Forced into Medicare

[futurebeachbum]

Article in the WSJ this week called "Forced into Medicare" which discusses the amazing position that the administration takes regarding Medicare and Social Security for citizens 65 and older. The really short version is that as much as possible they want everyone under their thumb and they'll penalize anyone who dares to differ.

Here is a bit of it (any added emphasis is mine.)

Several senior citizens in 2008 challenged the government, suing to be allowed to opt out of Medicare without losing Social Security. The plaintiffs paid their Medicare taxes through their working lives and are not asking for that money back. They simply want to use their private savings to contract for health services they believe to be superior to a government program that imposes price controls and rations care. They also dutifully contributed to Social Security and?fair enough?prefer to keep those benefits.

As recently as the fall of 2009, Judge Collyer provided support for the plaintiffs....She also refused the Administration's request to dismiss the suit, noting that "neither the statute nor the regulation specifies that Plaintiffs must withdraw from Social Security and repay retirement benefits in order to withdraw from Medicare."
...

Yet in a stunning reversal, Judge Collyer last week revisited her decision and dismissed the case. In direct contravention to her prior ruling, the judge said the Medicare statute does?with a little creative reading?contain a requirement that Social Security recipients take government health care. The Medicare statute provides that only individuals who are "entitled" to Social Security are "entitled" to Medicare. Therefore, argues the judge, "The only way to avoid entitlement to Medicare Part A at age 65 is to forego the source of that entitlement, i.e., Social Security Retirement benefits."

So, even though the money for both Social Security and Medicare was forcibly extracted from you (and your employer) throughout your working career, you cannot choose to have, at your own expense, a better health care plan than Medicare without forfeiting the entirety of your Social Security benefit. Further, to really prevent you from doing this, if you've been drawing the SS benefits you paid for all of your working career, you must pay those back too.

This is convoluted enough, but Judge Collyer's truly novel finding comes with her implicit argument that to be "entitled" to a government benefit is to be obligated to accept it.
...
That might explain why the Obama Administration fought this suit so vehemently. The government fisc?and taxpayers?would benefit if some seniors pay for their own health care. But for many liberals, the goal isn't saving money or providing choices. The goal is to force all Americans into the same programs to fulfill their egalitarian dreams.

This is really change I can't believe in.

 

[scooterbug44]

Yes, because Obama wrote all the rules for Social Securitity and Medicare. :roll:

I would love to know what insurance company was willing to write these folks a policy that covers them 100% past 65.

 

[NotDeadYet]

you cannot choose to have, at your own expense, a better health care plan than Medicare without forfeiting the entirety of your Social Security benefit.

Of course you can. I know several people who do this with what amounts to tiered insurance. The provider gets paid first from Medicare, second from the additional insurance. It's kind of like medigap coverage, but in the case of some people I know what they have is even better, amounts to several sources of payment for all their providers.

I don't see in the post that this is going to go away any time soon. Surely the insurance companies would object. Nobody is forcing them to offer these options to folks who can afford the coverage, they are making money on the policies they write.

Seems like what this might really mean is that the well off who buy additional insurance cannot opt out of paying their Medicare premium. I don't have a problem with that.

 

[GoodWitch58]

Article in the WSJ this week called "Forced into Medicare" which discusses the amazing position that the administration takes regarding Medicare and Social Security for citizens 65 and older. The really short version is that as much as possible they want everyone under their thumb and they'll penalize anyone who dares to differ.

Here is a bit of it (any added emphasis is mine.)


So, even though the money for both Social Security and Medicare was forcibly extracted from you (and your employer) throughout your working career, you cannot choose to have, at your own expense, a better health care plan than Medicare without forfeiting the entirety of your Social Security benefit. Further, to really prevent you from doing this, if you've been drawing the SS benefits you paid for all of your working career, you must pay those back too.



This is really change I can't believe in.

The bold above is simply not true. I know plenty of people who do this and Social Security is not affected. perhaps the article is referring to something else?

 

[futurebeachbum]

The bold above is simply not true. I know plenty of people who do this and Social Security is not affected. perhaps the article is referring to something else?

Are you sure that they still collect SS and that the plan that they have is their 'primary' coverage and is in lieu of Medicare and that Medicare is not their secondary coverage? Most people have Medicare supplementary coverage.

With Medicare (and supplementary coverage) you are still bound by the limitations and conditions of Medicare. If a treatment you need is not covered by Medicare at all, then your supplement won't cover it either.

If you are still actively employed past age 65 and your employer provides health insurance, you can have that as primary but I believe you are still required to have Medicare as your secondary coverage. This ruling basically says that the only way to be totally out of Medicare is to forfeit all future (and past) SS benefits.

 

[GoodWitch58]

Are you sure that they still collect SS and that the plan that they have is their 'primary' coverage and is in lieu of Medicare and that Medicare is not their secondary coverage? Most people have Medicare supplementary coverage.

With Medicare (and supplementary coverage) you are still bound by the limitations and conditions of Medicare. If a treatment you need is not covered by Medicare at all, then your supplement won't cover it either.

If you are still actively employed past age 65 and your employer provides health insurance, you can have that as primary but I believe you are still required to have Medicare as your secondary coverage. This ruling basically says that the only way to be totally out of Medicare is to forfeit all future (and past) SS benefits.

perhaps this is something new or has taken effect for those after a certain point because I know several people who have the plan as NDY stated.

 

[futurebeachbum]

Of course you can. I know several people who do this with what amounts to tiered insurance. The provider gets paid first from Medicare, second from the additional insurance. It's kind of like medigap coverage, but in the case of some people I know what they have is even better, amounts to several sources of payment for all their providers.

I don't see in the post that this is going to go away any time soon. Surely the insurance companies would object. Nobody is forcing them to offer these options to folks who can afford the coverage, they are making money on the policies they write.

Seems like what this might really mean is that the well off who buy additional insurance cannot opt out of paying their Medicare premium. I don't have a problem with that.

I don't see the correlation at all.

In your case, they are still covered by Medicare (and its their primary insurance.) That's significantly different from opt-ing out. They have additional gap coverage but doctors are still legally bound to charge them Medicare prices and they cannot be treated by doctors who choose not to honor Medicare pricing. This could easily eliminate their participation in concierge medical treatment for example.

These people feel like they can afford to manage their own care. Had you actually read the article, you would see that they have already paid both their Medicare and SS taxes throughout their careers. They just don't want to be constrained by the inadequacies and limitations of government administered health care.

I take it from your (admittedly weak) argument that while you don't understand the issues at the core of this, you do support denying them their SS benefits for wanting to choose and manage their own medical insurance.

 

[scooterbug44]

If they don't want Medicare OR any kind of refund, all they have to do is pay for their own health care.

No reason to go to court - it's called immediate cash payment and all concierge medical professionals/facilities happily accept it. (In fact all types do and many give a discount.)

It's not like you show up at a $$$ private doctor and they say "no rich person, you can't just pay me, I have to dink around with medicare."

 

[futurebeachbum]

If they don't want Medicare OR any kind of refund, all they have to do is pay for their own health care.

No reason to go to court - it's called immediate cash payment and all concierge medical professionals/facilities happily accept it. (In fact all types do and many give a discount.)

It's not like you show up at a $$$ private doctor and they say "no rich person, you can't just pay me, I have to dink around with medicare."

Actually. In the U.S. a doctor (regardless of their participation in Medicare, filing or not) is breaking the law if he/she charges a patient who is enrolled in Medicare more than the Medicare allowed fee for any service.

The only exception I can find is a doctor who has opted out (assuming his/her field is allowed to opt-out and not all fields are allowed to) can sign a 2-year contract to provide service with a Medicare eligible individual. The rates in the contract can exceed Medicare, but they must all be specified in the contract and the patient must be responsible for the payment, (I guess if a service is left off of the contract, then the doc cannot provide it to that patient for more than Medicare rate during the contract period.) If an opt-out doctor treats a non-contracted patient (in an emergency, for example) he cannot charge that patient more than the Medicare rate.

Its a pretty byzantine set of laws that are basically designed to make it as hard as possible (without making it totally impossible) to operate outside of Medicare.