tag:blogger.com,1999:blog-8512362.post8360691561143521883..comments2024-03-10T13:59:19.230-04:00Comments on xpostfactoid: How will Medicare enhancement change the current public-private Medicare ecosystem?Andrew Sprunghttp://www.blogger.com/profile/17601269968798865106noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-8512362.post-25581996984733422352021-09-04T09:33:11.473-04:002021-09-04T09:33:11.473-04:00The cost of adding dental, vision, and hearing be...The cost of adding dental, vision, and hearing benefits to Medicare has been estimated at $350 billion over ten years.<br /><br />But these ten year estimates are very misleading. I always restate these amounts in annual terms for greater understanding. The annual cost would be about $35 billion a year, which is just 5% of the $750 billion annual Medicare spending.<br /><br />In many cases, the dental-vision-hearing coverage in current MA plans is puny. A policyholder might get a $400 discount on a $2500 hearing aid....big deal!Bob Hertzhttps://www.blogger.com/profile/08889826739646491269noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-55575600706334774752021-09-02T22:12:15.244-04:002021-09-02T22:12:15.244-04:00Good Observation: "The biggest gap in FFS Med...Good Observation: "The biggest gap in FFS Medicare is the lack of an annual OOP cap."<br /><br />Separately, calling our Medicare system "byzantine" is of course accurate, and of course applies to the whole U.S. health care system.<br /><br />As a fine point on the byzantine complexity making a coverage-gap on Medicare a thing just waiting to happen, I note that one can not stop worrying about pre-existing conditions on Medicare.<br /><br />In particular because if a person doesn't get and continuously hold a Medigap policy in a small window around the start of reaching Medicare age 65, then at later ages, they can be excluded from Medigap plans at later ages on the grounds of pre-existing conditions. (Ref: https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights )<br /><br />(The rule apparently comes from trying to avoiding adverse selection: the rule tries to prevent people from picking up a Medigap plan just when they get sicker. It's analogous to, in pre-ACA days, in community-rated states like NY and NJ, the exclusion of pre-existing-conditions coverage for a period for people without continuous prior coverage.)<br /><br />Thus, one has to be careful on Medicare: if a person wants the option of traditional FFS Medicare with a supplemental, they essentially lose it if they don't start Medicare at 65 with the supplemental and hold the supplemental continuously.<br /><br />They have to avoid Medicare Advantage (with the exception of a brief allowed trial period--see the ref above).<br /><br />Medicare Advantage seems to be different: you can pick up any one of those plans at any time, regardless of pre-existing conditions, and regardless of whether you prior had traditional FFS Medicare, and regardless of whether you purchased a supplemental for that traditional FFS Medicare. (Adverse-selection risk exists from this aspect, but is not addressed by any rule. A little inconsistency there, but a minor for the U.S. health insurance system!) (Ref: https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/things-to-know-about-medicare-advantage-plans .)<br /><br />So, it's just a little pre-existing-conditions complexity for the folks 65 and up to have to deal with.<br /><br />Norm Spierhttp://nasmusicsoft.comnoreply@blogger.com