given that some are supporting a medicare type system of health care, there are a few things people need to know. medicare is not perfect and is controlled by the insurance companies. the insurance companies can choose which counties they want to be involved in and for some counties there is only one choice. There are extra plans such as A, B, D, G, etc. which offer additional services for quite a high fee, as well as separate drug plans which vary in price greatly. Moreover, the insurance companies can have different prices for the same services based on the county they choose to be in. For example, Kaiser charges $85/month if one lives in Solano county but there are no monthly fees if one lives in Sacramento county. this system is grossly unfair to medicare recipients.

Comments

Legend 16 weeks 5 hours ago
#1

What I do not like is that you pay 20% of a procedure that cost 5 times more than it would in most other countries. The 20% could bankrupt many people thus you are forced to buy gap insurance at great cost. When I studied the plans, because I am healthy and stay fit I picked the Kaiser Advantage plan which so far has worked out well. With it I pay the basic $121 per month for Medicare plus what seems to be reasonable fees on procedures. It also has an annual cap in the $4000 range.

I am an advocate for Medical Tourism. Take your business elsewhere.

zapdam's picture
zapdam 16 weeks 4 hours ago
#2

I cannot believe as a senior on a limited income, Americans are still forced to pay $121 a month plus 20% of the costs and that's only because " as one blogger, " Legend ' put it, " I studied the plans, because I am healthy and stay fit ".

I can't believe Americans have been so brainwashed, so programmed that they tolerate this horseshit and keep electing these same politicians that make sure things NEVER change except for the WORSE. Can you imagine any society allowing charlatans, crooks to profit off the aged, sick and the dying. Like one of Americas politicians said, 'in U.S of A don't get sick , but if you do you need to die quickly'. What's even more astounding is Americans pay double what single payer health care costs for everyone in other countries, but a large percentage of US money goes into the pockets of corporatist CEO's and HMO padded expenses, so you pay more than your fair share of health care costs and get 'rationing' instead of what you actually deserve and paid for, just so blood sucking CEO's can make ten million dollars a year.

WHEN is the revolution coming America? When are you going to take back your country? Oh wait you just elected eight years of more of the same , but this time much much worse. What the f^<k is wrong with you America.

http://www.fiercehealthcare.com/payer/top-health-insurance-ceo-pay-excee...

k. allen's picture
k. allen 16 weeks 1 hour ago
#3

It occurs to me, all these programs and proposals about healthcare really are about health insurance. I truly don't know much, but all the movies I saw that helped shape my impression of 'insurance' had to do with people in small(er) business having to 'pay up' or risk certain damages ... so what is new?

Someone around here mentioned it is now 2017, not 1967. In my view, this is relevant. I am not prepared to explain why I see it that way in 25 words or less - one observation:

Media influence - probably since the printing press, telegraph, film, radio, tv, ... industries associated with these technologies - all of this and more has supported and shaped USA's culture and related mindsets of those who depend on it, profit from it (or not) and contribute to it as consumers/producers.

Speaking for myself, television entered our home in 1957. I am not alone, I trust, in saying that radio, tv, film and popular culture have influenced my life and outlook immeasurably - and I _know_ I am out of touch already!

So how pervasive is it for others, and how can wee people find our way through this strange brew?

Adapt and evolve. This is the new frontier. We find ourselves in a wilderness, with so many trails marked we have no unified idea where to turn, on one hand, and no map in hand, on the other.

Talk about not letting the right hand know what the left is doing!

So Zap, you ask,


"WHEN is the revolution coming America? When are you going to take back your country? Oh wait you just elected eight years of more of the same , but this time much much worse. What the f^<k is wrong with you America?!"

Just off the top of my head, Zap, I'd say the "American revolution" is ongoing ... a wheel is built to turn, a ball to roll - or not ... today's chapter of this multifaceted process is the ((sweet and sour)) fruit of many generations of self-serving individualism progressing at great expense to the world at large.

I believe the human heart and soul is deeper than all of that ... and will find room to grow, regardless of circumstance. This is where politics is personal ... very, very personal.

Would this be that "leaderless revolution" we hear about from time to time ...?

Meanwhile, back at the front desk, is there a way to insure job security for bureaucrats, middle-management paper pushers, and industry sales reps so we can dispense with the duplicated efforts, unnecessary paperwork and wasted resources that cripple provision of effective, timely, affordable health care for one and all?

Or do the free, brave citizens of this land require competitive incentives just to get up and get on with the day?

What are we living for, anyway?!

Legend 16 weeks 30 min ago
#4

I am suggesting to Americans to set up a healthcare fund. Fly to a country of your choice for medical care. If you know of something major fly to India. Medical Tourism will become a popular method. Dental is excellent and cheap in Panama. And you can recover on the beach with some de-stress time. If you have $3000 in (USA) dental work you will save money. There are travel agents that specialize in it. example:

http://www.medretreat.com/

Stop giving money to these greedy CEO's.

k. allen's picture
k. allen 15 weeks 6 days ago
#5

That could work for those who are able to travel, or can afford it, or - given likely securitized borders - can be vetted for free passage without mountains of paperwork and logistical process.

It's kind of like telling someone who is recovering from serious injuries they have the right to sue ... as if a long, drawn out, contentious courtroom procedure will in any way support a healing process.

No, ... I have walked this trail for many years ... community clinics - available in cities/counties/states that support them ((not all do)) - are deemed not cost effective, therefore unaffordable. The upwardly mobile middle class insists on access to expensive, cosmetic and highly individualized technical treatments/procedures, yet complains about the 'takers' who want to see quality health care for all, regardless of financial status.

In fact, lack of access to critical health supports landed me on a threshold between striving to live - to 'save' my life, or accepting that all things come to pass, including me ... so, why expend the gift of this one life breath clinging to life - when, in the long run, I have to let it go?

I learned to let it go, and let it flow ... I know it sounds all 'new-age' and such, but it is true ... that was when I realized the breath of life is a gift ((albeit, a mixed blessing)) ... we do not possess it, it carries us ... as it comes to us, and through us, one breath at a time.

Anyway, I managed to wrangle a place where I could crawl in and die.
As it turns out, as I live and die with one breath, I am alive, and healing too!!

That truly blows my mind.

Say it any way you want, life is miracle, and angels are real.

I understand, this may not cure what ails the industry, but it sure helps me carry on, regardless of what is or is not available in the surrounding world, however so defined, categorized, labeled and filed into muted obsolescence ... uh, oops ... just a wee rant .... ka

zapdam's picture
zapdam 15 weeks 6 days ago
#6

k. allen

Summed it up by stating that if you're sick , you'll be in no shape to fly. Plus to to Asia where it's cheaper, the first leg of the trip is 13 hours in the air just from LA , and for a cancer patient or stroke or heart condition, they might just expire in transit. Plus to enter these countries, passports, visa's and no run in with the law would be required, Plus with the US reported a median personal income of $30,240 before taxes, how do you save for that $100,000 cancer treatment or even at discount the $50,000 bypass surgery. Plus there's much needed support from family or friends, then accommodation for god only knows and that's after being released by the hospital. Plus for many mobility is a big problem. Not to mention the fear of flying especially over 13 hours in the air or just the fear of being away from your country in a far away foreign land.

Legend i get it, its being done by hundreds if not thousands of people, but i'd venture to say that for the most part it's elective surgery, like cosmetic etc. Not only that, WHY should an American have to fly half way around the world to a foreign country they've never seen before or speak their language, JUST to receive what should be right , that being proper health care, that doesn't need credit approval before treatment.

Why should a spouse have to decide between death and selling their home and leaving their love ones destitute or deeply in debt, just to receive proper healthcare treatment to live or be one of the 40 thousand uninsured Americans that die each year of treatable illness. You know what's sick, the systems sick, Americas society is sick , for allowing this to continue or even start in the first place.

Americans suffer , Americans die and needlessly ,all for the 'all mighty buck', so some corporatist CEO can look good in front of his or her shareholders and take home their salary of a million bucks a month.

Legend 15 weeks 6 days ago
#7

The way to change things is to embarass the politicians. People dying in the streets is one way. The other is people flying to Cuba (excellent doctors) for medical care. Cuba could jump on this. I mentioned Panama for dental work because I know someone that did this and highly recommended it. I mentioned India because it is fairly well known for excellant and affordable medical care. The AMA keeps prices (demand) up by limiting the number of Doctors (supply). Take the demand elsewhere. It is going to get much worse with the new Fascist regime.

virginsnow 15 weeks 6 days ago
#8

Thank you for all your comments. My response to comment #1 is this. You are paying $121/month for your Kaiser plan while others depending on their location pay $0. IS this fair--of course not. This is how Kaiser controls their services in any given area. Furthermore, did you know that Edgar Kaiser was friends with Richard Nixon and records show that he only decided to start Kaiser after Nixon told him he could make a lot of money setting up the HMO.

I was with Kaiser (not by choice but because of income) and the service was for the most part horrific. I broke my foot and they told me it wasn't broken and I suffered for a year and could hardly wear any shoes but they kept telling me that the pain and swelling was normal for that part of my foot. I went back in and guess what--it was broken all along and this was only discovered after they agreed to take another x-ray, but you know what the doctor said? Oh, its healing nicely anyway. It still hurts sometimes to this day.

They recommended that I get some inserts for my feet and I ended up with excruciating pain in my legs and knees. Did they care? No.

i had to go through several doctors to find one that would even listen to my concerns. Eventually I found one that was considerate and nice, but it took a long time.

M son was also a member of Kaiser during this time and had PTSD. He went to the doctor to get a refill on his prescription and the doctor freaked out and thought he was suicidal (which he wasn't) and they did a 5150 on him. He was sent by ambulance to San Jose to the emergency room and was not given any food, until I called and demanded that someone take care of him. He was there all day without eating. They left his truck with all his work supplies (as he had a job to go to that day) in the parking lot unguarded in Gilroy, CA. After he saw the doctor in San Jose they then transferred him to San Mateo by ambulance again whcich was about 40-50 miles away, and kept him overnight. When they saw him, they told him he didn't have any of the problems the doctor said he had and gave him his prescription. However, he was stuck about 80-90 miles from where he orignally seen, so they gave him a ticket to take the train back. This is Kaiser.

I could go on but I think you can see what kind of service they really give. For some reason they are getting multople stars for their service, but I think that many of the people who go there don't realize that the quality of service they receive is poor. Many people who have left Kaiser have stories like mine.

virginsnow 15 weeks 5 days ago
#9

I agree with your assessment completely. See my response to the lady you wrote about who went with Kaiser.

Legend 15 weeks 5 days ago
#10

The $121 that I pay for my Kaiser Advantage Plan is the standard Medicare monthly fee. Same what ever plan I was on. Kaiser Advantage Plan is the only 5 star plan in CO. Its facilities are excellent. So far (1.8 years) I have found it to be almost more invasive than I want. They have checked me from head to toe and have been tough. I am healthy and stay fit and it was a better plan than a Gap plan charging me an additional $200 or more per month. If you are sickly and expect a lot of medical procedures a Gap plan might be better, but barely. As Kaiser Advantage has a $4500 maximum per year out of pocket excluding the $121. That means I could have heart bypass surgery for $4500. For stuff like that they use the best hospital in the area. I am sure that Zapdam will knock Kaiser but this is America and not Canada so you work with what you can get. I am also sure that there are complaints with every Health Insurance Company. It will get worse under Putins Puppet as insurance companies will be free to drop you etc. On top of it all Kaiser gives me a card that I can workout at thousands of atheletic clubs for free. An example is any 24 Hour Fitness. I have a gym at home but I use it when I travel and at a local swimming pool for swimming laps. The pool senior rate is $6 and I get it for free. Adds up. This is Kaiser Advantage plan. If you are 65+ you might want to check it out.

Legend 15 weeks 5 days ago
#11
Quote virginsnow:

I agree with your assessment completely. See my response to the lady you wrote about who went with Kaiser.

Could you reference a post #?

virginsnow 15 weeks 5 days ago
#12

So are you saying that kaiser has a zero premium? What about all the visit fees, prescription fees, blood test fees, etc.? kaiser out where I live has so many different fees depending on what county you are in, that it is ridiculous.

i had a medicare edvantage plan with them, had to pay over 80 dollars a month in addition to the $108 which was deducted from social security. They upped their fees on everything from office visits, x-rays, specialist visits, over the past couple of years.

As i mentioned previously, there are so many people that I have talked to our here that left Kaiser ASAP when they could find something else because of the horrible problems that occurred when they asked for care.

Since you are so healthy, maybe it won't be a problem for you, but for many it has been aside from the 5 star reputation.

virginsnow 15 weeks 5 days ago
#13

this as in reference to what zapdam said

Legend 15 weeks 4 days ago
#14

Zero monthly premium, $20 copay for primary doctor visit, $50 copay for a specialist visit, Prescriptions are $10 and $20 for 90 day supply of generic. Off hand I do not know what non generic is, but I know it is more. I only use generic. Lab tests are free. they are growing in CO. The facilities are nice. Plus I get the health club pass for free. If you travel to an area that Kaiser does not have facilites (they are only in about 5 states) you use Urgent Care Facilities or ER for $50 copay. They also have good call in number for nurse's advice.

Thom dislikes Advantage plans for some reason. It has worked good for me. GAP plans like he must have, have a $200+ monthly fee on top of medicare and will go up as you age. If you do not like the plan that you are on you can switch at end of the year.

Robindell's picture
Robindell 15 weeks 4 days ago
#15

Thom is not an expert on Medicare. Low-income people, such as the disabled, probably cannot afford to buy a "Medigap" plan. The Medicare savings plan which you apply for through your state social services and Medicaid agency would be very important and helpful for a low-income person on Medicare, except that there is a rather severe asset limitation, which is quite a bit higher than it would be for Medicaid, but still limits the number of eligible people who meet the income limitations.

In my area, there is an insurance agency which specializes in selling Medigap and probably Medicare Advantage plans. This agency has an employee who is a caseworker who helps clients of the insurance agency who have problems getting their insurance carrier to pay their medical bills due to some type of error. This man has a brief column in a free publication geared toward seniors that is distributed at some local businesses. He gives examples of cases where he has written to either an insurance company of Medicare to correct an error resulting in someone incorrectly not having their bill paid. This caseworker has often complained that the people who administer Medicare, which seems to involve both the government as well as outside, private contractors, make far too many mistakes and therefore are overpaid because they do a poor job, resulting in something like a billion dollars in unpaid medical bills that were eligible to be paid in full or in part, if only they had been correctly processed. He describes the system as being poorly managed and thus inefficient. He sometimes discovers that the insurance company never received the bill because it was originally sent to Medicare, which never forwarded it to the secondary Medigap insurance provider. Of course, some of his cases involve mistakes made by the private Medigap insurance company, but in some cases, he contacts Medicare. He publishes a copy of the letters he sends out, with the patients' names removed for confidentiality. In one case, Medicare had not made note of the fact that a man had switched from group insurance from a previous employer to Medicare. He had unpaid medical bills going back eight years. This may be a problem that is unique to the U.S. in our governmental health care systems, as the Veterans Affairs hospitals also had their own scandal not long ago involving veterans who had to wait for a long time to receive an appointment.

Another aspect of Medicare that I am concerned about is that you can be a hospital inpatient, but can be classified for billing purposes as an outpatient, so that Medicare Part A will not cover any of your inpatient expenses, especially the room charge. Before being kept overnight, a patient has to insist on being admitted as an inpatient and being classified as an inpatient, not as simply being on "observational" status.

Legend 15 weeks 4 days ago
#16

I agree that many seniors cannot afford $114 per month for Medicare when it only cover 80%. They also cannot afford a gap plan at $200+ per month. That comes to $314 per month and more as you get older. But the Republicans want to make it worse and voucherize it.

If you can go to another country for your medical needs. Write your Congress and Senate Reps and let them know that you went to another country for medical needs.

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Trump Is Going Back On His NAFTA Promise

Donald Trump won't be pulling the US out of NAFTA - at least not immediately.

But he's still permanently changed the debate about trade in America.

Donald Trump said yesterday that after speaking with the President of Mexico and the Prime Minister of Canada, he's decided not to immediately pull the US out of NAFTA.