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No, it's not an affordability issue and you're not getting something for nothing. First, you assign your Medicare benefit over to a corporation who then covers

No, it's not an affordability issue and you're not getting something for nothing. First, you assign your Medicare benefit over to a corporation who then covers your health care costs at their discretion. Then you'll pay your Part B premium ($174.70/mo) out of your Social Security benefit. So you will have the magical illusion of a $0.00/mo premium and the insurance company then makes a substantial profit to boot. I spend about $300/mo for A+B+G+D. My OOP max is the $240 Part B deductible (except for drugs but I only take a statin). That will go up over time, Community Pricing. I have no preauthorizations, no copays, no coinsurance. And generally no paperwork. When I went to my UCSF PCP for a sprained MCL, I made an appointment a few days later. I showed up and said who I was. A few minutes later I saw the doc. After that I walked out. The wallet stayed in the pants and I didn't fill out a single form. A colonoscopy had a little paperwork, disclosures and actual ID. I watch the billing on MyChart, but it's a spectator rather than participatory sport. It's UCSF vs Medicare and it settles in a month or so. A+B+G+D is by far the best health insurance I've had in my life.

jasode 3y ago
>So you will have the magical illusion of a $0.00/mo premium and the insurance company then makes a substantial profit to boot. I spend about $300/mo for A+B+G+D. I guess I don't understand what you're trying to explain. There is no "$0.00 illusion". For the situation I've laid out, there's literally no $174/month or $300/month spent. >"Then you'll pay your Part B premium ($174.70/mo) out of your Social Security benefit." < ... that $174.70 is 100% reimbursed by the company -- but only if the ex-employee enrolls in the company's approved Medicare Advantage plan from UHC. If instead they go your route by rejecting Medicare Advantage, the company reimburses 0% of that $174.70 Part B premium. The math for out-of-pocket premiums payments is literally: $0/year < $3600/year > I have no preauthorizations, no copays, no coinsurance. Yes I understand, and that "no red tape bureaucracy" ability you enjoy costs you ~$3600/year more than some seniors have the ability to pay if they're restricted by what their ex-employer will reimburse. It's still a tradeoff.
- CalChris 3y ago
  What you're talking about is something like a company retiree with an additional union retirement benefit. That's different from me. In that case, they are signing over their Medicare benefit and their union/company negotiated over their retirement health benefit. That is a different case. In my case, I had a choice between Traditional Medicare (A+B+G+D) or Medicare Advantage (C). Kaiser, for example, wouldn't have been $0/mo. I chose Traditional Medicare which for me is currently about $300/mo but I can go to UCSF or Mayo or anywhere that takes Medicare. I'm very happy with Traditional Medicare but I understand that there are retirees who've had their Medicare+company retirement benefits negotiated away. Their situation is ok but I prefer mine.

jasode 3y ago

>So you will have the magical illusion of a $0.00/mo premium and the insurance company then makes a substantial profit to boot. I spend about $300/mo for A+B+G+D. I guess I don't understand what you're trying to explain. There is no "$0.00 illusion". For the situation I've laid out, there's literally no $174/month or $300/month spent. >"Then you'll pay your Part B premium ($174.70/mo) out of your Social Security benefit." < ... that $174.70 is 100% reimbursed by the company -- but only if the ex-employee enrolls in the company's approved Medicare Advantage plan from UHC. If instead they go your route by rejecting Medicare Advantage, the company reimburses 0% of that $174.70 Part B premium. The math for out-of-pocket premiums payments is literally: $0/year < $3600/year > I have no preauthorizations, no copays, no coinsurance. Yes I understand, and that "no red tape bureaucracy" ability you enjoy costs you ~$3600/year more than some seniors have the ability to pay if they're restricted by what their ex-employer will reimburse. It's still a tradeoff.

CalChris 3y ago
What you're talking about is something like a company retiree with an additional union retirement benefit. That's different from me. In that case, they are signing over their Medicare benefit and their union/company negotiated over their retirement health benefit. That is a different case. In my case, I had a choice between Traditional Medicare (A+B+G+D) or Medicare Advantage (C). Kaiser, for example, wouldn't have been $0/mo. I chose Traditional Medicare which for me is currently about $300/mo but I can go to UCSF or Mayo or anywhere that takes Medicare. I'm very happy with Traditional Medicare but I understand that there are retirees who've had their Medicare+company retirement benefits negotiated away. Their situation is ok but I prefer mine.