Iow, those who need it most won't get it.

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Response to sabrina 1 (Reply #23)

Thu Oct 31, 2013, 12:53 AM

25. medicare part B is $105 for 2013.

i can tell you that those supplemental policies that pick up most of the charges medicare doesn't are expensive. my friend and her husband each pay $260 for supplemental insurance plus each pay $105 for medicare part b. like i said before some of her docs are not taking medicare. she's really upset. she's 68 and her husband is 65. there both still working, but don't make that much. that's $730 a month for health care.

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Response to DesertFlower (Reply #25)

Thu Oct 31, 2013, 01:00 PM

43. My Daughter Has A Masters Degree As An ARNP...

specializing in cardiology, her husband is now working toward his masters degree too. BUT, I know for a fact that some doctors WON'T take Medicare patients. I go to one myself, but since he's been my doctor for many, many years he set up a payment agreement with me. I have to see him for my OCD medications every 3 months & he charges me $90.00 every 3 months. My insurance will still pay for the medications he prescribes, but not for visits since he opted out.

My Primary Care doctor sends out a letter each year telling us which insurance her accepts and which he doesn't. I have a Humana PPO, but he won't accept Humana HMO. Most doctors around here don't accept the HMO's. My insurance is through my husband's Union company and very good. It has great benefits and coverage.

But obviously doctors ARE opting out of Medicare so it must be legal. My daughter has told me that this could become a problem. Not hearing much howling yet, but it is happening.

I live in Florida, a retiree state, so I wonder why a doctor chooses to do this. It seems it could hurt their practices, but maybe not. My county is one of he more affluent in the state and very Repuke. I'm not one of them, but they may be thinking the patients can afford their fees. I don't understand it much because many rich people find ways to get the best deals for the most part. My neighbor's doctor told her if she would agree to pay $1800.00 a year, he would cover all her visits. BUT, that doesn't include hospital stays and/or surgeries. Sounds like a crappy deal to me.

So, they are refusing Medicare here so it must be legal.

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Response to ChiciB1 (Reply #43)

Thu Oct 31, 2013, 04:26 PM

63. i live in phoenix, arizona.

we have a lot of seniors here too. i've only been on medicare for a little more than a year. no problems with my docs.

your daughter is right. it can become a big problem.

it's legal, but is it ethical?

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Response to DesertFlower (Reply #63)

Thu Oct 31, 2013, 04:37 PM

65. That's The Question That Needs Answering!

I have very little faith that many in D.C. are really working for "we the people!" Mostly Repukes, but there are some Dems that I don't trust either.

We may not be in Kansas anymore, but I'm not sure this is the country I knew as I was growing up. Are we still in America??

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Response to ChiciB1 (Reply #65)

Thu Oct 31, 2013, 05:00 PM

68. exactly. obama couldn't even get

a public option. insurance companies and lobbyists are very powerful.

BTW. i guess you know higher income retirees pay more for medicare. i fall into that category.

http://www.ssa.gov/pubs/EN-05-10536.pdf

my husband passed in 2012 from an inoperable brain tumor. hospice couldn't keep him because he was doing well. they told me to put him in assisted living which i did. i panicked and took $125,000 out of his 401k. my friend said i had 60 days to put it back so i opened an IRA in chase bank and put $100,000 in. $25,000 was automatically taken out in tax by the fund. when i filed my taxes i found out that the $125,000 was considered income. after he passed i inherited the 401k and turned it into an IRA. because i was 71 i had to take a mandatory distribution. to make a long story short my income for that year was almost $255,000. i paid almost $55,000 in federal tax and a bundle to the state. none of my medical deductions counted with that high income. i'll be notified by social security next month that my medicare will cost an extra $105. also just found out that my medicare part D will cost an extra $31.50 -- not paid to the insurance company but to medicare. my income for 2013 will be approximately $92,000 so next year the medicare will go down, but it will still cost me approximately $43.00 a month more. i'm not complaining about the $43.00 -- i'm fortunate to have a good income (i'm collecting hubby's pension) , but the 2012 income was a mistake and i was given wrong information by the bank.

there will be some who will read this and not be very sympathetic. fortunately it was a joint return or i'd be paying more.

i guess my point is. if i'm paying more for my medicare and my doc refuses to take it i'd be really pissed off.

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Response to DesertFlower (Reply #68)

Fri Nov 1, 2013, 05:51 PM

69. My Income Isn't All That Much...

We had saved a lot of money during the time we worked, but we had some personal financial issues concerning our son. But I know what you're saying about not being able to avoid taxes. We ended up paying a lot over several years. Our son had a serious drug problem and between rehab, lawyers and getting him back on his feet we used a very large amount of our savings. It is what it is and fortunately it paid off. He's now married with a son and doing very well for the past 5 years. He doesn't drink, smoke or use any drugs anymore. He really turned his life around and now has his own business. He does pay us money from time to time as repayment. but it would take longer than we will live to compare. But having him healthy and doing well is such a relief that we try not to remember the bad times.

Medicare will go up for us too, but our insurance is good enough that we don't need a supplement.

Yes, we need so much more for those less fortunate and even though we do struggle now and then, others do have it worse!

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Response to ChiciB1 (Reply #69)

Fri Nov 1, 2013, 09:38 PM

70. happy to hear your son turned his life

around. i had a son who took the wrong path. much as we tried we couldn't get him straightened out. he committed suicide.

like i said i don't mind paying the extra $43.00 for medicare. i'm fortunate to have a good income, but making an honest mistake -- well what can i say? i was so frightened. i knew he was dying. we had a few bucks in the bank, the house was paid off and so were the cars, but when the assisted living came up i really panicked. he only stayed for 1 month and was then transferred back to hospice where he died a week later. fortunately except for the assisted living we had good insurance. the max out of pocket was $6,000. i never added up what the hospitals and hospice cost, but i know it was a lot.

there's no way to prepare for the changes you have to go through when someone is terminally ill. i don't know how i survived. thank goodness i don't have to worry about money. so many people are struggling and i don't see things getting better.




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Response to DesertFlower (Reply #25)

Thu Oct 31, 2013, 01:15 PM

50. I only have parts A and B for which I pay $105 per month.

I cannot afford to buy supplemental insurance. That $105 payment out of a little more than z $1400 monthly Social Security is still a big chunk.

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Response to RebelOne (Reply #50)

Thu Oct 31, 2013, 04:55 PM

66. Apply for Medicaid

there are multiple Medicaid programs -- there are two that could help you, and are based on income w/o looking at assets. One pays your Part B premium, the other effectively supplies you with a supplement.

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Response to sabrina 1 (Reply #23)

Thu Oct 31, 2013, 02:09 AM

32. I didn't know about this until I was in the hospital and almost dead earlier this year, but...

...if you are on Medicare Part A only, and your income is near or under the poverty line, you will qualify for something called the Qualified Medicare Beneficiary program. This program is paying my $100-ish monthly Part B deductible and also helps cover some other costs. It's basically like having Medicare plus a subset of Medicaid at the same time.

http://www.medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-program/medicare-savings-programs.html

I didn't learn about this, despite spending time trying to dig up information, until a hospital social worker explained it to me. So, it's possible you and your relatives are equally in the dark.

Hope it helps you or someone!

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Response to Systematic Chaos (Reply #32)

Thu Oct 31, 2013, 06:25 AM

39. Helpful post!

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Response to Systematic Chaos (Reply #32)

Thu Oct 31, 2013, 12:35 PM

40. We were helping to take care of two elderly relatives over the past couple of years

and that was when I began to learn about Medicare. THEY were able to afford supplemental Ins which was expensive, plus they both had a prescription drug policy.

That's when I began to wonder about people who, unlike them, could not afford the supplemental insurance which was really very expensive.

Thank you for that information, it seems to have been in place and is not part of the ACA. Good to know that the elderly have something to help them out.

I'm glad you got the help you needed.

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Response to Systematic Chaos (Reply #32)

Thu Oct 31, 2013, 04:31 PM

64. thank you for the link.

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Response to sabrina 1 (Reply #23)

Thu Oct 31, 2013, 03:03 AM

35. "Low poor " seniors are eligible for Medicaid,

in addition to Social Security payments supplemented by SSI payments (Supplement Security Income).

So it's not true that there's nothing for them.

(In other words, people of all incomes who pay into Social Security receive Social Security. But low income retirees can also apply receive Supplemental Security income on top of Social Security payments. And these people can get Medicaid instead of Medicare -- so they won't need Medigap policies.)

http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/633/~/relationship-between-ssi-and-medicaid



What is the relationship between Supplement Security Income (SSI) and Medicaid?

SSI is the Social Security program that guarantees a standard of income to people who are age 65 or older, blind or disabled with limited income and resources.

Medicaid is a state-run medical program that is federally funded and pays for medical assistance for certain low-income people. Some of the people covered by Medicaid are certain children, the aged, the blind, the disabled and others with limited financial means.

Usually, a person receiving SSI is eligible for Medicaid. In 32 states and the District of Columbia, Social Security makes Medicaid eligibility decisions for people receiving SSI or federally administered state supplementary payments.

In seven other states and the Commonwealth of the Northern Mariana Islands, people receiving SSI have to file a separate application with their Medicaid agency. In those states, the agency will use the SSI rules to decide Medicaid eligibility for the aged, blind and disabled receiving federally administered cash assistance. The seven states are:

Alaska;
Idaho;
Kansas;
Nebraska;
Nevada;
Oregon; and
Utah.

The remaining eleven states require a separate application with the Medicaid agency and use their own Medicaid eligibility rules. Each of these states uses at least one Medicaid eligibility requirement more restrictive than the SSI program uses. The eleven states are:

Connecticut;
Hawaii;
Illinois;
Indiana;
Minnesota;
Missouri;
New Hampshire;
North Dakota;
Ohio; and
Virginia.

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Response to pnwmom (Reply #35)

Thu Oct 31, 2013, 12:38 PM

41. This was already in place, then. It's not part of the ACA?

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Response to sabrina 1 (Reply #41)

Thu Oct 31, 2013, 02:40 PM

58. This has been in place for decades -- not part of ACA. n/t

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Response to sabrina 1 (Reply #23)

Thu Oct 31, 2013, 06:17 AM

37. You're leaving out dual-eligibility for Medicaid

Medicaid picks up a lot of seniors' Part B premiums as well as acting as supplemental insurer.

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Response to Recursion (Reply #37)

Thu Oct 31, 2013, 12:44 PM

42. Well, I knew about Medicaid being available for the poor. What people have

been asking is, 'has anything changed for those on Medicare'. I did get an answer above to that question and it appears it has not, they will still be covered by Medicaid if they cannot afford private supplemental insurance. My concern was that their medicaid coverage would have to go through a Private Ins Company where a % is taken out for profit, diminishing the amount in the Public Fund that should be going directly to the poor and the sick.

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Response to sabrina 1 (Reply #23)

Thu Oct 31, 2013, 01:10 PM

46. are you on DU advocating that seniors leave Medicare for a private health insurance plan?

wow.

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Response to CreekDog (Reply #46)

Thu Oct 31, 2013, 04:14 PM

62. I received an answer to my question, thank you, except for one

issue regarding the medicaid coverage for poor seniors. I will ask it again, but probably not here on DU where it appears that any questions regarding HC are greeted with nasty responses from some people.

Not a good reflection on DU frankly as this is a very, very serious issue for most Americans.

Your response epitomizes how people with questions are greeted here, which is why DUers with legitimate concerns are now going elsewhere to find out what they need to know.

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 10:56 PM

4. "Docs who don't take Medicare"- I wonder if that will

change? And why would they be opting out?

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Response to babylonsister (Reply #4)

Wed Oct 30, 2013, 11:07 PM

8. i've heard it's too much paperwork.

most docs having billing services. i can't imagine my primary doc telling me he won't take medicare anymore. he's a decent, caring person.

there's stories going around (according to my friend) that ACA is hurting them. i think the medicare advantage plans are affected by being paid lower rates than before (they're insurance companies).

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Response to DesertFlower (Reply #8)

Wed Oct 30, 2013, 11:14 PM

10. They don't feel that get paid enough through Medicare. Few take Medicaid.

Has nothing to do with ACA.

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Response to DesertFlower (Reply #8)

Wed Oct 30, 2013, 11:20 PM

12. coding and billing is basically the same -just the payout rate has been going down for Medicare

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Response to babylonsister (Reply #4)

Wed Oct 30, 2013, 11:10 PM

9. my friend's rheumatologist said she take

medicare from my friend, but she ordinarily doesn't. this made my friend very uncomfortable -- like its welfare. her shrink won't take it at all and she can't afford to pay her $150 a month to see her.

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Response to babylonsister (Reply #4)

Wed Oct 30, 2013, 11:18 PM

11. Medicare has been paying out less and less to drs, in benefits over lasr 5 years

Every time your doctor provides care for a patient on Medicare, he or she is reimbursed by the Medicare program. Think of it this way: your doctor runs a small business—his or her medical practice. But while the costs of doing business continue to go up—paying nurses, rent, investing technology, purchasing medical equipment—the Medicare payments your doctor receives are going down
Private insur pays more so some docs have dropped Medicare but there are plenty of clinics available in the cities at least

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Response to lunasun (Reply #11)

Wed Oct 30, 2013, 11:48 PM

15. I could be wrong but I dont think there are many doctors that run their own show anymore

Most seem to be in grouped into clinics and are probably just treated as employees. (Please educate me if you work in a clinic) IDK if they get paid a salary or if they get paid by billing the patient.
And actually, my kids never see a doctor but see a Physicians Assistant.
Isnt it odd how complex our health care industry has become?

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Response to indie9197 (Reply #15)

Wed Oct 30, 2013, 11:55 PM

17. I work with independent private drs. and yes it is becoming harder and harder to stay out of hospita

systems and remain independent
Medicine is becoming very corporate
seriously where will people go for a 2nd independent opinion when all docs are in the same system?
The scenario I set was for a private doctor or private group

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Response to lunasun (Reply #11)

Wed Oct 30, 2013, 11:53 PM

16. here's an example from the medicare sight

of what my doc charges and what medicare pays.

$89.00
Medicare Approved: $72.02
Total Applied to Deductible: $0.00
Blood Deductible: $0.00
Physical Therapy Charges: $0.00
Psychiatric Charges: $0.00
Occupational Therapy Charges: $0.00
Patient Paid to Provider: $0.00
Medicare Paid You: $0.00
Medicare Paid Provider: $56.47

i'm looking at a recent bill. credit insurance adjustment -$18.13

per your insurance your deductible was $14.40

that's what i pay.

i have a medicare supplemental plan but it has a $4,000 a year deductible. if it didn't have the high deductible i imagine the supplemental plan would pay the $14.40.

so he gets paid a total of $70.97.

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Response to DesertFlower (Reply #16)

Thu Oct 31, 2013, 12:15 AM

20. i just looked up the doctor payment for last year

before i had medicare and was covered by UHC. same doc charged $89.00. insurance paid him $62.80 -- plan discount was $26.20. i paid nothing because seeing him was considered preventive care.

so actually he's getting paid more now that i have medicare. instead of $62.80. he's getting paid $70.97.

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Response to DesertFlower (Reply #16)

Thu Oct 31, 2013, 01:12 PM

47. for a 15 minute appointment?

just wondering.

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Response to CreekDog (Reply #47)

Thu Oct 31, 2013, 02:53 PM

60. yes. although he spends more

time with me if needed. he always runs late -- he doesn't rush anyone out.

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Response to babylonsister (Reply #4)

Thu Oct 31, 2013, 01:08 PM

44. My Doctor Downsized From 3 Office Personnel To 1...

He opted out of Medicare because of low pay outs. Now has smaller office and 1 office person. He takes NO insurance of any kind, but I only see him every 3 months for medications. I already mentioned this here. He's 66, still wants to practice but sees enough patients and doesn't over charge. He's been doing it for the last 3 years and it works for him.

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 10:57 PM

6. If you receive or are eligible for Medicare, no.

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 11:29 PM

13. On Medicare myself, having heard various things, I went to the Medicare website,

and it plainly states that Medicare is not part of the ACA.

We do still have the usual annual enrollment period (which ends on December 7 this year) if we want to make any changes to our Medicare enrollment.

http://www.medicare.gov/about-us/affordable-care-act/affordable-care-act.html

Quote from the site>

1. Your Medicare coverage is protected.

Medicare isn’t part of the Health Insurance Marketplace established by ACA, so you don't have to replace your Medicare coverage with Marketplace coverage. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now.

You don’t need to do anything with the Marketplace during Open Enrollment.

more at the site>

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Response to DesertFlower (Original post)

Wed Oct 30, 2013, 11:46 PM

14. Gee a doctor is not getting paid enough with Medicare

 

Poor doctor. More like a greedy snob.

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Response to Lifelong Dem (Reply #14)

Wed Oct 30, 2013, 11:58 PM

18. see #16. i've given a breakdown of

what my doc gets paid. he is part of a group that includes doctors and hospitals.

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Response to Lifelong Dem (Reply #14)

Thu Oct 31, 2013, 12:00 AM

19. Thar is why doctors are opting out they cant pay overhead and everyone who should be concerned

thinks they make too much already
Corporate medicine is willing to fill the void

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Response to Lifelong Dem (Reply #14)

Thu Oct 31, 2013, 06:20 AM

38. That's a big reason single payer has such resistance: medical providers would make much less money

If everybody in the country were on Medicare it's not remotely clear that all the hospitals and practices out there could sustain the financial hit they would take.

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Response to Recursion (Reply #38)

Thu Oct 31, 2013, 04:59 PM

67. Support that

the vast majority of doctors would make more -- not less under single payer plans as implemented in Canada or the UK. Some specialists would take a very hard hit, but most doctors would stand to benefit especially if (like the UK) they received schooling for free.

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 12:22 AM

21. I've notice lots of Dr's in my area banding together...

in Heathcare Cooperatives meaning they affiliate with each other instead of going alone.

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 12:23 AM

22. Here:

This should answer some questions:

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3953031

I thought it was a very good reply.

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 12:33 AM

24. Why would ANY doctor take Medicare patients if it only pays for

hospital care?????

Does this mean that they have to pay the doctor themselves, full price, for all outpatient care, lab, etc??

My grandparents were on Medicare for over 20 years, had lots of medical problems, had to see their doctor every month forever, and never complained that they had to pay for every single service. Hell, they were poor as church mice. I don't get it.

What the hell have they done to Medicare?????????

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Response to kestrel91316 (Reply #24)

Thu Oct 31, 2013, 01:02 AM

27. same with my grandparents, but not for 20 years.

grandpa died at age 73 and grandma at age 77.

my mom died at 85. the last few months of her life were in assisted living which came out of the small amount of savings she had.

remember that folks. medicare does not pay for assisted living.

my friend's dad died at 91 in a medicaid nursing home. they had to spend down the little bit of money he had first. his mind was still sharp but his body was breaking down. my friend said "it's better if you have dementia and don't know what's going on". he was miserable. his wife died in her early 70s from lung cancer.

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Response to kestrel91316 (Reply #24)

Thu Oct 31, 2013, 01:20 AM

28. Part A is for hospitalization, Part B is for doctor services, ect.

If you qualify you are automatically enrolled in Part A when you turn 65, however Part B requires a separate premium.

A&B only pay 80%, and it's been that way as long as I can remember. Without supplemental coverage, you could still be on the hook for a big bill.

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Response to tritsofme (Reply #28)

Thu Oct 31, 2013, 01:26 AM

29. exactly. nt

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Response to tritsofme (Reply #28)

Thu Oct 31, 2013, 01:54 AM

31. My income is low enough that what Medicare doesn't cover, Medicaid does.

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Response to tritsofme (Reply #28)

Thu Oct 31, 2013, 01:29 PM

51. Well if Medicare stopped paying for life-extending multimillion dollar procedures

on 100% mentally incapacitated permanently bedridden elderly instead of humanely letting nature take its course, it could afford to pay more like 95% or even more. When my mom's mind was gone and her body failed, we went with hospice. No way were doing the "spare no expense" approach to keeping her corpse breathing.

This country is still so messed up.

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Response to kestrel91316 (Reply #24)

Thu Oct 31, 2013, 02:53 AM

34. It doesn't only pay for hospital care. Where are you getting that?

Although most seniors get Part B coverage -- the Medigap policies -- and I think that's the part that covers office visits. Maybe that's the cause for the confusion.

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Response to pnwmom (Reply #34)

Thu Oct 31, 2013, 01:30 PM

52. It is. I'm not close to Medicare age yet so I don't know this stuff.

My sister took care of all that for my mom.

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Response to kestrel91316 (Reply #24)

Thu Oct 31, 2013, 01:14 PM

48. whoa, whoa, hang on there...the thing you are so upset about is fiction

Medicare doesn't just pay for hospitalization.

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Response to CreekDog (Reply #48)

Thu Oct 31, 2013, 01:33 PM

53. I didn't realize about Part A and Part B. Though now that I do, I am completely baffled as to why

the two parts exist.

Just pay for senior healthcare needs, period, doofuses. And when their minds are gone and their bodies fail, keep them on happy drugs until they pass peacefully.

This country is just messed up. Everything has to be SO complicated, just so certain wealthy people can get wealthier.

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Response to kestrel91316 (Reply #53)

Thu Oct 31, 2013, 01:44 PM

54. So Medicare's a conspiracy now? Wow. Well, that's wrong.

At its creation, Medicare consisted of two parts: Medicare Part A hospital insurance coverage, which is financed by payroll deductions and charges no premiums to those who have contributed; and Medicare Part B, an optional medical insurance program for which enrollees pay a monthly premium.


http://www.aarp.org/health/medicare-insurance/info-07-2013/medicare-anniversary-july-30-1965.html

so you're saying you didn't know the basics about Medicare but even not knowing anything, have immediately concluding why it was set up and for whose benefit exclusively?

i usually agree with you on things, but you've taken leave of your senses.

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Response to CreekDog (Reply #54)

Thu Oct 31, 2013, 01:56 PM

56. Huh? I thnk maybe you have gotten confused about something i said or confused me with somebody else.

What "conspiracy"???

Everyone knows that Medicare was set up to provide medical care for the elderly (over 65). Duh.

I just think it's idiotic that 90% of this country's healthcare dollars are spent in the last year of people's lives, particularly the very elderly with failed minds and failing bodies who are terminally ill and completely dependent on physical assistance to live day to day, unaware of their surroundings.

My BIL (who works in healthcare) and I had a recent conversation about things and he is concerned, as many people are, about rising healthcare costs, particularly when those costs are for extremely expensive care for bedridden dementia patients. We agreed that everybody we know, and probably most people we DON'T know, would NOT want life-extending, hideously expensive care once we reached that stage. I know we didn't subject my mom to it, and we don't want ourselves subjected to it.

Doctors and hospitals, however, love that sort of thing because it's so profitable, even though the benefit to society is virtually nonexistent. I think we would do better to fund hip replacements and cancer care for old folks with good minds than hip replacements and cancer care for people who no longer know who or where they are.

Pretty sure there's no conspiracy talk in there.

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Response to kestrel91316 (Reply #56)

Thu Oct 31, 2013, 02:14 PM

57. WTF? You think Medicare doesn't cover hip replacements?

what the heck is the person who 15 minutes ago didn't know what Part A and B was?

I understand the larger point about what our health care dollars are spent on, but you're the one who opened up the conversation about another topic --that Medicare is a scheme to enrich doctors and hospitals, even though when it started Part A was just for hospitals, but that's beside the point, when you were talking about Part A and B you hadn't actually heard of them.

Sometimes when we realize we don't know what we're talking about --like saying Medicare doesn't cover hip replacements, we need to stop talking.

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Response to CreekDog (Reply #57)

Thu Oct 31, 2013, 03:21 PM

61. Wait, what? When did I say Medicare was a scheme to enrich doctors and hospitals????

You took something out of context or misunderstood sarcasm about some RW meme.

My dear CreekDog, Medicare and Social Security don't have a bigger fan than me. None of my grandparents (AND the one great-grandparent I knew) all had comfortable, secure elder years exactly because of Medicare and Social Security. So did my om, to the extent that was possible given her mental illness. And I hope they are around, or better yet Medicare For All, when I retire.

I've been arguing with a relative on FB about Medicare and the ACA and their stupid nonsense about denying hip replacements (the new version of death panels) so maybe I got my wires crossed and misspoke somewhere?

But it's more likely you misunderstood my snarking about some stupid RW claptrap.

I DO agree with my flaming liberal BIL that there is going to have to be a discussion at some point about cost controls. He sees far too many breathing corpses getting major procedures that physicians order up (with dollar signs in their eyes, no doubt) that really don't make any sense to society. If you have limited dollars for medical care (which we do), is it not better to face reality about the nearly dead and spend a few more of those dollars on people who can actually appreciate the fact that they are alive rather than on those who don't know they are alive?

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 01:38 AM

30. I agree..once again I keep sayin:

UNIVERSAL SINGLE PAYER HEALTH PLAN

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 02:48 AM

33. I m 72 years old and I am on Medicare

I carried Humana Gold as my supplemental insurance...Human Gold and Medicare merged.......I pay no extra out-of-pocket expense for my health care services....everything is paid in full except for my meds...I pay $4.00 for each med I am on...so it runs me about $30/month....I still get my same doctor and I have a choice of hospitals

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Response to chillfactor (Reply #33)

Thu Oct 31, 2013, 03:50 AM

36. that's a medicare advantage plan

Last edited Thu Oct 31, 2013, 04:45 AM - Edit history (2)

not a supplemental plan. it's an HMO and it's my understanding that you have to use network doctors and facilities.

http://wendellpotter.com/2013/04/medicare-advantage-or-disadvantage/

http://www.caring.com/articles/disadvantages-of-medicare-advantage-plans

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 01:08 PM

45. In Ky some social security recipients are eligible for adult medicaid

I only do family medicaid which is a different set of eligibility requirements so I am unsure of the exact details but you must 65 or older, blind, or disabled.

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Response to DesertFlower (Original post)

Thu Oct 31, 2013, 01:53 PM

55. My husband fought (and lost) his battle

with brain cancer for two years. He passed in March of 2013. He had Medicare ($104.90 per month) as well as supplementary insurance ($185 per month) through the CT Teachers' Retirement. I have yet to receive a bill for all the doctors appointments and care at the three hospitals he was in, as well as his radiation and stereo tactic procedure. If we had to pay out all the costs for his treatments, we would have had to file bankruptcy. I live in the largest retirement community in Florida and the streets and highways are flooded with every kind of doctor imaginable and they take Medicare. That's why it is so hard for me to understand doctors who won't take Medicare patients. It must still be lucrative for these doctors to accept Medicare or why would they chose to practice in a place where almost everyone is a senior?

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