Medicare Part A & B (Doc and Hsp) run about $160 a month
Part C & D (usually a Medicare Advantage plan varies)
The one I have is United Health Care, and there is a $0.00 monthly premium.
There are no copays for Dr. visits, Hospital in-patient is $250 a day
All my Tier 1 Rx are free, my insulin is $35 a month, and I have a Tier 3 that is $131 every 90 days
So, Karen, I would investigate more… my ANNUAL payment is <$3000.00 total (barring a another hospital visit)
you have bars in your hospitals ???
You are on a Advantage plan. I’m taking about traditional Medicare with Medigap.
Between the Part B premium and the better medgap option (we essentially only have 2 levels of medigap plans in my state) those 2 alone come out to about $400/person. Add in a good Part D plan and you can easily get to $500/Month/Person.
Advantage plans can work out well if you don’t need to use it a lot… but can be not to so great if you do (and most eventually do with age)
-Karen
yes, but they use an IV so you don’t spill any
to me Medigap and Advantage are the same, perhaps I am wrong.
UHC is $0, and I use it quite a lot as I now see my GP and a Cardiologist, not counting speical exams (EchoCardio, Xrays) etc… without this my out of pocket would have be 10’s of thousands, with it it is near zero.
but you do what you think is best.
If I have to think about: multiple scleroses is costing my health insurance per month 7500. They pay without any problem. And that until my life ends. And that can be in 5 years : if they are lucky or in 40 years if I have luck. What ever if I would live in US I would not know how to pay that for the rest of my life. And at least 4 times per year a week hospital. All of this is included in my health insurance ant what I have to pay depends on what I earn. But the highest amount is 12 k per year, the lowest I think around 2600 per year. In America I would not be able to pay that.
And by the way my wife is insured for free, my youngest daughter (she studies) is also for free included)
They are very much different with different coverages…
Advantage has some additional beyond Medicare/Medigap benefits and also typically incudes a drug plan, but a many of them have a lot of co-pays and deductibles, and you typically need to go in-network.
Medigap is accepted by all who accept medicare with no network requirements, and depending on plan, you don’t have to pay anything after the part D deductible … but it does not include a drug plan which you need to buy separately.
In general the insurance industry makes more money on Advantage Vs Medigap (Advantage plans get more money from the government) … which is why Advanatge plans are heavily advertised and Medigap plans are not.
-Karen
well as I said, I have no premimum , no medical professional vist co-pay, no Rx copay on all but two of the meds I take. There is no Part D minimum (but if the two non-Tier 1 drugs go beyond a certain figure, they are free for rest of the year).
And honestly I don’t care how much THEY make, it is based on how much I save, which is literally 1000’s per year.
And yes I do have to stay “In Network”, but I chose a plan where my provider of choice was the main network of the plan.
An in network plan is great in some areas. My in-laws have an in-network medicare option and it works really well because there are lots of options close to them. My parents went with the other type of plan because they would have had to drive all over the place to get to doctors that were in the same network. And both my parents and my in-laws love the way it works, so I guess that’s good.
But I still hate the way we do insurance here.
OK WTF is “in network” ?
Here I go see Dr and never have to worry about that sort of thing so its not something I understand
Medicare Advantage is like an HMO. You have to go a provider that contracts with that Insurance company and they are regional… some networks don’t have a lot of options.
With Traditional Medicare + Medigap you can use any provider that accepts medicare - which is like 90+% in the US.
When working in Houston for just-under 4 years, the health-care system took some time to learn how it works.
I was with a large company, which paid for my health care insurance, and originally from Canada, I didn’t understand how much it actually costs.
A family member had to use the hospital and was admitted for 4-hours. According to the insurance policy, I personally only had to pay for 20% of the bill. The bills (yes, more than one) for my 20% of the 4-hour visit was $4,000.00 USD. The bills would start trickling in - a bill for the doctor visits, a bill for the nurse, a bill for the hospital, a bill for the medication, etc.
When talking with other fellow Houstonians, it was easy to understand why they said the highest cause of death was pneumonia. People would feel lethargic, and not worry about going to the physician because it was too expensive, and just wouldn’t wake up from their sleep. This happened to a colleague that I worked with, he felt sick and did not go and get checked out. I attended his funeral.
The United States medical system is different.
In an article I’ve read recently it was stated that the US is the only developed country with decreasing live expectancy.
Either that as very bad insurance, or it was HMO type insurance and the providers in this case were out of network… which, if covered, usually has much larger copays.
That is why I am strongly considering traditional medicare + medigap instead of medicare advantage even though Medicare Advantage is significantly cheaper and covers a few 'extras".
The US healthcare system is definitely not “consumer” oriented.
-Karen
One MAJOR change in all US Insurance (Medicare or not)… is IF you are in hospital and a provider is “out of network” (which happens alot), They MUST by law TELL you before they do anything. If you accept, then they bill as out of network… You can request an in-network provider. However, if they DO NOT say anything, they have to accept in-network compensation.
Years ago (40+?) I had a hospital stay where they nickeled and dimed me for every little thing, Meds, syringes, IV hose… and every single person who did as much as look in my room.
So at that time, Doctors would “consult” just to get on the invoice. The insurance companies audit that much closer these days.
My stepdaughter was in Spain her Junior year in high school on a foreign exchange program. Just before she came home she caught a stomach flu and was violently ill and admitted to the hospital. We were freaking out back here in the states trying to figure out if it was covered and how we would pay. I’ll never forget contacting the hospital in Spain and their response. “Bill? What bill? Your daughter is our guest and will receive the very best care at no cost. We are not barbarians.”
This is true but there are multiple causes
COVID, health care system, gun deaths all contribute to that drop in life expectancy
True but much of it comes back to the health care system. COVID outcomes were worse than they inherently were because of the crap system, IMO. We got just a LITTLE more “socialistic” during the early pandemic, providing free PCR testing to all, free vaccines to all. And that helped a little. But all those hospitalized or (temporarily or permanently) disabled by COVID are being systematically bankrupted and/or marginalized by the system in ways that mostly don’t happen elsewhere.
And even apart from the medical system, just think how different things would be if it were on employers to prevent COVID spread at work. There’d be a lot more masking and distancing going on, that’s for sure. But they are so eager to get away from remote work and forced labor, that would never happen here.
The CDC report is here