The Annual Election Period known as AEP for Medicare begins on October 15 and runs until December 7 every year. This is the time enrollees (beneficiaries) can make changes and enroll in prescription drug plans and Medicare advantage plans.
There is a national movement to enact Medicare for everyone. Is this a good idea? I get it; as a health insurance broker I have seen premiums increase to unaffordable rates. If you do not have health insurance at work or receive a subsidy, the average for an individual is more than $800 per month and for a family more than $2,000. Group health insurance costs have increased as well with plans offering higher deductibles.
But what does Medicare for all mean?
First let’s discuss what Medicare is and is not. Medicare Part A pays for hospital stays after a deductible of $1,340 per stay for days 1–60. On the 61st day your co-insurance costs are $335 until you reach day 90 and then increase to $670 per day until you reach your lifetime maximum limit (up to 60 days over your lifetime). After your limit, you pay 100 percent.
Doctor’s services are paid by your Part B. The Part B deductible in 2018 is $183 and covers 80 percent of the cost. Your 20 percent co-insurance could bankrupt you because there is no limit. That is the reason Medicare supplements and Medicare advantage plans are needed, to offset the cost of co-insurance.
Medicare Part B has a cost of $134 per month per person and is adjusted on a sliding scale depending on income.
Medicare does not include prescription drugs. You will need a Prescription Drug Plan (PDP). These plans are offered by insurance companies and vary in cost depending on the formulary (list of drugs). This is known as Part D.
This is a partial list of services covered under group or individual health insurance that is not covered by Medicare:
- Birth control
- Well baby care
- Pediatric dental
Medicare was designed as health care for the elderly and disabled. Many of the procedures and services covered under group or individual care are not needed by this demographic.
In order for Medicare to be a viable solution, Medicare would cease to exist as it now stands. If we change Medicare to include everyone, the cost for Part B will increase.
Retirees are on a fixed income and can’t afford increases. Many retirees are choosing whether to pay for food or the high cost of their medications.
Ask your parents and grandparents how an increase in their Medicare Part B premium would affect them. Listen to what they say!
Is Medicare for everyone? Be wary of unintended consequences.