The purpose of government is to improve and protect the lives of the governed.
Is the Medicare Advantage plan an admission that Medicare itself is unnecessarily incomplete?
A story: You receive a call from the wealthiest man on earth. He owns an infinite amount of money.
He tells you he’s in the mood to do a good deed.
He has picked your name randomly, not based on anything but the luck of the draw, and he is giving you a free, no-strings-attached, Rolls Royce automobile.
Well, actually, there are two small strings. You must choose between two Rolls.
One has no heater. The other has no air conditioning.
And you must wait until you are 65 years old before you pick your car.
This puzzles you, so you ask him, “Why would someone having infinite money decide that when does his good deed, he gifts you a car that is missing either a heater or air conditioner?”
And why must you wait until you’re 65?
What’s his purpose?
While you ponder that question, consider this: The federal government, being uniquely Monetarily Sovereign, has infinite dollars. It never can run short of its own sovereign currency.
The government provides you with Medicare, which comes in two basic “models,” Original Medicare and Medicare Advantage.
And you typically must wait until you are 65 to join (with certain exceptions).
But Medicare and Medicare Advantage have different options depending on many of your personal factors.
WHY? Why doesn’t Original Medicare simply cover all medical conditions for everyone?
The American Association of Retired People (AARP) published “8 Reasons to Change Medicare:
1. My prescription costs have jumped.
That happens usually due to one of two scenarios: You’ve been prescribed a new drug your Plan D policy doesn’t cover, or your current medicines have fallen off your Plan D’s formulary (list of covered medicines), Neuman says.
Each September, Part D prescription plans will send out a list of changes to drug coverage, giving you time to make sure your medicines are still covered.
If not, you can shop around for another plan or ask your doctor to apply for an exception in covering your favored medicine.
WHY? Why must a person pay extra for Part D, and why must that person shop around for a plan that covers all his medicines?
2. I’ve decided to spend my winters (or summers) in a different state.
Advantage plans typically charge more to go to doctors outside of their networks; in some cases they won’t cover any charges if it’s not an emergency.
So a Midwesterner might have to pay more to see out-of-network doctors while in Florida.
You need to read the details of your plan, or talk with a representative, to know where you stand. If you’ll be living a dual-residence existence for years to come, you might consider a switch to original Medicare, with the usual caveats.
WHY? Why the “in-network, out-of-network” rigamarole?
3. I need surgery and prefer a specific doctor.
Original Medicare allows patients to choose any doctor or hospital that accepts Medicare.
But if you’re in a Medicare Advantage plan and its surgeons don’t meet your needs, you may need a different MA plan or to switch to OM.
The people who really need to focus on whether doctors are in network are those who’ve suffered major problems like cancer and heart attack, says Joseph Antos, health care expert at the American Enterprise Institute.
“A specialist may be key to their treatment,” he says.
WHY? Why does one Medicare plan cover any doctors or hospitals that accept Medicare and the other plan doesn’t?
4. I’m super healthy and rarely need a doctor.
If you’re in original Medicare, all should be well: As a “pay-for-service” arrangement, not seeing the doctor isn’t costing you anything extra beyond your mandatory parts B and D monthly insurance premiums.
If you’re in an MA plan in which you’re paying a monthly premium on top of your standard Part B premium, that may be for a plan that offers lots of extras , such as gym memberships.
Consider switching to a lower-cost MA plan that doesn’t offer services you don’t plan to use in the coming year.
WHY? Why are there any premiums, and why does one plan not cover the “extras?
5. I’ve been diagnosed with a chronic condition.
A serious medical change should trigger a full review of your Medicare coverage. Make sure your Plan D policy pays for new prescriptions.
Consider the care you’ll need . If you want disease-specific programs, find an MA plan that offers them.
But if you will need lots of specialists, there’s an argument for OM. Making critical changes early can “really affect your pocketbook and save you money,” says Gretchen Jacobson, a vice president with the Commonwealth Fund.
WHY? Why the difference in plans? Why doesn’t one plan cover everything?
6. My income has dropped sharply.
If you are in original Medicare, your Part B monthly premium is locked in, but your Part D drug plan isn’t.
And there’s a chance you can find a lower-cost policy that covers the medicines you are on.
If you’re in an Advantage plan, consider a switch to a plan in which there is no extra payment on top of the mandatory Part B premium.
And you might qualify for help. Ask your state Medicaid office about Medicare Savings Programs. Find the state offices here or call 800-MEDICARE (800-633-4227).
WHY? Why is there a monthly premium? Why does one plan not even lock in premiums? Why the difference in costs?
7. My former employer is changing its retiree health benefits.
Some companies provide retirees with Medigap supplemental insurance, which covers many health costs not covered by OM.
If you have changes to your retiree benefit coverage, or for some reason that coverage no longer is offered, contact Medicare’s Benefits Coordination & Recovery Center (855-798-2627).
Someone can tell you whether you fall in the window in which Medigap insurers cannot deny you coverage based on preexisting conditions.
WHY? Why are some retirees not covered by Medigap supplemental? Why is there even a need for supplemental?
8. My regular doctor is no longer in network for my plan.
If you deeply want to stay with a doctor, ask directly whether he or she is moving to a different MA plan, accepting OM patients or dropping out of Medicare completely.
If you decide to make a change, make sure a short-term decision won’t affect your long-term coverage (for example, switching to original Medicare to temporarily stay with one doctor but sacrificing Medigap coveragefor the long term).
It might be safer to ask your doctor to recommend a colleague in your current plan.
I’m in need of serious dental care. Original Medicare doesn’t cover routine dental care costs, but many Medicare Advantage plans do.
If you don’t have your own dental insurance and can’t afford dentistry costs out of pocket, consider finding an MA plan that will cover a portion of the costs of your needed work.
Antos warns that figuring out what portion of your dental bills an MA plan will cover is complicated, so it helps to know what services you will use in the coming year.
WHY? Why does a person need to consult a crystal ball to guess what medical coverage will be needed at some unknown time in the future?
HERE IS WHY: Our Monetarily Sovereign government has infinite funds. It can afford any expense, even without collecting a single dollar in taxes. It has ultimate control over the value of the dollar, i.e. inflation.
Thus, the federal government has the unlimited ability to fund comprehensive, no-deductible Medicare for every man, woman, and child in America. There is no financial reason why you, your family and everyone you know does not have free, total healthcare protection.
But . . .
At the behest of the very rich, who run America, our information leaders promulgate the Big Lie that taxpayers fund federal spending, and that the federal government is in danger of running short of dollars if spending increases without tax increases.
You have been sold the bill of goods that “there is no such thing as a free lunch,” and that federal spending causes inflation, and that the phony Medicare “trust fund” is running short of money.
The rich do this to widen the Gap between the rich and the rest, for it is the Gap that makes them rich. The wider the Gap, the richer they are.
Better “Medicare for All” plans have been proposed, but they have been rejected supposedly because tax dollars are needed to pay for it.
They aren’t. It’s the Big Lie, the sole purpose of which is to make the rich richer.
There is no other purpose.
Rodger Malcolm Mitchell Monetary Sovereignty Twitter: @rodgermitchell Search #monetarysovereignty Facebook: Rodger Malcolm Mitchell
THE SOLE PURPOSE OF GOVERNMENT IS TO IMPROVE AND PROTECT THE LIVES OF THE PEOPLE.
The most important problems in economics involve:
- Monetary Sovereignty describes money creation and destruction.
- Gap Psychology describes the common desire to distance oneself from those “below” in any socio-economic ranking, and to come nearer those “above.” The socio-economic distance is referred to as “The Gap.”
Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics. Implementation of Monetary Sovereignty and The Ten Steps To Prosperity can grow the economy and narrow the Gaps: Ten Steps To Prosperity:
- Eliminate FICA
- Federally funded Medicare — parts A, B & D, plus long-term care — for everyone
- Social Security for all
- Free education (including post-grad) for everyone
- Salary for attending school
- Eliminate federal taxes on business
- Increase the standard income tax deduction, annually.
- Tax the very rich (the “.1%”) more, with higher progressive tax rates on all forms of income.
- Federal ownership of all banks
- Increase federal spending on the myriad initiatives that benefit America’s 99.9%
The Ten Steps will grow the economy and narrow the income/wealth/power Gap between the rich and the rest.