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#298949 - 02/24/17 01:50 AM Re: A big insurer just quit Obamacare [Re: pdx rick]
NW Ponderer Offline
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Carpal Tunnel

Registered: 09/09/11
Posts: 15467
Pretty much exactly what I said. Oh, really!?
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#298950 - 02/24/17 02:19 AM Re: A big insurer just quit Obamacare [Re: NW Ponderer]
Ujest Shurly Offline
stranger

Registered: 10/16/16
Posts: 228
Loc: Michigan, USA
Originally Posted By: NW Ponderer
Imagine my surprise today, when I got a bill from my wife's Medicare provider for an additional $805.92 for medications we paid for over the last year... My wife has been on SS disability for nearly 5 years, now, and thus Medicare. We dutifully pay our Medicare Advantage so that she can have the same medical care she has had for the last 20+ years. Suddenly her medication cost quadrupled, and now they are going back to last year to add that onto her bill. Same fixed income... something is not right.


I would call Medicare (1-800-633-4227) and just in case Medicare website. Also take a look at Section 9, page 103, of your Medicare & You 2017 handbook, there maybe something in there that can help. Also have you past Ins SoBs and quarterly Medicare statements available.

Since Medicare is the primary, the Advantage plan should have submitted those charges to Medicare first.

Good luck
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#298955 - 02/24/17 06:36 AM Re: A big insurer just quit Obamacare [Re: pdx rick]
pondering_it_all Offline
old hand

Registered: 02/27/06
Posts: 6999
Loc: North San Diego County
Medicare Plan D and Plan C with drug coverage both have the same problem: There is no maximum out-of-pocket for expensive drugs that are in the formulary. So the drug company can set the list price to ANYTHING they like and you then have to pay a percentage. Even if you get up to catastrophic care, you still have to pay 5%. Which can be thousands of dollars.

ACA was a lot cheaper for me, which kinda defeats the purpose of MediCare.

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#298958 - 02/24/17 10:00 AM Re: A big insurer just quit Obamacare [Re: Spag-hetti]
pdx rick Offline
Member
Carpal Tunnel

Registered: 05/09/05
Posts: 40471
Loc: Puget Sound, WA
Originally Posted By: Spag-hetti
So, if we cut out the insurance companies, we could send our money to the government and save all the money that goes to profits. That would sure cut the cost to taxpayers who supplement those who cannot afford to pay much.

Makes sense to me.

That's because you're a Liberal. cool
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#298959 - 02/24/17 02:56 PM Re: A big insurer just quit Obamacare [Re: pdx rick]
rporter314 Online   content
old hand

Registered: 03/18/03
Posts: 6189
Loc: Highlands, Tx
former Spkr Boehner became suddenly enlightened and offered a reality check to the delusional conservative Congresspeople ... there is no Republican plan which can do everything ACA does and still keep costs down
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#298961 - 02/24/17 04:40 PM Re: A big insurer just quit Obamacare [Re: pdx rick]
bigswede Offline
newbie

Registered: 03/25/16
Posts: 300
There is no way there will be neither emergency care nor healthcare available without any profit incentive.
What happens in tax funded medical aid systems is that the system finds it profitable to do away with staff. That way the few left are able to get more money each. The way to get this done is to institute the socialist standard: sick people aren't customers, they are patients without voice or say. They wait patiently (bad pun intended) in line on their turn. If they die or get sicker while waiting, it's only a regrettable side effect of free medical aid. The system accepts no blame.
The queue is the hallmark sign of socialism.

Oh, and bigwigs at the party top can pass the queue or even buy insurance to get health care abroad.

The best way would be to allow public systems real negotiating power when buying medicine, surgery or what ever. That way profit would be available only to those who can produce most effectively. Wouldn't that be the American way?


Edited by bigswede (02/24/17 04:43 PM)
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#298963 - 02/24/17 05:11 PM Re: A big insurer just quit Obamacare [Re: pdx rick]
rporter314 Online   content
old hand

Registered: 03/18/03
Posts: 6189
Loc: Highlands, Tx
it always seems that everyone has something to say after the fact .... free markets (FM) will solve the problem

if FMs will solve a problem which has existed for over 100 years how fast does the FM move??? the reality is the FM has no solution because the FM is only interested in making money. it is not sentient so it would not know that there is a problem in search of a solution unless people, you, me, elected officials, offered directions to the FM.

If one says they believe in universal healthcare then one is saying government must provide the impetus to implement that policy. the problem is the cost drivers. absolutely no plan which relies on FM principles will lower costs. what FM principles do with increased competition is lower premium costs to just above rising cost drivers.

your proposal is only temporary. once pricing has adjusted the cost drivers will once again take hold and carriers will be forced to increase premiums.

ACA had mechanisms to impact the cost drivers and this is precisely what is needed in addition to all other tweaks.

I had to laugh at your queue statement. perhaps you have not noticed the "queues" at emergency rooms or doctors offices none of which has anything to do with ACA or socialized medicene. It is the direct result of the failure of the FM to provide more doctors, more hospitals, etc as a solution for an increasing population in need of healthcare.

when the FM can not provide a solution, it is the obligation of our government by contractual agreement to provide it
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ignorance is the enemy
without equality there is no liberty

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#298964 - 02/24/17 06:04 PM Re: A big insurer just quit Obamacare [Re: pdx rick]
bigswede Offline
newbie

Registered: 03/25/16
Posts: 300
Perhaps the queues in American health care is a sign of a market not enough free?
Or just regulated the wrong fashion?
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#298965 - 02/24/17 06:21 PM Re: A big insurer just quit Obamacare [Re: bigswede]
logtroll Offline
veteran

Registered: 04/26/10
Posts: 8594
Loc: New Mexico (not old Mexico)
Originally Posted By: bigswede
Perhaps the queues in American health care is a sign of a market not enough free?
Or just regulated the wrong fashion?

Very interesting! Would you pleasure our intellects with a detailed scenario about how this would work?
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#298966 - 02/24/17 06:25 PM Re: A big insurer just quit Obamacare [Re: pdx rick]
bigswede Offline
newbie

Registered: 03/25/16
Posts: 300
Detailed, that's a tall order!
Obama's staff of professors weren't able to.


Edited by bigswede (02/24/17 08:01 PM)
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