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Look at the age group of the pool..it is likely pretty easy..it isn’t like the young and healthy are helping pay for the elderly
Hmm, I don't think so. For that kind of money, every single senior in the US would have to make more than 50 visits to specialists per year. Even if you are sick as a dog, you don't need to be comprehensively evaluated 1.7 times per week, every week after the age of 65. I don't think that is happening - I think more administrative maneuvering inside insurance companies than medical work is happening.
I still think a larger insurance pool containing more healthy people would bring down the premium quite a bit.
Well part B is up to 80% funded by users so it is what it is . That amount changes every year as costs change so the amount comes from actual expenditures
Gasp. The average cost of OUTPATIENT services cannot possibly be $11k per year. No wonder insurers are doing well.
The ACA requires that health insurers have minimum loss ratios, typically 85%. That means they MUST spend at least 85% of the premiums they take in on healthcare claims. All of their profits and operational costs MUST come from the other 15%. If their loss ratios fall below the minimum they must pay it back as a dividend to policyholders.
They're operating on a cost-plus basis with the "plus" part strictly regulated.
There is no way that Medicare can be structured to include all in the Medicare For All plans.
It would be no more Medicare for anyone and something totally new would be put in place.
They didn’t do such a great job the last time they attempted to put Medical Insurance in place.
10 years later and it’s still not working and in Courts.
Medicare is medical insurance. That happened in 1965 and it's working pretty well.
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Originally Posted by RationalExpectations
That is far too low to cover the costs of the health care being insured by Medicare, let alone the administrative overhead for the average person in the USA, and of course aging people consume more than the average.
A one-time buy of (65-your age)*$25,000 plus at least $2,000/month is more like it. That's expensive, but then again the only people who should use it are affluent people who have accumulated the assets to retire early.
I agree that $200-$300/mo is way too low. I honestly don't know where people get the idea that you can get insurance that cheap.
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Originally Posted by RationalExpectations
The entry age for being considered a senior is 65. By definition, there is no such thing as a senior who is not yet eligible.
This is as it should be.
You do have to have paid in for 40 quarters (10 years) or have a spouse who did so.
Quote:
Originally Posted by Kthnry
Not true. You can buy ACA-compliant plans with low deductibles/high premiums or high deductibles/low premiums. Pretty much the same range of options offered by a lot of employers. High-deductible plans are not unique to the ACA.
Quote:
Originally Posted by Kthnry
Exactly. Thanks for the summary. There's a lot of misunderstanding about ACA vs. private insurance.
It's important to keep in mind ACA is the law, not a type of insurance. Some people conflate ACA with the insurance you can get on the exchanges, but by law all insurance (with a few exceptions) has to be ACA compliant, no matter who writes the policy, or what kind of a policy it is (e.g. high-deductible, low deductible, PPO, whatever).
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Originally Posted by elnrgby
While I didn't read this entire thread, to me (as an economic conservative) the idea of younger seniors buying into Medicare seems fairly good (meaning that it will probably fly with the Republicans too, as my economic thinking always ends up being aligned with Republican, although I am not actively aiming for that as a non-partisan). I think the idea is good because more people paying into an insurance pool, particularly people who tend to be less sick than people over 65, will bring more money into the insurance pool, and therefore decrease an individual premium (or at least keep it from rising), and will certainly help in keeping Medicare solvent.
I don't think you understand what Medicare is. You are in all probability paying into it right now. Pretty much everyone pays in to Medicare while they are working. There are no premiums for Part A (hospitalization) for the benficiaries. Part B (major medical) does have premiums but they are based on income, rather than age. https://www.medicare.gov/your-medicare-costs
Part A I think runs 413 a month for seniors without enough credits for it free . So that is almost 5k a year and part B full fare is 11k plus about 400 a year for a drug plan..
So you are looking at a cost of about 16k per year per person or 32k a couple if you were to pay on your own.. Medicare ain’t cheap when the govt is not picking up 75% or so of part B..
Keep in mind Medicare only pays 80% and does not Pay in full for a lot of stuff ,so you still need medigap to cover what is not covered ..
I'm still not getting your math. Seniors who have taxable income of less than $85,000 (or couples earning less than $170,000) pay the Part B standard cost of $135.50/month or less per enrollee. The additional 75% picked up via the taxpayers would be approximately $406.50 per enrollee, correct? $542 total per month is $6504/year. About 3.5% pay less than the standard $135.50 and roughly 5% pay more than the standard amount. Where are you getting a full fare price of 11k plus? (Is this in the trustees' report?)
Part A is relatively cheap. Folks who have greater than 30 credits but less than 40 credits (or were married to someone with greater than 30 credits) can buy in at $240/month. Folks who have less than 30 credits (or were married to someone with less than 30 credits) can buy in at $437/month. https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles
I'm confident I had earned the requisite 40 credits (10 years of minimal earnings) by the time I reached my late 20's if not earlier. In 2019 one would need earnings of $1360 to earn ONE credit and $5440 to earn the maximum FOUR credits per year. IOW, some of us could work ONE month in 2019 and pick up the yearly maximum credits.
I'm in favor of extending Medicare to those 50 and over under the same rules that applied to current retirees. And for those who fear that extending the pool to the younger seniors will increase the premiums of the current Medicare recipients, well, that boat may have already sailed. If the republicans follow through with their plan to allow the older retirees to keep their traditional Medicare plans and require the newer retirees to shop around for the best plan using their "vouchers", the pool of traditional Medicare retirees will naturally shrink and the premiums will therefore rise. Such is the nature of insurance.
Originally Posted by fluffythewondercat
Some states, such as California, offer a COBRA extension (Cal-Cobra) for another 18 months.
The buzz I've heard is that pre-existing conditions will be covered (somehow) in whatever succeeds ACA.
Quote:
Originally Posted by Katarina Witt
Source?
The Republicans were briefly interested in pre-existing conditions for a few weeks before the midterms, but now they've moved on. They may have succeeded in destroying the ACA, but they've had ten years to identify a replacement and they have nothing to show for it.
This is a good summary of their positions on protections for pre-existing conditions.
I'm still trying to understand the one-time buy-in. If I am 62 when the ACA is repealed, I would need three years of coverage to get to 65. If I continue working during that time (which I expect to do), then I wouldn't need to pay a buy-in, would I? I would just continue paying my share of my Medicare tax plus the monthly premium, right? I have plenty of quarters.
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