Tag Archives: coverage

Your Questions About Medicare Insurance Coverage

Donald asks…

Why are people on Medicare happier with their coverage than people with private insurance?

Why do people like a single-payer government-run health insurance plan more than they like private insurance?

Source:
http://www.commonwealthfund.org/Content/News/News-Releases/2002/Oct/Survey–Medicare-Beneficiaries-Report-Greater-Satisfaction-With-Insurance–Better-Access-To-Care-Tha.aspx

Medicare Insurance AZ staff answers:

I would take FREE over PAY any day also. But that isn’t what the GOVT is offering, no matter how much kool aid you drink to try and believe it.

George asks…

Doesn’t Medicare deny coverage? So how can Obamacare say no denial for preexisting conditions?

I am just trying to figure this out. I am not trying to be a smart butt. According to what I heard,
Medicare has a higher denial ratio than does private insurance companies. So if Medicare regularly
denies coverage, why should anyone think Obamacare isn’t going to deny coverage? I am just trying to make sense of it. Thanks.

Medicare Insurance AZ staff answers:

First of all, the requirement to cover pre-existing conditons has nothing to do with Medicare. It is for direct pay plans for everyone not in Medicare or other programs.

Medicare is not an insurance company. Several people have been posting a statistic that indicates Medicare has a higher rate of claim denial than the big insurance companies. I had a look at the published source which did not explain why there were denials. I figured out that these figures were taken out of context from one source, copied to look like authentic reliable sources and put into a question on YA. The fact is Medicare gets claims from providers and suppliers, not patients, and is required to pay them within 30 days. The only time they deny claims is if they are suspicious or fraudulent. And there are plenty of those. That accounts for a delay while they are investigated.They do not take claims directly from patients.

What you call Obamacare has not changed the programs we currently have. It adds to them. We don’t yet know all the changes but it is a 10-year projected plan and will be tweaked, revised over time as needed, I would think.

Everyone is upset about having to buy insurance but no one minds if you have to pay your employer from your paycheck for group insurance. This is better because it is your own policy and you choose from a bunch of them on an exchange and you may get a subsidy to pay for it.

Michael asks…

Do you know of health insurance coverage in the philippines?

I have a relative in the philippines who is in and out of hospitals and so it can become costly. I would like to know if there are health insurance like here in the states such as a government type insurance like Medicare or private ones? It would be less worrisome for me knowing that whenever an emergency arrives, my relative will have insurance to cover whatever cost without waiting to receive money from me to get the medical attention

Medicare Insurance AZ staff answers:

The Government health insurance here is Philhealth. It only costs P100 a month and will cover a family of four. Good news is every citizen is eligable. Bad news is it takes six months to become effective and only covers 25% of the bill up to P100,000. Not great, but better than nothing. There are private health insures that cost way more, the problem there is they all have pre exixiting conditions clauses. With a relative in and out of the hospital it’s obvious they have pre existing conditions that would not be covered by the more expensive insurers like Philippine Blue Cross etc.

Evan with Philheath you pay upfront and wait for reimbursement. Sad but true here if you don’t have money , you don’t get treatment and rarely does the baranguay carry the more expensive meds like antibiotics.

Betty asks…

If the cost of INSURANCE is the problem, why has Medicare gone bankrupt?

Democrats are constantly telling us that their health care ‘reform’ is needed, in large part, to cut the cost of insurance and stop insurance company abuses.

But if this is the case, if insurance companies are the problem, why is medicare bankrupts? Why are states like Virginia having to reduce funding for Medicare and deny coverage to patients who use Medicare? ‘Insurance company abuses’ have nothing to do with the cost of Medicare. So why is Medicare costing the government so much? And what does the government intend to do to reduce the cost of Medicare other than to deny patient’s care and service?

Doesn’t this come back to the fact that the problems with health care is not the cost of insurance, but the rapidly growing cost of the health care itself? And if so, what does the Obama administration propose to reduce the cost of health care?

I don’t see anything, but maybe I haven’t been paying attention.
@oft suspended: That ‘incredible rate’ has bankrupt Medicare. Medicare is not self sustaining and cannot cover the cost of needed health CARE. Your President has done NOTHING to address the cost of health CARE. Nothing. That’s sort of the point. He’s using a bandaid to ‘cure’ a cancer.
@itsamini: So does Medicare, which is why fewer and fewer doctors are accepting Medicare patients.

Medicare Insurance AZ staff answers:

Medicare is like ANY program the Govt. Runs, failing. And we have a President who has NEVER had ANY leadership experience ever in the private sector. And we have a president and Congress who are rejecting options that will actually improve the quality of care and lower costs, in TORT reform and making Health Insurance portable and in doing so increasing competition between companies, and would drive DOWN the costs of insurance.

Steven asks…

PET scan insurance coverage?

My mom had colon cancer that has now been in remission for two years. Her doctor wants her to do all kinds of testing, but will not tell her what will be covered under her insurance plan. My mom has both Anthem and Medicare coverage. Can anyone tell me how often a PET scan can be done per year and still be covered? Thanks!
Can approval be given by the insurance provider before the PET scan is done? My mom can’t afford the procedure so that cost would kill her! She just tole me a CT scan is done at that time too so can approval be given for both prior to haveing them done? Thanks for all your insight!!!
All of you are great! Thanks for your detailed explanations AND for wishing my mom well!!!
UPDATE: My mom called and got some lab work done. All was well AND she got approved to schedule her PET test. They said she didn’t need her CT scan. Thanks again for your insight!!!

Medicare Insurance AZ staff answers:

Her doctor has no idea what will or will not be covered under her insurance . . Everyone in the US has a different plan so it is almost impossible to know who might qualify and who won’t. In either case she needs to have the scans done . . Make sure the doctors office sends off the request to receive the appropriate ‘permissions’ . . We had to go through two steps to get this approved . . There is some type of ‘national clearing house’ that determines if it is ‘medically appropriate’ and than there is the insurance to pay for it. We never were turned down by either of them (we had Anthem and Medicare too).

We have had experience being turned down for different treatments though and here is what we did .. We did not get emotional but called the insurance company and explained . . We than had our doctors office also call to talk to the insurance company . . If we were still denied we would appeal the decision in writing . . We usually would ‘win’ the appeal and the insurance company would pay. I do know others who sometimes went another round of appeals . . But in the end the insurance would pay. The PET is something your Mom needs and is the entire reason she has health insurance to begin with . . Insist that the insurance cover this for her . . But approach it diplomatically and don’t give up.

In general your mother should follow her doctors recommendations for the frequency of the PET scan . . And insurance should cover it. And, yes, approval is generally given before the procedure is done. If denied this benefit you should appeal to the insurance company and keep appealing until they agree to pay.

Your Questions About Medicare Private Insurance Coverage

Sandy asks…

Under the Ryan plan, once I retire, how will I get a private company to insure me if I have a medical problem?

in the post-Medicare era…

assuming I’m not in the 55+ age group today…

let’s say I’m 52 today, and have a heart condition 15 years from now and need a transplant…

If I’ve paid into Medicare coverage for 40+ years to guarantee I have some type of Insurance coverage when I retire, how will the GOP/Ryan plan at least guarantee I have access to coverage?

Medicare Insurance AZ staff answers:

You probably won’t, but Ryan and the republicans don’t care. By not giving you or anybody else Medicare, rich people get more money in their pockets. That’s all they care about.

Sharon asks…

Why does Obama call Meidcare Advantage wasteful?

Does he still despise and ridicule Seniors?

Seniors defend Medicare plan Obama calls ‘wasteful’
WASHINGTON — One of the largest spending cuts Congress could rely on to pay for an overhaul of the nation’s health care system comes from a Medicare program President Obama has called a “wasteful” subsidy for the health insurance industry.
Don’t tell that to cancer survivor Maurice Engleman, 82, who says the controversial Medicare Advantage program — which allows seniors to buy Medicare coverage through private insurance companies — helped him beat cancer.

“There was a seamless link between the medical support and the emotional support,” said Engleman, who was diagnosed with tongue cancer last year within a week of his wife’s death. “I don’t believe Medicare would have taken care of the kind of services I required.”

http://www.usatoday.com/news/washington/2009-08-04-healthcare_N.htm

I guess since it’s a private component and not a “social” one Obama fears it. I have to wonder if he would have been glad if this man had died.

Medicare Insurance AZ staff answers:

Okay, wastefullll

http://cid-17610ad2c13ec04d.skydrive.live.com/self.aspx/Public/healthcare-chart-small.jpg

Michael asks…

Can my private university force me to buy its student health insurance?

I am currently covered by a state-enhanced version of Medicare; my family is extremely low-income and this health coverage is far superior to that offered by the private graduate school I will be attending this fall. However, the school is not accepting my waiver form saying that government insurance does not meet the school’s waiver qualifications (only employer insurance programs do). Can they do this to me and make me pay thousands of dollars I don’t have for redundant school health insurance I don’t need? Anyone knowledgeable enough to know whether this is something I can fight legally? The school and my insurance are in NJ.

Medicare Insurance AZ staff answers:

A private school can require you to do just about anything as a condition of admittance — because they are a private institution, not a govt agency. It’s all a matter of contract — you can either do what they want, or not accept admission. Your choice.

Racial prejudice is about the only thing prohibited — and that’s only under the 13th Amendment, which affects private groups — the 14th only applies to govt action.

Charles asks…

Did you know that the US already has a mixture of most of the world’s health insurance systems?

When it comes to treating veterans, we’re Britain. Health care is provided and financed by the government through tax payments, just like the police force or the public library.

For Americans over the age of 65 on Medicare, we’re Canada. Insurance coverage comes from a government-run insurance program that every citizen pays into

For Americans whose employers offer insurance, we’re Germany. Private insurers are financed jointly by employers and employees through payroll deduction.

For those Americans whose employers don’t offer health insurance we’re Cambodia – with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you’re sick enough to be admitted to the emergency room.

Medicare Insurance AZ staff answers:

BUT US is the ONLY Country’s Heath Care system is making tons of $$$ of the people. Because there is NO CAP on treatment/drugs prices. This is the MAIN problem! It’s driving the country and citizens to go bankrupt because of the health care bills!

George asks…

Support the Affordable Health Care for America Act?

Will Republicans support the Affordable Health Care for America Act if the public option is dropped?

This would include the following:

prohibiting health insurers from charging different rates based on patients’ medical histories or gender
prohibiting health insurers from refusing coverage based on patients’ medical histories
repeal of the exemption for insurance companies from anti-trust laws
requiring most employers to provide coverage for their workers or pay a surtax on the worker’s wages up to 8%
new restrictions on abortion coverage in private insurance plans (note: Medicare is already prohibited from covering abortions by law)
expansion of Medicaid to 150% of the Federal Poverty Level
providing a subsidy to low to middle income Americans to help buy insurance
a central health insurance exchange where the public can compare policies and rates
a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)
a 2.5% excise tax on medical devices
reductions in projected spending on Medicare by $400 billion per year
inclusion of some language originally proposed in the Tax Equity for Domestic Partner and Health Plan Beneficiaries Act
inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009 (H.R. 2708).

Without the public option, it is just massive healthcare reform overhaul. There would be no government run national program (administered by the US Department of Health and Human Services).

Why wouldn’t anyone with a conscience want to support this?

And why do Republicans keep claiming that taxes will be raised on the middle class? Do the majority of Americans really make $500,000 to 1 million a year?

Medicare Insurance AZ staff answers:

Considering that they are funded by (un)insurance companies and ignore the facts, then no.

FACT – Insurance companies in the USA admit to pushing up prices, buying politicians and not paying out claims when they should [1]
FACT – PER PERSON the USA spends more on healthcare than any other nation on the planet [2]
FACT – Obama debated his plans before the election for healthcare [3]
FACT – the chance of a child under five of dying in the USA is greater than industrialised nations with universal health coverage [4]
FACT – Obama was elected by the American people to bring in change [5]
FACT – Obama wants to stop insurance companies from screwing American [6]
FACT – The reforms Obama wants work in the Netherlands and Switzerland [7]

Let me know if my facts are wrong, but please provide proof.

Your Questions About Medicare Supplement Insurance

Mary asks…

My husband died a year ago. Today I received a bill for surgery that was performed in 2004. Do I have to pay

Our insurance comanies, Medicare and a supplement have paid this bill but there is still a few hundred outstanding. Am I resonsilbe?

Medicare Insurance AZ staff answers:

First find out if your state is a community property state. If it is than unfortunately his debts are your debts as his property is yours.
If you are not in a community property state then I would encourage you to seek legal counsel with an estates attorney or a bankruptcy attorney.
I work in the financial industry and deal with peoples credit regularly the only real repurcussion I can forsee is that they may place you in collections which can adversly effect your credit score but thats about it.
Also check with your insurance providers and the death benefits provided by his employer or retirement group.

God bless and my condolences on your loss best of luck on this one.

Ken asks…

asking about insurance?

A person of 79yrs old has medicare…goes as an outpatient for echocariogram…has paid for supplement insurance…then gets a bill for 134bucks…then is told that the supplment does not pay for the deductable therefore the 134 bucks are owed. The supplement is Blue Cross-Blue Shield and very expensive. Is this really true that they owe the bill?

Medicare Insurance AZ staff answers:

There are several different Medicare Supplement Plans. Plans C, F, and J are the only plans that will pay the deductible. If this person has a high deductible plan F, high deductible plan J, a Medicare Select plan, or any of the other plans they will have to pay the bill.

Sharon asks…

I am medicare eligible as of 1-1-07. my problem is i am not 65 yrs.,, i am on disability.?

Because I am under 65 I am not eligible for most supplements. Medicare says I can get a MEDIGAP policy, except I cannot find an insurance co. that sells this type of plan. Medicare says that all states are required to offer this plan for people in my situation. If anyone else has encountered a problem like this please help. The insurance co. keep on trying to sell me the advantage plan, but none of my doctors are on those plans (HMO). The Medigap plan works as the supplement to your original medicare & the rates are supposedly reasonable. If anyone has any info let me know.

Medicare Insurance AZ staff answers:

Since you have medicare you can get what is referred to as Medagap Insurance. Make sure that you have signed up for part B through Medicare. Most insurance companies offer Medigap sometimes called Medicare Supplement. You also need to evaluate if you should get the prescription coverage. Getting B coverage is a must the presciption coverage may not be but if you don’t get it during the open enrollment period the rates go up if you get it latter.

Donna asks…

Question concerning diabetic test strips?

My dad has cut his testing down to twice a week to save on his test strips since they are expensive for him. He was testing daily. Perhaps testing twice a week is sufficient. His doctor said it would be fine. His blood sugar stays pretty stable, but in the past, has had problems with it being too high. He has Medicare, AARP supplement insurance, and goes to the VA clinic for appts. Is there a way to get test strips at a reduced rate? I thought his insurance would pay for them or partially at least, but he is buying them himself. I am considering sending him some money to help pay on them, if the doctor says he ever needs to be checking it more often. So how safe is it that he is only checking twice a week? I’m not impressed with his doctor, so I hope he is being honest with my dad on testing twice a week asw being fine. Anyone with diabetes that could advise?

Medicare Insurance AZ staff answers:

The doctor has to write a prescription. If the doctor writes a prescription specifically stating to check blood sugar twice a day, the insurance will give your father 60 strips a month. Alot of time it is a pain in the butt for people to run around and get scripts. Have the doc write a script for ‘diabetic supplies’ including how many lancets, strips, and needles (if used) are used a month. The only thing insurance wont pay for is alcohol wipes (they are cheap anyway) and medicare pts can get a new meter every 5 years, but usually its better to just buy your own meter (they arnt much, the companies make 90 percent of their money off the strips) have the doc write on the script the type of meter it is , get a new script to match a new meter. Insurance pays for strips!!! Now of course if your dad doesnt have a script he will have to buy them, even have the doc write to check sugar three times a day and he will have extras. I am a home care nurse and have figured this all out. If your dad uses insulin he needs to check at LEAST twice a day. If he is on orals, once a day in the am before meals, if he is good for a long time then once or twice a week is ok with some docs but i would watch it closer.

Linda asks…

how soon do you get medicare after your disability is approved?

my wife is 46 and i was wondering if we had to pay for medicare…i heard it was 100.00 out of each check….is that true?
is that permanent or just until she’s 65?
is it better to get the medicare and a supplement or should i leave her on my insurance and could i get a supplement then?
if we don’t do the medicare now, will it be more difficult to get it later?
when getting us the lump sum for her disability, when do they start the proration of her pay out?
does it start when we met with the attorney or when social security first turned her down?
when do the monthly checks start coming?

Medicare Insurance AZ staff answers:

Part B premium is currently $96.40 for most people and is permanent. Medicare will be available to her after being on SSDI for 24 months.

When she becomes eligible for Medicare she’ll have a guaranteed issue period where she can sign up for a Medicare Supplement or a Medicare Advantage plan with no underwriting. Medicare Supplements are not available to people under 65 in all states and where they are available there are usually not many plans from which to choose. If she doesn’t get on a Supplement during the guaranteed issue period she may have trouble in the future because they can decline to accept her. However, she’ll have another guaranteed issue period when she turns 65.

Medicare Advantage plans are available in all states to people under 65. If she doesn’t get an Advantage plan right away she can get on one during the annual enrollment period from November 15 through December 31 of each year. She cannot be declined with an Advantage plan unless she has ESRD.

Whether it is better to keep her on your insurance would depend upon your current coverage and cost compared to the coverage and cost of whichever plans are available to her in your area. There is no way anyone here can tell you which is better. You’ll need to visit a local agent that works with all of the major plans in your area. The agent can work with you and compare the plans and suggest which would be best based upon her health conditions.

Your Questions About Medicare Insurance Coverage Part D

James asks…

Hatch usually works with Dems on health care, did you see why he pulled out of negotiations?

“Hatch was one of a handful of Republicans involved in negotiations with Senate Finance Committee Chairman Max Baucus (D-Mont.) before dropping out two weeks ago…..

“The Democrats want a public option and they’re going to have a public option in the final bill,” Hatch said in reference to a proposal to create a broad government-run insurance program. He predicted that even if Baucus manages to pass a healthcare reform package with a membership-run co-op insurance plan instead of a government-run program, he would lose out to liberals in negotiations between the Senate and House.

“He’ll be crushed in the middle,” Hatch said of prospective Senate-House negotiations, adding that Democrats are intent on creating a system of “socialized medicine” in the United States.

Hatch pointed to what he considered major problems with Democratic healthcare reform proposals:

· They make no effort to curtail medical malpractice lawsuits, which Republicans claim cost $100 billion a year.

· Pending legislation could result in drastic cuts in Medicare payments to doctors and hospitals. Hatch said that doctors could see their reimbursements go down 25 percent and hospitals could see a 35 percent drop.

“The real problem is their ideas are out of this world,” he said of the Democrats’ healthcare proposals. “They’re saying they’re going to get $400-plus billion out of Medicare and Medicare is in debt right now.

“They’re going to pay doctors 25 percent less and going to pay hospitals 35 percent less and they think that system is going to work.”

A reform plan put together by House Democrats calls for $500 billion in Medicare cuts over the next decade to help pay for the cost of covering about 45 million Americans currently without healthcare insurance.

But this does not sit well with Republicans and conservative Democrats given Medicare’s projected insolvency within the next decade.

In May the Obama administration announced that Medicare is running out of funding faster than projected. Obama administration officials predict that Medicare’s Hospital Insurance Trust Fund will become exhausted by 2017.

Defenders of the House healthcare bill say the legislation would reinvest nearly $300 billion back into Medicare to increase payments to doctors. But that would still result in a net reduction of about $200 billion, which would be used to pay for expanded insurance coverage.

Hatch’s strong opposition is a troubling sign for Democrats because he has been party to some of the biggest healthcare bills to pass Congress in recent year.

He joined with Sen. Edward Kennedy in 1997 to create the State Children’s Health Insurance Program (SCHIP) to cover the kids of working-class parents who did not qualify for Medicaid.

Hatch also teamed up with Democrats to pass legislation expanding stem cell research in 2007, one of the first priorities of Democrats after they regained control of Congress.

Before the Democratic take-over, Hatch sided with Democrats in pressing former President George W. Bush to accept legislation that would have expanded SCHIP by $35 million over five years. Bush vetoed the legislation.

Hatch voted against an expansion of SCHIP when it came up for another vote earlier this year because Democrats rewrote the bill and excluded him from having input. Hatch said the version that passed in January made “a mockery of the original intent by expanding CHIP to cover people for whom the program was never intended.” The bill expanded health coverage in some parts of the country to the children of families earning up to $88,000.
What do you think?
Stonecold, the problem with the insurance industry is that the govt gave them preferences creating monopolies. I agree we need reform and I will look at that one. I like Ron Paul’s too. I just can’t stand what the Dems are pushing.
But I don’t think the govt has the right to mess with ins for those of us who don’t want their plan, now or after we lose our current plans Why don’t they just address preexisting conditions?

Medicare Insurance AZ staff answers:

He’s spot on.

…

By the way, I’ve not been negligent lately. Y!A has chosen not to alert me when you and my other contacts ask questions. It’s like I’m living in the no-zone lair.

…

Mary asks…

Which of the following provisions of the Senate HC Bill do you disagree with?

I know that the House HC Bill is better, and has public option. And that the Senate Bill will have to be reconciled with the House Bill, before each house again votes for the final product. Can CONSERVATIVES help me out, and help Congress by selecting the parts they don’t want in the final bill? Thanks! (from following list, please)

– Extend coverage to 31 million Americans, the largest expansion of coverage since the creation of Medicare.

– Ensure that you can choose your own doctor.

– Finally stop insurance companies from denying coverage due to a pre-existing condition.

– Make sure you will never be charged exorbitant premiums on the basis of your age, health, or gender.

– Guarantee you will never lose your coverage just because you get sick or injured.

– Protect you from outrageous out-of-pocket expenditures by establishing lifetime and annual limits.

– Allow young people to stay on their parents’ coverage until they’re 26 years old.

– Create health insurance exchanges, or “one-stop shops” for individuals purchasing insurance, where insurance companies are forced to compete for new customers.

– Lower premiums for families, according to the non-partisan Congressional Budget Office — especially for struggling folks who will receive subsidies.

– Help small businesses provide health care coverage to their employees with tax credits and by allowing them to purchase coverage through the exchanges.

– Improve and strengthen Medicare by eliminating waste and fraud (without cutting basic benefits), beginning to close the Medicare Part D donut hole, and extending the life of the Medicare trust fund.

– Create jobs by reining in costs — fostering competition, reducing waste and inefficiency, and starting to reward doctors and hospitals for quality, not quantity, of care.

– Cut the deficit by over $130 billion in the next 10 years.

Medicare Insurance AZ staff answers:

Conservatives would be against all of the improvements because:
1) They don’t want government mandates

2) They don’t want Democrats to get credit for making health insurance more fair, more affordable, and also improve competition between existing providers.

3) They haven’t read bills and believe any use of “government of the people, by the people, and for the people” to be socialism, marxist, or plain UN-American (like our current prosperity and freedoms haven’t come in part with government interventions)

But, that’s not all.
They have created lies, and falsehoods that promote fear, rather than look at the actual facts. We have nothing to fear, but not doing anything.

That would be a disaster, to leave health care in the hands of “for profit” corporate America, with hardly any regulations or competition, that benefit ordinary Americans, and taxpayers.

Good Question, I gave you a star

EDIT: Kojak: Then who will solve these problems?
Doris’s “facts” are listed before you, the improvements are factual, if signed into law.

Who else besides the FEDS can solve the problems you recognize?
The Nov 2008 elections were in part a referendum for action.

Government help for medical care was first suggested 100 yrs ago by Teddy Roosevelt, a Republican. Even Senator Lieberman was for a public option, at one time. (was he bought off?)

Public options and government regulations are not UNmanageable, and they will be efficient, and economical with “economy of scale.”

Huge overhead and extra admin costs result now from hundreds of health insurance payers, different companies and different forms that create massive paper work, and fraudulent multiple claims.

The Federal government now has “success” or experience with management of MEDICARE, MEDICAID, Social Security, IRS, CIA, FBI, Federal Highways, EPA, FDA, etc. The Federal Reserve System has saved our banking system from ruin, several times.

I trust the people, and “we” are the government.

Maria asks…

Another suboxone question?

I’ve been on 3 suboxone for two years. They are switching my insurance to medicare because I’m disabled. I think I’m gonna have to give up the subs. If I have a bunch, whats the best way to wean down? Give me a chart please. Like 2 a day for a week, then 1 1/2 a day for a week, then 1 a day for a weeek, then half a day for a week, then quarter a day for a week, then quarter every other day for a week, then done? sound good? I don’t want withdrawals. I’ve been through them so many times. They are switching me to medicare june first. I am so scared. Does anyone know if any part D coverage covers suboxone? I’ll cut down, but I don’t wanna give it up. I’m so scared. The government is changing my insurance, and its like a blindside. I cant even pick a medicare prescription plan till may 1st. My Masshealth paid for everything. I don’t get it. I’ve robbed pharmacy’s, I’ve pickpocketed, I’m a menace to society when I’m getting high. It’s in the government’s best interest to keep me on suboxone. It’s like a mirical. I dont crave. I dont get high. I am stable, and now they want to f*** me up. I just don’t get it.
Hey Lone! Thanks for the assumption. I am fine. Many people take 3 aday. Thats why masshealth pays for 3 a day. If it was too high, then the doc and ins would say something. I’ve done my research. I’ve made my decision. I don’t need snide remarks from a know it all. I am fine. I asked a simple question and you lecture me. U must be a peach to hang with. Loser. Don’t answer questions if your only goal is to insult the person asking. I’ve been to long term treatment many times. I’ve been locked up. Everything. My doctor and insurance came up with a medical option for me. I never I repeat never feel high. Never ever ever ever. I hope you feel good trying to knock people down. You probably trip blind people too huh? Whatever, I’m not gonna let one idiot ruin my day. U haven’t done 1/100th the research I’ve done. Keep your mouth shut. Tool
Lone blocked…..I love tech. How am I even thinking straight on such a whopping dose. I used to shoot up 5 80mg oxy every day for years. I tried one suboxone and still had cravings. Went to two and still had cravings. Went to three (which the insurance pays for so it must be a safe dose) and I have no cravings. I’m stable. I live life. I’m engaged. I take care of everything. I don’t need someone like Lone to come and knock me down. I will stand up for myself. It is not too high a dose for ME. see its different for everyone. If 3 a day was bad then ins wouldn’t pay. I’ve been on 3 for over two years with no problem. I’ll just slowly ween down. I gueess. Thanks for the help, I mean insult, It means alot to me. I’m glad I got the support.

Medicare Insurance AZ staff answers:

Sooner or later the Suboxone will stop working anyways, so you might better get off it before that happens.

24 mg’s a day is a WHOPPINGLY HUGE DOSE. That dose would KILL anyone who is not opiate dependent.

No one, and I mean no one needs that big a dose. I know hardcore heroin addicts that get by on 2 mg’s a day juts fine.

It seems more like you are worried about losing your free high than getting clean, and it sounds like you are anything BUT stable.

Can you say long term rehabilitation?

William asks…

Let’s change this law!?

The law that is plain stupid and costly to both taxpayers and to the government is the law which requires that I sign up for Medicare Parts A, B, and D upon my 65th birthday regardless of my circumstance. I have a wife and dependent son. As a retired person I have medical insurance. If I discontinue my medical insurance and sign up for Medicare A,B & D, my wife and son are without medical insurance. If, I continue my medical insurance then I pay for the supplemental insurance plus my premiums for my existing coverage (that covers also wife and son) so that the only ones that benefit are the insurance companies. Additionally, this option costs the taxpayer for the federally provided portion of Medicare A, B & D. So, both the taxpayer and the Government pay out unnecessarily for duplicate coverage. However, since I am currently insured (as is my wife and son) and I do NOT sign up for Medicare A, B, and D, I am penalized by the Federal Government (10% per year, for every year that I DON’T sign up and cost both myself and the taxpayer additional money). Why should anyone be penalized for having Medical Insurance? Why should I be REQUIRED to have duplicate coverage? Why should the taxpayer be required to pay for duplicate medical coverage? Like I said, stupid and costly.

Medicare Insurance AZ staff answers:

Right on get people talking this is a good idea. Starred

George asks…

Is anyone bothered at all by these statistics? Do we really have?

the best health care system? PLEASE just read through and tell me that something is really wrong when the greatest country in the world stacks up to other countries in the way we do.

Reports & statistics from the OECD:

• Half of all bankruptcies IN THE US are caused by medical bills
• Three-quarters of those filings are by people with health insurance.
• The average overhead cost for U.S. private health insurers is 11.7%; for Medicare, it is 3.6%; for Canada’s national health insurance program, it is 1.3 %
• A baby born in El Salvador has a better chance of surviving than a baby in Detroit.
• The infant mortality rate in Detroit is 15.5, compared to El Salvador’s rate of 9.7.12
• Over the next decade, the US federal government will give the drug & health care industries an estimated $822 billion as a result of the 2003 Medicare Part D (Medicare prescription drug plan).
• There are four times as many health care lobbyists in Washington as there are members of Congress
• There are 100 times more lobbyists of all stripes in Washington today than there were during the Reagan presidency.
• 90% of Americans believe the American health care system needs fundamental changes or needs to be completely rebuilt. 75% of Americans believe the federal government should guarantee universal health care for all citizens.
Life expectancy

1. San Marino …….. 80
2. Australia ……….. 79
3. Cyprus …………. 79
4. Iceland…………. 79
5. Israel……………. 79
6. Japan………….. 79
7. Sweden………… 79
8. Switzerland…… 79
9. Andorra………… 78
10. Canada…………. 78
11. Italy……………… 78
12. Monaco……….. 78
13. Netherlands…. 78
14. New Zealand .. 78
15. Norway………… 78
US 38th on list

LOWEST INFANT MORTALITY (RATE per THOUSAND BIRTHS)

1. Singapore….. 2.31
2. Bermuda…… 2.46
3. Sweden……… 2.75
4. Japan………… 2.79
5. Iceland…….. 3.23
6. France ………. 3.33
7. Finland……. 3.47
8. Anguilla…… 3.52
9. Norway…….. 3.58
10. Malta……….. 3.75
11. Andorra…… 3.76
12. Czech Republic … 3.79
13. Germany……… 3.99
14. Switzerland….. 4.18
15. Spain ………….. 4.21

2007- United States Infant Mortality Rate Average = 6.37 Deaths per 1000 Live Births

One of the worst, AFGHANISTAN, is at 152 deaths per 1000…..

TOP FIVE – CHILD DEATHS – DUE TO MALTREATMENT SOURCE – UNICEF

1. Mexico: …………. 2.2 per 100,000 children
2. United States:.. 2.2 per 100,000 children
3. Hungary:……….. 1.2 per 100,000 children
4. New Zealand:… 1.2 per 100,000 children
5. Austria: …………. 0.9 per 100,000 children

TOP FIVE — CHILD POVERTY – SOURCE: UNICEF

# 1. Mexico:……… 26.2
# 2. United States:.. 22.4
# 3. Italy:…………… 20.5
# 4. United Kingdom:. 19.8
# 5. Turkey:……….. 19.7

2008 – FORBES – TOP TEN – OVERALL HEALTHIEST COUNTRIES

1. ICELAND
2. SWEDEN
3. FINLAND
4. GERMANY
5. SWITZERLAND
6. AUSTRALIA
7. DENMARK
8. CANADA
9. AUSTRIA
10. NETHERLANDS

** USA was #11!

Among the OECD’s 30 members – (which include Australia, Austria, Belgium, Canada, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, South Korea, Luxembourg, the Netherlands, New Zealand, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland, and the United Kingdom) – there are only 3 members lacking universal health coverage[. Two of them, Mexico and Turkey, have the excuse of being poorer than the rest (and until the onset of the world economic crisis, Mexico was on the way to providing healthcare to all of its citizens).

The third, of course, is the United States.
Maxwell, that's too bad. The stats are NOT mine. They are from the OECD. So you think they just make up numbers that are not true? That's about as logical as the birther movement.

Medicare Insurance AZ staff answers:

As someone who works closely with the medical insurance industry, I know all about those stats, man.

I’m just surprised people are this ignorant to assume that nothing should be done about it. Obama is, at least, thinking in the right direction even if his ideas are not embraced.

Your Questions About Medicare Part D

William asks…

What is the deal with Medicare part D? Is it right for most everybody?

Medicare Insurance AZ staff answers:

If you have drug coverage from Tricare,the VA, employee or retiree coverage (check with the benefits administrator to see if it’s creditable) then you usually are better off keeping that coverage. Medicare accepts creditable coverage, which means if you have a prescription drug benefit that is at least as good as Medicare coverage, you can keep it.

Ken asks…

I have part D medicare, yet their is one of my meds they will not pay for. I have contacted various places for?

contacted the drug company and they will not help because we make too much money, of course they don’t take into consideration that the difference between income and bills. I have also contacted various agencies for help and no way…do any of you have any suggestions for me?

Medicare Insurance AZ staff answers:

You should go through the appeal process, according to the Medicare website. It says:

“What can I do if my Medicare drug plan says it won’t cover or pay for a drug that my doctor prescribed for me?
If your Medicare drug plan decides that it won’t cover or pay for a prescription drug, it must tell you in writing why the drug isn’t covered. This written decision is called a coverage determination or “Notice of Denial of Medicare Prescription Drug Coverage.” You should read this decision carefully because it will explain how to ask for an appeal. You have the right to ask for an appeal if your Medicare drug plan says it won’t cover or pay for a prescription drug. You should also talk to your doctor about whether you can take another drug that your Medicare drug plan covers.”

As part of your appeal, I suggest you have the doctor include a letter of exactly why you need it.

(My insurance company once refused to pay for my bone density scan. My dr. Wrote them a letter, calling then “dunderheads” and then saying if it were not paid, he would refer it to the state insurance commissioner. The insurance company then paid for it upon appeal).

John asks…

Why isn’t Medicare part D refered to as BushCare since Bush signed it to law? Why is ObamaCare so special?

Medicare Insurance AZ staff answers:

Susan asks…

Need Help with medicare part D?

Questions about Medicare Part D For NewJersey?
Question #1. If you are on disability that is SSDI and under the age of 65 and on medicare part A and B, do you have to sign up for Medicare Part D?

Question #2. If you are on medicare part A and B no matter what age no matter what reason, is it voluntary to sign up for medicare part D, or is it a choice? does one have the freedom of choice? Or does medicare automatically sign you up?

Question #3. If you are a patient that was on hospice for 5 years and then discharged because you outlived the doctors prognosis does medicare automatically sign you up for medicare part D? and would a patient have to pay a penalty for something that was out of their control? This patient has medicare part A and B.

Medicare Insurance AZ staff answers:

NOTE: This is a better option versus trying to find a Medigap policy that includes Part D. They are called Medicare Complete policies and they even show Medicare Health Insurance Plans by States.

Http://www.medicaresolutions.com/

When you click on New Jersey, this is just one paragraph of what it says–New Jersey’s Pharmaceutical Assistance to the Aged and Disabled (or PAAD) program is a state funded prescription program which helps income eligible New Jersey residents with the costs of prescription medication. Drugs purchased outside the state of New Jersey are not covered and neither are pharmaceutical products whose manufacturer has not signed a rebate agreement with the state of New Jersey. Individuals looking to obtain Medicare insurance and specifically Medicare Prescription Drug coverage often have questions about the relationship between Medicare Part D and PAAD

NOTE: You should consider getting a Medigap policy that includes Medicare Part D. There are many plans out there that offer this option.

Here is a link concering Medicare Part D–http://mypartdusa.com/

NOTE: The answer below addresses all three of your questions above.

You always have to take the initiative to sign up and it is voluntary, even though there may be a penalty if you don’t sign up when eligible.

I believe (although I’m not positive on this so call up your local Social Security Office) that while under hospice, if medicines were included, you can still enroll in Medicare part D without penalty.

Of course, it’s always best to call your local Social Security Office or you can call the national 800 number at 1-800-772-1213.

If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible–This is under the section (click on the first link below)–How does Medicare prescription drug coverage work?

When can I get Medicare prescription drug coverage?

You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don’t sign up when you are first eligible, you may pay a penalty. If you didn’t join when you were first eligible, your next opportunity to join will be from November 15, 2009 to December 31, 2009.

Http://www.medicare.gov/pdp-basic-information.asp#whympdc

There are also prescription cards you can get through private companies that might be just as good though.

RxAssist provides medicines to people who can’t afford to buy medicines.–http://www.rxassist.org/

There’s Partnership for Prescription Assistance–http://www.pparx.org/

Special Reduced and Free Prescription Drug Programs

http://www.peoples-law.org/health/charity-care/special_drug.htm

There are discount drug cards–http://www.needymeds.org/indices/discountcards.shtml

Daniel asks…

Medicare part D?

what is medicare part D?

Medicare Insurance AZ staff answers:

This is a very large subject.Medicare Part D is the Medicare prescription drug program that goes

into effect on January 1, 2006.

“Explaining Medicare‘s New Drug Plan—Not An Easy Task,” by Betsy White

Booz (July 21, 2005)

Town Times

http://www.towntimes.com/articles/2005/07/21/news/local_news/news11.txt

An official page concerning this program is:

“Your Medicare Prescription Drug Coverage Options”

Medicare.gov

http://www.medicare.gov/MPCO/Home.asp

Your Questions About Medicare Insurance Coverage Gap

Mary asks…

Question on Medicare Part D?

I totally do not understand how ALL the Medicare Part D plans work. I’m told there is what they call a Dough-nut hole, or Coverage gap period in ALL the different plans, in where you have to keep paying some company your monthly premiums, but your actually have no coverage on your prescription medicine discounts. During this period you have to pay regular high prices for your prescription medicine. This seems crazy to me. Would be like buying Life insurance, and paying a monthly premium twelve months out of the year, but if you should die between July and December you have no coverage, ONLY if you die between Jan. and June. I would appreciate it so much if someone out there could explain to me how this Part D works, and why it is set up the way it is, I just don’t get it. Thank you so much for your help.

Medicare Insurance AZ staff answers:

I took a course on health care systems and we learned a lot about Medicare. Part D is drug coverage. I’m not sure on the exact number amounts, but if you have costs ranging from $1.000-$3,000 (this is just an estimate), then that’s the Basic level and they’ll cover 50% of your bills and you’ll have to pay for the other 50%. If your bills are anywhere from $3,00-$5,000, then that’s the Donut Hole, and you’ll have to pay for 100% of it. Basically, since it’s not Basic and it’s not Catastrophic, you have to take care of it. If your costs are in the Catastrophic level, for example $5,000+, they’ll pay for 95% of it and you’ll pay the remaining 5% of your bill. You can find more information on the Medicare website. You can search it in Google.

Sandra asks…

How did Obama bribe his way to getting the health bill passed?

As the suicidal Democratic congressmen proceed to rubber-stamp the Obama healthcare reform despite the drubbing their party took in the ’09 elections, the president trotted out the endorsements of the AMA and the AARP to stimulate support. But these – and the other endorsements – his package has received are all bought and paid for.
Here are the deals:
The American Medical Association (AMA) was facing a 21 percent cut in physicians’ reimbursements under the current law. Obama promised to kill the cut if they backed his bill. The cuts are the fruit of a law requiring annual 5 percent to 6 percent reductions in doctor reimbursements for treating Medicare patients. Bravely, each year Congress has rolled the cuts over, suspending them but not repealing them. So each year, the accumulated cuts threaten doctors. By now, they have risen to 21 percent. With this blackmail leverage, Obama compelled the AMA to support his bill…or else!
The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.
Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP — which supposedly represents them — will make more money. (If this galls you, join the American Seniors Association, the alternative group; contact sbarton@americanseniors.org. This e-mail address is being protected from spambots. You need JavaScript enabled to view it .)
The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs. (A drop in the bucket of their almost $3 trillion projected cost over the next decade.) They also got administration assurances that it will continue to bar lower-cost Canadian drugs from coming into the U.S. All it had to do was put its formidable advertising budget at the disposal of the administration.
Insurance companies got access to 40 million potential new customers. But when the Senate Finance Committee lowered the fine that would be imposed on those who don’t buy insurance from $3,500 to $1,500, the insurance companies jumped ship and now oppose the bill, albeit for the worst of motives.
The only industry that refused to knuckle under was the medical device makers. They stood for principle and wouldn’t go along with Obama’s blackmail. So the Senate Finance Committee retaliated by imposing a tax on medical devices such as automated wheelchairs, pacemakers, arterial stents, prosthetic limbs, artificial knees and hips and other necessary accoutrements of healthcare.
So these endorsements are not freely given, but bought and paid for by an administration that is intent on passing its program at any cost.

Medicare Insurance AZ staff answers:

He could sell an electric razor to an Amish man. Everybody just believes Obama. I don’t. Wake up America.

Betty asks…

Does any one know the real reason that the AMA and AARP are supporting Obamacare ?

Here are the deals:

* The American Medical Association (AMA) was facing a 21 percent cut in physicians’ reimbursements under the current law. Obama promised to kill the cut if they backed his bill. The cuts are the fruit of a law requiring annual 5-6 percent reductions in doctor reimbursements for treating Medicare patients. Bravely, each year Congress has rolled the cuts over, suspending them but not repealing them. So each year, the accumulated cuts threaten doctors. By now, they have risen to 21 percent. With this blackmail leverage, Obama compelled the AMA to support his bill…or else!

* The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.

Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP — which supposedly represents them — will make more money. (If this galls you, join the American Seniors Association, the alternative group; contact sbarton@americanseniors.org. This e-mail address is being protected from spambots. You need JavaScript enabled to view it .)

* The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs. (A drop in the bucket of their almost $3 trillion projected cost over the next decade.) They also got administration assurances that it will continue to bar lower-cost Canadian drugs from coming into the U.S. All it had to do was put its formidable advertising budget at the disposal of the administration.

* Insurance companies got access to 40 million potential new customers. But when the Senate Finance Committee lowered the fine that would be imposed on those who don’t buy insurance from $3,500 to $1,500, the insurance companies jumped ship and now oppose the bill, albeit for the worst of motives.

The only industry that refused to knuckle under was the medical device makers. They stood for principle and wouldn’t go along with Obama’s blackmail. So the Senate Finance Committee retaliated by imposing a tax on medical devices such as automated wheelchairs, pacemakers, arterial stents, prosthetic limbs, artificial knees and hips and other necessary accoutrements of healthcare.

Medicare Insurance AZ staff answers:

Because obama is in bed with them as he is with everyone! These people truly do NOT know what and who they voted in!

Ruth asks…

do you wonder how this healthcare unread bill passed the house?

Obamacare Endorsements: What the Bribe Was
Sunday, November 8, 2009 10:39 AM
By: Dick Morris & Eileen McGann
As the suicidal Democratic congressmen proceed to rubber-stamp the Obama healthcare reform despite the drubbing their party took in the ’09 elections, the president trotted out the endorsements of the AMA and the AARP to stimulate support. But these – and the other endorsements – his package has received are all bought and paid for.
Here are the deals:
The American Medical Association (AMA) was facing a 21 percent cut in physicians’ reimbursements under the current law. Obama promised to kill the cut if they backed his bill. The cuts are the fruit of a law requiring annual 5 percent to 6 percent reductions in doctor reimbursements for treating Medicare patients. Bravely, each year Congress has rolled the cuts over, suspending them but not repealing them. So each year, the accumulated cuts threaten doctors. By now, they have risen to 21 percent. With this blackmail leverage, Obama compelled the AMA to support his bill…or else!
The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.
Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP — which supposedly represents them — will make more money. (If this galls you, join the American Seniors Association, the alternative group; contact sbarton@americanseniors.org. This e-mail address is being protected from spambots. You need JavaScript enabled to view it .)
The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs. (A drop in the bucket of their almost $3 trillion projected cost over the next decade.) They also got administration assurances that it will continue to bar lower-cost Canadian drugs from coming into the U.S. All it had to do was put its formidable advertising budget at the disposal of the administration.
Insurance companies got access to 40 million potential new customers. But when the Senate Finance Committee lowered the fine that would be imposed on those who don’t buy insurance from $3,500 to $1,500, the insurance companies jumped ship and now oppose the bill, albeit for the worst of motives.
The only industry that refused to knuckle under was the medical device makers. They stood for principle and wouldn’t go along with Obama’s blackmail. So the Senate Finance Committee retaliated by imposing a tax on medical devices such as automated wheelchairs, pacemakers, arterial stents, prosthetic limbs, artificial knees and hips and other necessary accoutrements of healthcare.
So these endorsements are not freely given, but bought and paid for by an administration that is intent on passing its program at any cost.
© 2009 Dick Morris & Eileen McGann

Medicare Insurance AZ staff answers:

The Dems didn’t care what it said…as long as it passed. Just like everything else.

William asks…

Have any of you read this article today about healthcare reform?

I have copy and pasted it below. Is this accurate? If so, it does not really sound so bad like some people are thinking. I am an independent and fiscally conservative. I have always been but something REALLY needs to happen about our crazy healthcare system. I am a healthy 38 year old female and pay through the roof for health care and it is ridiculous. I am self-employed and make 100k+ per year. I am NOT a fan of Obama but something had to change and lets face it….if ALL republicans were in power I am almost sure nothing would happen.
Congress approved a major overhaul of the nation’s health care system for President Barack Obama’s signature. Here are some of the features of the legislation.

HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 94 percent of eligible non-elderly Americans would have coverage, compared with 83 percent today.

COST: $938 billion over 10 years, according to the Congressional Budget Office.

INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine, which takes effect in 2014. There is an exemption for low-income people.

INSURANCE MARKET REFORMS: Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear. Major consumer safeguards would also take effect in 2014. Insurers would be prohibited from denying coverage to people with medical problems or charging them more. Insurers could not charge women more.

MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of costs for covering newly eligible individuals through 2016.

If the Senate approves a package of changes this week, a special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity would be eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.

TAXES: To make up for the lost revenue, the bill applies an increased Medicare payroll tax to the investment income and to the wages of individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent. If the Senate follows through, it would impose a 40 percent tax on high-cost insurance plans above the threshold of $10,200 for individuals and $27,500 for families. The tax would go into effect in 2018.

PRESCRIPTION DRUGS: Gradually closes the “doughnut hole” coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare‘s catastrophic coverage kicks in.

EMPLOYER RESPONSIBILITY: Employers are hit with a fee if the government subsidizes their workers’ coverage. The $2,000-per-employee fee would be assessed on the company’s entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement.

SUBSIDIES: The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.

GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.

ABORTION: The bill tries to maintain a strict separation between taxpayer dollars and private premiums that wou
I got this news from yahoo finance.
http://finance.yahoo.com/news/A-look-at-the-health-care-apf-3833703794.html?x=0&sec=topStories&pos=1&asset=&ccode=

Medicare Insurance AZ staff answers:

Doesn’t sound too bad? Of course it doesn’t this is only part of the bill… Where did you get this from because I would like to know where the rest of the information that is in the bill and is not mentioned in your cut and paste…

Then of course, there’s the items in the ‘reconciliation bill’ that have absolutely nothing to do with health care or insurance… But i suppose if you only focus on the piece of the ice berg sticking out of the water, all appears well – if you don’t think that is the case ask yourself how it is remotely possible to summarize 2700+ pages of legislation in roughly 2 pages?

Your Questions About Medicare Supplement Insurance

Ken asks…

Now I am asking about Medicare and retirement!?

OK, I am 56 and I have employer medical insurance. When I turn 65, I get medicare insurance. So far, so good with my understanding. So what about all those medicare insurance “supplement insurances, such as AARP, etc. I see on tv? Do you pay for them, or use them to ‘enhance; medicare, etc, etc.? I guess – are they worth it? I will still be working, have my employer medical insurance. My goal is to work to age 70,,, Anything you can tell me about medicare, so I can compare it to my employer insurance of NOW, would be appreciated.

Medicare Insurance AZ staff answers:

I have Medicare and Blue Cross/Shield supplemental insurance. It works fine! I can go to any Dr or hospital I want. The cost of the BC/S is subsidized by my former employer. I retired at 61 and regret I didn’t do it sooner. Retirement is a blast!

Sharon asks…

Does anyone know if I can buy more coverage for Medicare?

The Veteran’s administration is my main medical insurance but I also have medicare A and B.

Can I purchase a supplement insurance for optical insurance? I.E. Glasses and lasix surgery?

Medicare Insurance AZ staff answers:

Supplementing your current insurance with a good vision plan is a great idea. The vision plan site below has two plans you can choose from.

Richard asks…

My wife is eligible for medicare. I am going on cobra insurance. Should I keep paying for her insurance ?

My medical insurance plan had a $1200 deductible and $25 co pay.
We do plan on paying for b supplement right at the start.

Medicare Insurance AZ staff answers:

Go for it!

Pay for your cobra and put her on Medicare, making sure you have a supplement for B and drugs.

Your bank account will thank you!

John asks…

If health insurance copay for generic drug is more than the price of drug what do you pay?

I am looking at medicare supplement plans. Most plans say they cover generic drugs. The copay for one plan for a 30 day supply of a generic drug is $10. Suppose the generic drug is one that Wal-mart charges $4 for a 30 day supply. What do you pay; $4 or $10?

Medicare Insurance AZ staff answers:

The way my plan works is you pay the copay or the cost of the drug, whichever is less. For example, I have a $10 copay for generic drugs. I recently filled a prescription that only cost $8, so I only paid $8. I’m pretty sure this is the way it works with most plans, but it’s always a good idea to double check. Contact the customer service line for the plans you are interested in. Good luck.

Sandra asks…

need to find answers to medicare supplement?

trying to sign up for medical insurance thru american senior choices

Medicare Insurance AZ staff answers:

So call and ask them to send you the information

Your Questions About Medicare Supplemental Insurance Coverage

Paul asks…

Supplemental Plan for Children’s Health Insurance Program?

My child is enrolled in the children’s health insurance program (CHIP) and some of her claims are not fully covered by CHIP, are there any supplemental programs or plans available to her? (For example, my grandparents are enrolled in medicare and have a plan called Care Improvement Plus that compliments her Medicare coverage) Do you know of any companies or programs that would do that for kids? or can they do that?

Medicare Insurance AZ staff answers:

Healthquotes.awardspace.info – here is my health insurance plan. As I remember they can provide such a service.

Daniel asks…

All it took to sway a Senator from his so called conviction was this?

Nelson also secured full and permanent federal funding for his state to extend Medicaid eligibility to everyone below 133 percent of the federal poverty level. The bill would require all states to do so, but Nebraska alone would not be required to pay a portion of the additional cost after 2016. Nelson also won concessions for qualifying nonprofit insurers and for providers of supplemental Medicare coverage from a new insurance tax, and he was able to roll back cuts to health savings accounts.

Man had convictions didn’t he?

Medicare Insurance AZ staff answers:

Can I resign my citizenship so I don’t have to pay the $750 penalty for not having healthcare insurance? I can’t even afford that! Are they going to throw me in jail because I’m POOR?

Republican from before she was born… And PROUD of it.

George asks…

my 85 year old dad’s retiree health plan was phased out and i need to find him new insurance.?

he is covered mostly be medicare but needs supplemental insurance. I have no idea where to find reputable insurers or don’t even know what really to look for. I feel so lost. He needs good coverage. Does anyone know of a good, unbiased source of info or can offer any tips

Medicare Insurance AZ staff answers:

You should contact a local independent insurance agent by phone where you live and get some recommendations for supplemental insurance plans which costs about $150-200 or so per month depending on the company and your area. He has to have Medicare in order to get supplemental insurance.

Sandra asks…

Medigap insurance coverage?

My mom was in the hospital after having part of her leg amputated, now she’s in a skilled nursing home. My mom had Medicare and Anthem Senior Select supplemental. The nursing home told us that Anthem doesn’t cover the co-pay after Medicare stops paying 100 percent. I thought that was the purpose of having medicap insurance.

Medicare Insurance AZ staff answers:

Medicare only covers part of nursing care for up to 100 days after surgery. Medigap does not cover long term care because Medicare does not cover it. Medicare covers limited nursing after surgery.If she has Original Medicare, Medicare covers the first 20 days, then you pay $137.50 for 21 to 100 days in nursing and after 100 days Medicare will not pay anything and neither does Medigap.

The purpose of Medigap is to cover the 20% of medical costs except for long term nursing care.

What she needed was long term care insurance but it is too late to buy it after the fact.

Chris asks…

What is the best medicare supplement for Oklahoma residents?

I am 52 years old, single, and recently was approved for Medicare Parts A & B. I need Diabetic, Thyroid, and Pain medications. I would like some input from any Oklahoma residents who have had some experience with different supplemental insurances. Does anyone recommend the AARP prescription coverage?

Medicare Insurance AZ staff answers:

I sell all of the major plans in my state and can tell you there is no one plan that is any better than the others in all situations.

You’ll need to check each plan available in your area, or find a local agent that can do it for you, to find out the following:

1. Are your medications covered and on what tier level. Most generics are at tier 1 with a copay of around $5 but other companies can put the same drug on tier three with a copay of around $80. There is one generic pain med that in my state is on tier 4 or 5 (with a co-pay of $800 per month) with all of the companies except one, where it is a $6 co-pay.

2. Are the tier levels a flat copay or are they a percentage. Drug costs change during the year so a plan with a percentage can cost more later in the year.

3. Do you go into the donut hole and what are the costs at that time. You pay 100% of the negotiated cost during the donut hole and each insurance company will have a different cost with the pharmaceutical companies. That generic drug I spoke of cost $2800 in the donut hole but with that one company it is still just $6. Big difference for that client.

4. If you come out of the donut hole how much do they cost at that time. Some plans will cover some meds through the donut hole but often the premium far outweighs the cost savings.

5. If you do mail order on your maintenance medications how much do they cost. Different plans will have better savings using mail order than others. One plan can be more cost effective if you use local pharmacies while another plan can be more cost effective if you use mail order.

6. What time of year do you get the plan. Plans with deductibles can be more cost effective earlier in the year while plans without deductibles could be more cost effective later in the year.

7. Plans with deductibles have a lower premium and often cost less over the year than plans without deductibles.

8. What are you getting for your health coverage? Many Medicare Advantage plans also include drug coverage and are often a better overall deal. I’ve sold very few AARP stand-alone prescription plans this year but the AARP Medicare Advantage plan has consistantly come in amongst the better plans for many clients so you can’t go by company name.

9. Plans, the drugs covered, the costs, and your needs will change each year so you’ll have to do this comparison each year. I often change my clients to different companies each year if any plan becomes better for them. Companies that I sold more of last year are not the same companies I’m selling more of this year.

Your Questions About Medicare Insurance Coverage Part D

Daniel asks…

how many lie has the RNC told about healthcare reform?

(http://www.newsweek.com/id/214254/output/print)

The Five Biggest Lies in the Health Care Debate
By Sharon Begley | NEWSWEEK
Published Aug 29, 2009
From the magazine issue dated Sep 7, 2009
To the credit of opponents of health-care reform, the lies and exaggerations they’re spreading are not made up out of whole cloth—which makes the misinformation that much more credible. Instead, because opponents demand that everyone within earshot (or e-mail range) look, say, “at page 425 of the House bill!,” the lies take on a patina of credibility. Take the claim in one chain e-mail that the government will have electronic access to everyone’s bank account, implying that the Feds will rob you blind. The 1,017-page bill passed by the House Ways and Means Committee does call for electronic fund transfers—but from insurers to doctors and other providers. There is zero provision to include patients in any such system. Five other myths that won’t die:
You’ll have no choice in what health benefits you receive.
The myth that a “health choices commissioner” will decide what benefits you get seems to have originated in a July 19 post at blog.flecksoflife.com, whose homepage features an image of Obama looking like Heath Ledger’s Joker. In fact, the House bill sets up a health-care exchange—essentially a list of private insurers and one government plan—where people who do not have health insurance through their employer or some other source (including small businesses) can shop for a plan, much as seniors shop for a drug plan under Medicare part D. The government will indeed require that participating plans not refuse people with preexisting conditions and offer at least minimum coverage, just as it does now with employer-provided insurance plans and part D. The requirements will be floors, not ceilings, however, in that the feds will have no say in how generous private insurance can beNo chemo for older Medicare patients.
The threat that Medicare will give cancer patients over 70 only end-of-life counseling and not chemotherapy—as a nurse at a hospital told a roomful of chemo patients, including the uncle of a NEWSWEEK reporter—has zero basis in fact. It’s just a vicious form of the rationing scare. The House bill does not use the word “ration.” Nor does it call for cost-effectiveness research, much less implementation—the idea that “it isn’t cost-effective to give a 90-year-old a hip replacement.”
The general claim that care will be rationed under health-care reform is less a lie and more of a non-disprovable projection (as is Howard Dean’s assertion that health-care reform will not lead to rationing, ever). What we can say is that there is de facto rationing under the current system, by both Medicare and private insurance. No plan covers everything, but coverage decisions “are now made in opaque ways by insurance companies,” says Dr. Donald Berwick of the Institute for Healthcare Improvement.
A related myth is that health-care reform will be financed through $500 billion in Medicare cuts. This refers to proposed decreases in Medicare increases. That is, spending is on track to reach $803 billion in 2019 from today’s $422 billion, and that would be dialed back. Even the $560 billion in reductions (which would be spread over 10 years and come from reducing payments to private Medicare advantage plans, reducing annual increases in payments to hospitals and other providers, and improving care so seniors are not readmitted to a hospital) is misleading: the House bill also gives Medicare $340 billion more over a decade. The money would pay docs more for office visits, eliminate copays and deductibles for preventive care, and help close the “doughnut hole” in the Medicare drug benefit, explains Medicare expert Tricia Neuman of the Kaiser Family Foundation.
Illegal immigrants will get free health insurance.
The House bill doesn’t give anyone free health care (though under a 1986 law illegals who can’t pay do get free emergency care now, courtesy of all us premium paying customers or of hospitals that have to eat the cost). Will they be eligible for subsidies to buy health insurance? The House bill says that “individuals who are not lawfully present in the United States” will not be allowed to receive subsidies.
The claim that taxpayers will wind up subsidizing health insurance for illegal immigrants has its origins in the defeat of an amendment, offered in July by Republican Rep. Dean Heller of Nevada, to require those enrolling in a public plan or seeking subsidies to purchase private insurance to have their citizenship verified. Flecksoflife.com claimed on July 19 that “HC [health care] will be provided 2 all non US citizens, illegal or otherwise.” Rep. Steve King of Iowa spread the claim in a USA Today op-ed on Aug. 20, calling the explicit prohibition on such coverage “functionally meaningless” absent mandatory citizenship checks, and it’s now gone viral. Can we say that none of the estimated 11.9 million illega

Medicare Insurance AZ staff answers:

Countless. Conservatives never wanted health care reform in the first place, like they never wanted Medicare. The definition of conservative is opposed to change, and there is apparently more money in working for insurance companies than there is in working for the public. It appears that they will do everything they can to water down the bill and then not vote for it anyway, since they can’t kill it altogether. The plan seems to be to block the public option so the insurance companies won’t have any competition and can continue to raise premiums, causing the number of uninsured to increase. If they require those people who can’t afford it now to buy from private insurance companies, as the premiums go up and coverage goes down, they can blame the Democrats, because Conservatives won’t even vote for the bill after they have ruined it. The fact that health care reform is President Obama’s top priority gives them another unreasonable reason to work to make it fail. If so many people didn’t stand to lose so much you could almost feel sorry for the party, which is disintegrating before our eyes and stubbornly goes deeper into the elitism, bitter partisanship, and obstructionist policies that got them into trouble in the first place.

Thomas asks…

McCain`s Health Plan Spread Wealth FROM Elderly/Disabled TO the rich Insurance Co.s? ?

What if your Health care plan at work only costs $700? But McCain`s $5,000 “Tax Break” goes right to the insurance co.s Mean while the poor, disabled and elderly, Who by the way paid into Medicare/Medicade all there lives with the promise that they would be covered, will have there benefits cut to the tune $1.3TRILLION over 10 years! Didn’t Bush just do this same thing for the Rx co.s with “Part D Rx coverage. My part D plan requires that I meet a $3,600 deductible(every 6 months) before it will cover my meds. The state has to pick up the differance. $3,600 Thats 1/2 of my income for 6 months. But the Rx co.s got a sweet deal, the Gov. can not have other countries bid for drugs so they charge GREATLY inflated prices that the tax payer is stuck with. This is much like McCain’s Health care plan Another huge “Gimme” for the insurance Co.s and the disabled ,poor and elderly get SCREWED! Why should he care we pay for his health care and he has $100,000,000.**
http://firstread.msnbc.msn.com/archives/2008/10/06/15

Medicare Insurance AZ staff answers:

Good points. There is a way to help RX companies with new research called grants. This would help them originate new treatments without a heavy burden left to pay and it would bring cost down for insurers as well as those who have no RX plans. The best way to pay for the lower and mid income levels is to assess their incomes and allow them to buy in to a plan that regulates costs fairly and then the state buying the leftover unpayable amount by the person who doesn’t have enough to pay the co pays. It lets state/federal funds reach further and people to get what they need. The other part is that the systems work together. They are not playing games to hold more and more wealth to gain pure investment profit for CEOs and higher management or investors only. They fulfill their actual purpose first as money managers and tragic loss funds.

Tax credits to people encourage higher price because the companies know they can now get it.

Obama will do something similar to grants and efficient working of programs with minimal taxes and will repeal bush tax cut to wealthy. McCain will be problamatic as free market healthcare with no controls is not working. What competition is there when more need exists than is being purchased due to too high of cost. Normally demand will bring high cost, but with healthcare purchases not being made to match need and price continuing to rise because it can, demand will grow and no one gets paid, so providers become less. It is a royal mess. We do not need to continue this path and McCains plans will do that.

David asks…

When disability pay is gone, does Pepsico still give me full medical coverage?

I am trying to prepare for Medicare and I am not sure I will need it. It is impossible to get a hold of a real person at Pepsico so I am posting here.

I am on disability from Pepsico and now have medical coverage that I pay for. When my disability is gone, am I allowed to keep my medical coverage with Pepsico. They send a letter saying that yes I will be covered if I do NOT take part D with Medicare. They said nothing about the health insurance. I cannot seem to get answers from anyone. I am trying to figure all of this out before I turn 65 in a few months.

Thank you

Medicare Insurance AZ staff answers:

Will you still be disabled? Can you retire disabled and get your medical coverage?

You probably won’t get full medical coverage without paying some portion of the premium….isn’t medical coverage the same as health insurance?

Robert asks…

Help with Medicare? I need advice.?

Sorry, if this is a pain. I am really confused and need help.
I am on disability and get Social Security.
My one year waiting period for Medicare is almost up. I got my Medicare Card in the mail with booklet that I have read 3 times and went online. I am more confused than ever!
I am 41.
I know I get part A and B for 115.00 month. I take a lot of medication so I want a good drug coverage for my part D but I have to be certain with my plan that all medication is covered.
Do I need Medigap? If so I could not find the price? Then I read about Medicare Advantage Plans….is this needed?
Then everyone says you need supplemental insurance. Do I? How does that work and what plan should I go with if needed?
Sorry for asking so many questions. I am just really confused here!
I talked to AARP and other companies already. The issue I have is my age being 41 and I don’t qualify for a lot of options out there. That is why I am confused with all of this. I have contacted local private agencies (like Humana). I can get it from them but due to my age and preexisting conditions, I will be paying out A LOT more due to those factors. But, if I was 65 there would be no problem.

Medicare Insurance AZ staff answers:

1. Medigap is a privately paid insurance supplemental plan to cover the 20% of costs that Medicare does not cover. It has no connection to Medicare. You have to call an insurance company to buy this type of policy and it costs about $125-150 a month. If you dont get a Medigap supplementary policy then you are responsible for that 20% of your costs that Medicare wont cover.

2. If you have Medicare Advantage which is like an HMO, that includes your Part D drug plan. If you choose Original Medicare, then you have to add a drug plan which are on the open market to purchase and you have to find out which one covers your drug.

3. Part A is automatic for almost everyone. Part B is what you will be paying your monthly premiums for. Part B covers outpatient costs.

4. Medicare Part D does not cover every medication and every year it covers fewer brand names so you might have to get a generic or similar drug.

Laura asks…

Is this really supposed to help health care?

Obamacare:

1) Individual Mandate Excise Tax
2) Employer Mandate Tax
3) Surtax on Investment Income
4) 40% Excise Tax on Comprehensive Health Insurance Plans
5) Hike in Medicare Payroll Tax
6) Medicine cabinet tax.
7) HSA Withdrawal Tax Hike
8) Flexible Spending Account Cap – aka“Special Needs Kids Tax”
9) Tax on Medical Device Manufacturers
10) Raise “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI
11) Tax on Indoor Tanning Services
12) Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
13) Blue Cross/Blue Shield Tax Hike
14) Excise Tax on Charitable Hospitals
15) Tax on Innovator Drug Companies
16) Tax on Health Insurers
17) $500,000 Annual Executive Compensation Limit for Health Insurance Executives
18) Employer Reporting of Insurance on W-2
19) Corporate 1099-MISC Information Reporting
20) “Black liquor” tax hike
21) Codification of the “economic substance doctrine”

http://www.atr.org/comprehensive-list-tax-hikes-obamacare-a5758

Medicare Insurance AZ staff answers:

I’ve read the new health care laws, and I recognize about 15 of those. I’ll have to look for the others.

I’ve already done tax returns with several, and everyone in my office has read AICPA literature on several that haven’t taken affect yet.

(Your item #19 has been repealed.)

You left out a little-known tax because it’s not really a tax. Insurance companies are now mandated to pay out 85% of premiums to claims. This effectively reduces overhead to 15% and eliminates profits, which is why many carriers have gone out of the health insurance business.

Your Questions About Medicare Insurance Coverage Gap

Sandy asks…

Being that John McCain is a senior….. do you think?

…do you think he would support closing the gap in Medicare coverage per the Health Care plan ?..that is, if he wasn’t an lying GOP politician…and didn’t already get free healthcare from our tax dollars …

My point is… it’s easy to take positions on things you are never going to be personally affected by. John McCain is never going to have to worry about losing his job and not having insurance or Medicare not covering certain prescriptions. If John McCain, was just John “average guy” McCain….and not married to a rich old lady…his opinion would likely be very different regarding health care..

Medicare Insurance AZ staff answers:

Being that McCain is am American patriot, you would think that he wants to do what is best for Americans.

I am always amazed how many Americans seem not to be aware about the real healthcare issues relying instead on FOX and other sources to spread lies about the healthcare system of the USA and those abroad. I mean, if healthcare in nations with universal coverage is so bad, why do they keep it?
Obama wants to make insurance more available to all and change the system so that it gives the American people value for money [1]. He also wants change so that the insurance companies find it harder to get out of paying for treatment. The system he is proposing looks similar to that which works in Taiwan where private companies are involved in providing healthcare [2].
Obama campaigned on reforming the healthcare system. He said he wanted to make insurance more available and he was elected by the American people to do this [3].
FACT – the US has higher death rates for kids both for kids aged under one and those under five than western European countries with universal health coverage [4].
FACT – American insurance companies push up prices and work to stop paying out claims on those they cover [5].
FACT – the USA spends more on healthcare PER PERSON than any other nation on the planet [6].
That means that a dead American four year old would have had a better chance of life if they were born in any western nation with universal health coverage.
If you do not like the policies that Obama was elected to bring in, he can always be voted out of office in 2012. But if you disagree with the facts, please let me know. I am always willing to learn, but please provide proof. None of those who disagree with me have been able to do that so far.

Mary asks…

Why don’t insurance companies pay for dialysis? Or do they?

The government provider, Tricare, won’t pay for hemo-dialysis or a kidney transplant. My spouse will be transferred to Medicare if I continue to work for the government and Tricare will become a sort of “gap” coverage.

What I’m trying to find out is how private and group insurance companies handle kidney disease patients or if they are coverable at all. I don’t understand the health insurance system but it seems to me that if someone with as serious/more serious conditions can be covered why can’t kidney patients?

If nothing else, can anyone tell me where else to ask these types of questions? Any health care specialists?

Medicare Insurance AZ staff answers:

End-stage renal (kidney) disease is handled differently from most other conditions because the usual requirement to be age 65 before being covered by medicare does not apply to end-stage renal (kidney) disease patients. Because they are covered by medicare, even if they are under 65, they do not need other coverage as much as someone who does not qualify for medicare. The non-medicare coverages that you mention are primarily meant to cover someone until they become eligible for medicare, which usually happens at age 65, but happens immediately if a person has end-stage renal (kidney) disease.

David asks…

When Obama claims this bill would “extend coverage” does he actually mean FORCE coverage?

I can understand if you think an individual mandate to buy private insurance is a good idea. (I don’t agree…..seems unconstitutional… but…)

But why don’t the people pushing this idea be honest about what they’re doing instead of using phrases like “extending coverage“? (In reality: They’re mandating you buy private insurance or pay a fine…..don’t pay the fine and you go to jail)

http://news.yahoo.com/s/nm/20100222/pl_nm/us_usa_healthcare;_ylt=Ak.VyvQ79QtGIc0YYBwMsvBH2ocA;_ylu=X3oDMTE1OGdobjVtBHBvcwMzBHNlYwN5bi1jaGFubmVsBHNsawNvYmFtYXByb3Bvc2U-

It provides U.S. government authority to block insurance premium hikes.

It also eliminates a controversial Senate deal exempting the state of Nebraska from paying for Medicaid expansion costs, closes a “doughnut hole” gap in prescription drug coverage, and incorporates a January deal raising the income threshold for a tax on high-cost “Cadillac” health insurance plans.

The proposal provides more tax credits to small businesses than in either the Senate or House bills and provides all states full federal funding for an expansion of Medicaid, the government health insurance program for the poor, for four years, the White House said.

The Obama proposal would close the “doughnut hole” in prescription drug coverage under Medicare by imposing $10 billion more in fees on drugmakers.

Like the Senate bill, the proposal would not include a mandate on employers to offer insurance and would extend coverage to about 31 million uninsured Americans, the White House said.
rico………..So forcing them to buy insurance is a viable solution in your opinion??

Medicare Insurance AZ staff answers:

What it requires is parents and people making over 40K per year to have coverage. Thats not unreasonable, especially when you consider in most cases these people could get subsidization

Charles asks…

Does this show that the intelligence level of most liberals is not that high?

A HEALTH CARE HORROR STORY FROM CANADA

By DICK MORRIS & EILEEN MCGANN

There are howls of outrage coming from the liberal community in Alberta, Canada. It seems that some doctors, desperate to protect their patients from the overcrowded and failing socialized medical system in their country, have set up private clinics to treat them. To circumvent Canadian laws, which prohibit charging for medical care, they have set up private, membership clinics where, for $2,000 a year, patients can access well staffed and equipped clinics and avoid the long waits and compromised care of the public system.

The leading Canadian newspaper, the Globe and Mail, reports that “critics say that the clinics are taking physicians away from the public system making it even harder…to find a family doctor.” David Eggen, executive director of a group that supports the Canadian socialized system, Friends of Medicare, said that it’s already hard to find a family physician in Canada and that clinics like these, springing up in several Canadian cities, could make it even harder.
It does not seem to have occurred to defenders of socialized medicine that the system itself is causing the doctor shortage. Cuts in medical fees, overcrowding of facilities, shortages of equipment and space, and bureaucratic oversight have all combined to drive men and women out of family medical practice. Now, with a critical shortage looming, those who can afford to pay for adequate care are opting out of the public system and, literally, taking their lives into their own hands.

But it is illegal to make patients “have to pay a fee to gain access to health services” that are provided free by the government system. So patients and doctors are forming membership-only groups to avoid the legal penalties that could potential stop them from getting or giving the care that they need.
This is where the United States is headed. Socialism dries up the supply of medical care and forces ever stricter rationing of the available resources. As Margaret Thatcher famously said, “Eventually socialism runs out of other peoples’ money.”

With the full implementation of Obamacare and its likely cuts in physician reimbursement, more and more doctors will choose to opt out of Medicare and charge their patients for their care. The elderly who need specialized care will have no choice but to take out insurance, not to fill gaps in Medicare coverage, but to overlay the system with private coverage so they can get the care Medicare now provides to all seniors. If you want to see a family doctor, it will be rough unless you are paying for the care privately. And to see a specialist, at the low reimbursement rates afforded by the program in the future, will be well nigh impossible.

Medical care for the elderly will become like public housing or public education in the inner city. Those who can afford to go elsewhere will. Those who can’t will be left to fend for themselves in overcrowded public facilities that will be, at least, free.

And then, as in Canada, liberal critics will rail, not against the system that dried up the resources in the first place or against the socialist rules that drove doctors out of medicine, but against the private clinics for resources from the public sector.

By plunging our excellent medical care system into this new world of regulation, fee cuts, and care rationing, the U.S. is going down the disastrous road Canada has taken.

Unless we can elect a Republican majority in November and a GOP president in 2012, this is our future.

Medicare Insurance AZ staff answers:

Liberalism: Doing the same thing over and over again expecting a different result.

Not only do these parasites want UHC, they want us to be socialists. UHC has always been a dismal failure; socialism has always lead to bread lines, death camps and misery.

Carol asks…

Do you like my list of important things you should now about the health care reform?

10 THINGS EVERY AMERICAN SHOULD KNOW ABOUT HEALTH CARE REFORM

1. Once reform is fully implemented, over 95% of Americans will PAY to have MANDATED health insurance coverage, including 32 million who are currently uninsured but could possibly have a job in 4 years. Those that don’t will go on medicare

2. Health insurance companies will no longer be allowed to deny INDIVIDUAL people coverage because of preexisting conditions—or to drop INDIVIDUAL coverage when people become sick. However, they may drop the coverage all together for everyone under that one particular group for that one particular condition.

3. Just like members of Congress, individuals and small businesses who can’t afford to purchase insurance on their own will be able to pool together and choose from a variety of competing plans with lower premiums paid for with tax breaks that may not save them more money than the fine they will have to pay if they do not.

4. Reform will cut the federal budget deficit by $138 billion over the next ten years, and a whopping $1.2 trillion in the following ten years based on a theorized decline in the cost of health insurance.

5. Health care will be more affordable for families and small businesses that chose not to offer health insurance, thanks to new tax credits for INDIVIDUALS, subsidies, and other assistance—paid for largely by taxing insurance companies, drug companies, and people making over 200,000 dollars a year. These credits will be available to only the very lowest income families. Those who make less that 133% the poverty level will have to pay 3 to 4% of their yearly income to qualify. Most families will have to spend over 10% of their yearly income on medical expenses to qualify.

6. Seniors on Medicare will pay less for their prescription drugs because the legislation closes the “donut hole” gap in existing coverage by taking them off Medicare and making them pay for private insurance through the above mentioned government aid.

7. By reducing health care costs for employers but at the same time taxing them to create the so called “surplus”, in theory, the reform will create or save more than 2.5 million jobs over the next decade by mostly establishing a government run and appointed branch of the executive government called the “health commission” that will oversee who, what, when, where and how procedures are covered under medicare and the aforementioned government aid is handed out.

8. Medicaid will be expanded to offer health insurance coverage to an additional 16 million low-income people who make less than minimum wage at 40 hours a week.

9. Instead of losing coverage after they leave home or graduate from college, young adults will be able to remain on their families’ insurance plans until age 26 causing their parents extra financial burdens that can not be included in their tuition as is currently the case.

10. Community health centers would receive an additional $11 billion, doubling the number of patients who can be treated regardless of their insurance or ability to pay assuming they use that money for employees rather than medical supplies.

Source:

http://docs.house.gov/rules/health/111_ahcaa.pdf

Medicare Insurance AZ staff answers:

I find it interesting that the people who are fighting this reform measure are afraid of possibly helping people who need medical care and are unable to provide it themselves.

Often, we pay for that care anyway; usually in inflated ways. Hospitals are obligated to provide certain amounts of care regardless of a person’s ability to pay. Someone without health insurance often will not seek medical care until things reach a crisis level. This means that something that could have been treated in a doctor’s office and with drug therapy is ignored until the person is required to go to an emergency room or be admitted. In either case, treatment at a hospital will cost a fortune. If the person is unable to pay, guess where the money comes from? Our pockets via government funds, tax write-offs, or the usual higher medical costs for all of us.

The people that might get a “free ride” because of this reform are getting a “free ride” anyway because of Medicaid.