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Re: medicare

Jim, really very nice of you to give a concise explanation. It's still
sort of vague (you don't need to explain, though) to me because I've
never been involved in Medicare in the first place and am not eligible
for 12+ more years (emphasis on "+" because they'll probably push it up
to 70 by the time I get there)

Also, for me it has been all or nothing. I had insurance coverage from
age 16 to 51 and it was always fully funded by employers and included
prescription coverage, eyes, dental, etc. Now I have no insurance, fully
unfunded by me.

So when the time does come, you're telling me I'll have to deal with
parts A through D (did you mention a C?) - and probably by then they'll
throw in an E and an F.

Hmmm.....maybe I should just concentrate on keeping healthy.


-- james singer <islandjim1@verizon.net> wrote:
Medicare is a mess, mostly because of "free enterprise, economic 
competition" shibboleths--none of which pertain the medical 

Basically, there are two kinds of Medicare--fee-for-service Medicare, 
controlled mostly by the rapacious insurance industry, and HMO 
Medicare, controlled by opportunistic third parties such as Humana, 
Universal Health Care, and United Health Care. Hospitalization [called 
Medicare Part A] is not a big deal in either kind because the coverage 
is essentially the same. The Big Deal is Part B, euphemistically called 
"physicians' services."

Part B Medicare is supposed to cover physicians' services, but doesn't. 
There is a large financial gap between what most geezers need and what 
Medicare will pay for. Covering this financial gap is where the 
fee-for-service hucksters and the HMO hucksters go there separate ways.

First, be aware that Medicare [currently] deducts $88.50 from your 
monthly Social Security check to "pay" for Part B. If you are a 
fee-for-service person [that is, that your family doc knows at least as 
much as the average of the rest of the medical profession], you will 
probably have to buy a Medi-Gap insurance policy to cover the 
difference between the pittance Medicare will pay him and his monthly 
Mercedes payment. From ARRP, this kind of insurance costs about $135.00 
and up [bells and whistles stuff] per month. But it doesn't cover 
drugs--so if you've got a bunch of drug prescriptions, you may want a 
Plan D policy. That's the new marketing Hoo-Ha with all the confusing 
jibberish. And since there are a zillion D plans [with no requirement 
that they have the same formulary], the amount one saves depends on the 
discount given by a specific plan for a specific drug, which is 
precisely why it is so confusing and difficult to choose the best one 
plan for any one person.

If you decide to be an HMO person, there are two or three things worth 
worrying about. First, of course, is the HMO--an HMO is an HMO is an 
etc. Restrictive panel of providers, utilization review, co-payments, 
and so on. Second is Medicare HMOs have a history of cutting and 
running. They are allowed to market their plans by geographic area 
[usually a county]; and if for some reason, a county does not develop 
enough subscribers or yield enough participating providers, the HMO 
simply goes away, leaving it's "members" to scramble for 
fee-for-service coverage.

The upside of HMO membership is, one, Social Security pays the 
membership fee; two, SS does not deduct $88.50 from your monthly check; 
and, three, HMO coverage includes drug coverage--with co-payments [no 
deductibles] of $10 per generic and $20 per proprietary drug. This 
benefit effectively cuts the price of most drugs by at least 50 

On Jan 4, 2006, at 2:38 PM, Chapel Ridge Wal Mart National Hearing 
Center wrote:
> Locally, Humana has a booth set up in Wal-Mart to answer questions.  
> Then
> the man gives talks everyday at lunches provided free at Chicago Uno or
> Golden Coral.  He asked a co-worker and me to come, but I'm not old 
> enough
> and Jenny is only 30.  Not sure why we'd be there.  But lunch at Uno 
> would
> be nice....  I hear there are as many as 40 or 50 plans to choose from 
> in
> some states.  What a pain that would be.
> Kitty
> ----- Original Message -----
> From: <Cersgarden@aol.com>
> To: <gardenchat@hort.net>
> Sent: Wednesday, January 04, 2006 9:51 AM
> Subject: Re: [CHAT] medicare was Somebody stop me
>> In a message dated 1/4/06 12:45:22 AM, judylee@lewiston.com writes:
>>> if your current insurance provides medicine coverage,
>>> the penalty is waived if you later need to use the medicare benefit 
>>> for
>>> medicine.
>> That is great to know.   The company sent us a letter stating if we 
>> signed
> up
>> for coverage under one of the plans we would lose all provided 
>> insurance
>> coverage.   As confusing as it is, I hope no one would make that 
>> mistake.
>>      Ceres
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Island Jim
Southwest Florida
27.0 N, 82.4 W
Hardiness Zone 10
Heat Zone 10
Minimum 30 F [-1 C]
Maximum 100 F [38 C]

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