Blogs
- Open Enrollment 2023 FAQ
- Get Ready! Medicare Open Enrollment Begins October 15th
- Ten Shocking Medicare Stats
- Minimize Home Care Costs with Medicare
- 4 Ways to Make Your Home Safer for Loved Ones with Alzheimer’s Disease
- 7 Million Californians to Benefit from State-Run Retirement Plan
- 5 Ways to Get the Most from Medicare
- How to Spot Medicare Open Enrollment Scams
- 200,000 Doctors are Turning Away New Medicare Patients
- Doctors Warn Patients About Upcoming Medicare Changes
- The Mystery of Medicare
- Medicare Cost Plans vs. Medicare Advantage
- Shopping for Medicare Last Minute
- 5 Reasons to Switch Your Medicare Advantage Plan
- Medicare Help: Get Help Choosing a Hospital
- What do Medicare drug plans cover?
- How Medicare Online Works for Medicare Beneficiaries
- Medicare Part A Costs
- When to buy Medigap Insurance
- The Latest in the Battle for Prescription Drug Coverage
- Don’t Miss These Medicare Deadlines
- 4 Tips for Protecting Your Retirement Savings
- Medicare Open Enrollment Starts Soon
- The Ultimate Retirement Checklist
- Health Care to Cost $10K Per Person
- 8 Things Seniors Should Know About Hospice Care
- Do seniors know enough about their Medicare choices?
- Retirement Plans You Might Regret
- Medicare Penalized for Being Too Careful
- Paul Ryan’s Plan to Make Medicare a Voucher Program
- Thrown Away: $3 Billion in Cancer Drug Spending Wasted
- How Seniors are Winning with Home Care
- Medicare Facts - Are Injections Better Than Eye Drops for Addressing Cataracts
- 3 Things You Don’t Know About Medicare But Should
- Americans Want Medicare to Cover Obesity Treatments
- Best Places to Retire with Affordable Healthcare
- Medicare to Test New Drug Pricing for Doctors and Hospitals
- Retirement – 5 Websites Made for Retirees
- Medicare Home Health Agencies
- Medicare Part B Costs And Coverage 2016
- Medicare Advantage is Changing in 2016 – Are you Ready?
- Choosing a Home Health Agency
- Medicare Part D Costs and Coverage 2016
- DIY Guide to Medicare Shopping
- Should Medicare Cover Genetic Sequencing?
- CMS Bars Cigna from Enrolling New Medicare Members
- Is Medicare for All an Achievable Goal?
- Trump – Medicare Should Negotiate Drug Prices
- A Guide to Medicare Part A
- 5 Things You Didnt Know About Medicare
- Medicare News: A Look Back at Medicare Changes in 2015
- Hospital Prices Vary Across U.S.
- Five Ways You’re Wasting Your Retirement Money
- Government Targeting Remaining Uninsured
- Retirement Benefits Set to Change in 2015
- Medicare Costs: These 5 Screenings will Help You Keep Medicare Costs Down
- Medicare Spending: New way to explore Medicare prescription-drug spending
- Infections & Mistakes - Medicare Penalizes South Florida Hospitals
- Three Changes Coming to Medicare in 2016
- Quit Smoking with Help From Medicare
- Get Your Free Flu Shot Before It is Too Late
- Antibiotic Use: When Not to Take Antibiotics
- Medicare Premium Costs Are Not Going to Spike For Now
- A Migraine even without throbbing pain is a migraine
- Deciding on your best options according to your circumstances and needs
- Medicare Advantage Plans (Under part C)
- Medicare Prescription Drug plans (Part D)
- The things that Medicare doesn’t take care of
- Nurture your body by drinking plenty of water
- Avoid paying more for prescription drug coverage
- Dear Coffee lovers, Caffeine may actually be beneficial for you
- How does one select a primary care provider for oneself or a loved one?
- Know how traveling affects your Medicare plans
- Have Medicare costs been worrying you? The good news is, you may qualify for financial hel
- What should be done if I want to make a transition from Health Marketplace to Medicare
- The drawbacks of Medicare Advantage
- Can Medicare Advantage provide quality, savings, satisfaction and access- all together?
- Refining Medicare Advantage
- What are my expectations from a Medicare program?
- Medicare Additional/Supplemental Insurance Plans
- Working towards better American Health care- Medicare Advantage
- Managing out-of-pocket costs and paying for Medicare
- The basics of medicare and how it works
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The things that Medicare doesn’t take care of
Medicare is at times regarded as a “single-payer” system and some experts—such as the New York Times commentator Paul Krugman—have debated on that point intensely. Honestly speaking, this isn’t true (sincere apologies to Prof. Krugman) even though Medicare does share some traits with single-payer systems. Together, Medicare Parts A and B constitute a “direct payment” program. In the narrow sense, the program resembles some of the “single-payer” systems that people like Krugman have proposed. This program implies that service providers and facilities are paid directly by the federal government. Ultimately, the debate over whether “traditional” Medicare is a “single-payer” or “direct-payer” plan is less important to consumers compared to what the program takes care of.
The combination of Parts A and B, which is known as the ‘Traditional Medicare’ - does not cover:
- outpatient prescription drugs (having only a few exceptions)
- monthly premiums for Parts A, C or D
- dental care and dentures
- hearing aids
- routine foot care and/or orthopedic shoes
- routine eye care and/or glasses
- custodial care (help with bathing, dressing, toileting, and eating) at home or in a nursing home
- health care you receive while traveling outside of the United States (except under limited circumstances)
- cosmetic surgery
- routine or yearly physical exams
-
§ deductibles, coinsurance requirements or co-payments when you get health care services (and, as we’ll see below, these can be significant)
Medicare Part B, particularly, requires significant out-of-pocket payments from the consumer. According to the main Medicare web site (www.medicare.gov):
Part B pays all covered hospital, skilled nursing facility and home health care benefits for each benefit period except for the deductible. For the year 2011, for any hospital stay that implies 60 days or less, the deductible is $1,132. If the stay exceeds 60 days, a Medicare co-payment will apply. For stays that last 61 to 90 days, a Medicare co-payment of $283 per day will have to be paid by you. For stays of 91 to 150 days, you will have to pay $566 per day. If your hospital stay lasts longer than 150 days within a single benefit period, you will be required to pay the full cost for each day after the 150th day. For people on Medicare who receive care in a skilled nursing facility, a Medicare co-payment of $141.50 per day will apply to days 21 through 100. Medicare will cover days 1 through 20 in full. You will be required to pay in full any days after the 100th day.
For most people over 65, all of these exclusions add up to quite a bit of out-of-pocket expense. It’s more than most people—especially those living on fixed incomes—can afford. So, a long hospital stay can be expensive—in fact dreadfully expensive—even with this coverage at your rescue. This is the reason why traditional Medicare can’t completely be called a single-payer program; with so much that isn’t covered, someone is paying a significant amount in addition to what’s paid by the Feds.