We are young. We have plans for our thirties and forties, but we don't want to think about our late future. Nevertheless, we should ponder our elder years now because regulations and laws take years to become a reality. It is not too much longer that we will be in our sixties or seventies. Also, you should have parents, aunts, uncles, grandparents, and friends who are struggling with Medicare reality.
According to Medicare's website: "Medicare is the federal health insurance program for: People who are 65 or older and Certain younger people with disabilities." Don't get me wrong; Medicare is an excellent program which helps hundreds of thousands of Americans. However, Medicare is not perfect; we can make it better. But, first you need to know how Medicare works; remember, Medicare can have some differences between states, but the main rules are the same.
1. Medicare is not free.
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Today, people who have Medicare pay for it. The amount could be up to $422; the average pays $232. Let's be clear, all of the Americans who qualify for Medicare paid 2.9% of each of their paychecks. Then, even though you pay all your life for Medicare, you still have to pay for it when you are retired.
2. Even with Medicare, it is necessary to have an insurance plan.
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Yes, Medicare is a federal health insurance; it only covers hospitals, inpatient facilities (Part A), doctors' visits and exams (Pat B). People who want drug coverage (Part D) and others benefits, such as, vision, dental, transportation or fitness need to get a private insurance (and pay the premium).
3. Medicare does not cover 100%.
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Most of the medical services have a copay or deductible; we are talking about doctors' visit, X-Rays, lab work, MRIs, ultrasounds, ER, ambulance, urgent care facility, nuclear medicine, electros, stress test, surgeries, inpatient facilities, etc. Most of these copays are payable.
The problem starts with a serious illness such as cancer. If somebody needs radiation therapy or chemotherapy, this person has to pay 20% of the cost. It means thousands of dollars for a person who lives with his/her retirement check. Many people cannot afford this.
4. Medications are expensive.
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Medicare patients need a private insurance to have drug coverage. Even though people have insurance, they have copays for medications. For most of the generic drugs, the copays are a couple of dollars; the problem starts with expensive medications, for example, for diabetes, cardiac conditions, cancer or renal issues. These kinds of medications are expensive, and the copays can turn in hundreds and thousands of dollars.
Also, it is important to explain something else about Medicare and medications. People do not pay the same amount for medications the whole year. There are four stages: Deductible, Initial, Coverage Gap and Catastrophic. This is not a Medicare class; however, it is important to know better the Coverage Gap (or donut hole).
After people reach $3,750 (2018's numbers) in medications by their pockets and the insurance plan, the person has to pay 35% and 40% of the cost of the medications; again, we are talking about medications that cost hundreds of dollars. For instance, a person who has diabetes may pay over four hundred dollars.
We have the chance to vote this year. Before you make any decision, check what your candidate is offering for Medicare. It sounds far, but we need to work today for a better future for all of us.
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