'Our Seniors Deserve Better': Jayapal Demands End of All Medicare Privatization Schemes

[Ms. Toad]

33. Did you resesarch them BEFORE you enrolled, or only as an option to switch

from Medicare Advantage to original Medicare?

Stop implying that those of us who are promoting original Medicare "don't get it," are on grandfathered plans, etc. That's just nonsense. Most of just have a bit of money savvy, or experience with chronic illness, so what we get are the consequences of enrolling in a plan with a large out-of-pocket cap.

I enrolled in Medicare on January 1 of this year - so while I'm **now** already on it, I made my decision during the most recent annual open enrollment period for Medicare Advantage - not years ago when these supposedly much cheaper, much better plans were available. What is available now is essentially what was available 25 years ago when my parents enrolled in Medicare. I'm on a plan one step better than my father's and one step below my mother's (the best supplement plan ever available). My mother's plan is the only option not available to me. That plan was avaialble to my spouse. It would have saved her a grand total of $233 in out-of-pocket expenses each year. For that savings, she would have needed to spend about $300. It makes no sense to spend $300 to save $233. So that super-fantastic grandfathered plan is not even a loss, at all, for anyone handy enough with a calculator or mental arithmetic to multiply 12 by the ~$50 higher monthly premium.

I rejected Medicare Advantage plans because I am not willing to accept up to (currently) potentially $11,300 in out of pocket expenses each and every year until I die (the cost for declining original medicare during your once-in-a-lifetime enrollment period). A $0 premium plan is only affordable if you have the ability to pay the deductible, coinsurance, and copays for the actual care you use. All cost comparisons need to include both premiums (Part B and either MA premium OR the supplement premium) and your share of the actual medical expenses. As noted in an earlier post - at 6 months, because my out-of-pocket costs are capped at $233 for the entire year, I have already saved about $300 (total costs) over the $0 premium Medicare Advantage plan. That savings will only grow as I continue to be provided with no-additional-cost medical care (for which, under a MA plan, I would continue to accrue costs until I hit the out-of-pocket max of $4,500 on the plan I used for comparison purposes).

It IS unaffordable to try to switch AFTER enrolling in Medicare Advantage. That is by design, because Medicare supplement premiums would be unaffordable if you could just go without insurance until you really needed it. That design is poorly implemented - since even very bright, very educated people have a hard time deciphering the consequences of opting out of original Medicare.