Sometimes it amazes me how politicians and big business are afraid of giving people the full truth. Over the past 4 years I have become more skeptical of politicians from both parties. I paid very close attention to the Health Care debates of 2009-2010.
Since the Patients Protection and Affordable Care Act, aka Obamacare, was signed into law on March 23, 2010, I have watch how the Obama administration has implemented and enforced the new law.
What I have seen is that politicians are willing to make a bunch of noise about things that paint them in a good light. They are not, however, as loud about the things that are just as true but not as popular.
For example, the Secretary of Health and Human Services was very vocal about the new Preventive Medicine benefits that went into effect for all permanent health insurance policies when they renewed after September 23, 2010. She was not as vocal when president Obama elected to suspend Title VIII of the law in December, 2011.
Lest you think that I believe that only politicians hide truth that they are not thrilled about, I know that insurance companies do the same thing. This morning I saw evidence for myself.
On the weekends I set aside 6 hours for myself. On Saturday I watch my son’s Alma Mater play football. On Sunday I watch my local NFL franchise. Fortunately, this year both the Aggies and Texans are winning the majority of their games.
When I turned the “Boob Tube” on this morning it was on a different channel than the one I wanted. Before I was able to change the channel, the handsome spokesman caught my attention.
I must admit that he is better looking than I am. Unfortunately, he was communicating just like a politician. In my opinion that lessens his appeal.
The problem is that unless you already know the full truth, you will not know that he is only telling you selected facts.
This good-looking spokesman was promoting Medicare Advantage. During his “pitch” he mentioned that with Medicare you are responsible for a small deductible but after you have paid your deductible, Medicare will only pay 80% of your medical bills.
What he said is only partly true. He did not explain that Original Medicare has 2 separate parts and pays in different ways.
MEDICARE PART A
When you are required to be hospitalized for medical reasons, the hospital’s bill will be paid under Medicare Part A.
What was not mentioned is that Medicare will pay 100% of your hospital bill after you have paid your Medicare Part A. That is the good news.
The not as good news is that there are some differences with Medicare’s deductible from what you had when you had private health insurance.
- The deductible is subject to change each year at the whim of the Centers for Medicare and Medicaid Services.
- Medicare A’s deductible is applied for each hospitalization you have during the year and not an annual deductible like you are used to.
MEDICARE PART B
The advertisement I saw mentioned that Medicare only pays 80% of your medical bills after you have paid your deductible. It did not mention that Medicare will only pay 80% of the “Medicare Approved” amount that your doctor charges.
If your doctor is not willing to accept the “Medicare Approved” amount as full payment for his services, he is allowed to charge an additional 15% above what Medicare says is a fair price. When that happens, Medicare will still only pay 80% of the “Medicare Approved” amount.
The spokesman painted an ugly picture but it could be even more ugly. If your doctor does not participate in Medicare, you could end up paying as much as 35% of your medical bills.
I guess I need to thank Pelosi, Reid, Obama and Sebelius. Without their lies and half-truths over the last 4 years, I would not have been as detailed in my studies of insurance. I would not be able to detect the difference between propaganda and fact by health insurance companies who are willing to skirt the truth about Medicare in order to sell more policies.
There are a couple of lessons that everyone on Medicare should learn.
- Ask your doctor before you get treatment if he accepts Medicare’s Approved amount as payment in full or if he charges the 15% Excess Fee.
- Medicare has 2 distinct ways in which it pays. Learn the difference between Part A & Part B and make plans accordingly.
I am not willing to say that there is no reason for Medicare Supplement insurance. Quite the contrary. In my opinion, anyone who has Original Medicare should have Medicare Supplement insurance.
When it comes to Medicare, people do not need to be scared with half-truths. I believe that Medicare Supplement insurance will sell itself if you understand exactly how Medicare pays and what you remain liable for.