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View Diary: Understanding the $716 Billion Dollar Figure (113 comments)

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  •  This complex interaction between Medicare and (2+ / 0-)
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    hungeski, HappyinNM

    the ACA is at the core of what the Republicans are attacking on., which tries to explain it implies that Medicare Advantage will still remain, but that

    "Starting in 2014, the Affordable Care Act offers additional protections for Medicare Advantage Plan members by taking strong steps that limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care."

    This may be a better explanation than I could give late late night when I was doing this research.  It stands to reason that by providing lower costs care through the 80/20 rule, and providing preventative care etc. far less seniors will also need to utilize Medicare Advantage.

    •  Intention is not to eliminate MAs. (1+ / 0-)
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      the intention is to eliminate the bloated subsidy to MAs, and to ensure MAs offer quality care.

      I chose a Medicare Advantage plan with Kaiser when I became eligible for Medicare a few years ago. The plan is among the top rated in the country, with many geographically convenient clinics in my area, so I can have a physician appointment, x-rays, lab tests, and pick up prescriptions all in the same place on the same day, seamlessly. Kaiser in Southern California uses electronic medical records, so at every visit the health care provider sees what I'm treated for, my prescriptions, my allergies, what tests are coming due.

      I can email my doctor and am guaranteed to get a reply within 24 hours, and many lab test results are available for my viewing online within hours and I can compare them to past test results along with explanation of the test results.

      If I need to see a doctor immediately, I can always do so - same day.

      I chose this MA plan for the reasons above and because I'd been uninsured for several years, didn't want to shop for a family physician who accepted Medicare. In the past year some of my copays have increased but are still manageable; probably not much more than I'd have to pay elsewhere (maybe less than what I'd pay elsewhere).

      Overall I'm satisfied and not ready to drop this MA plan to search for doctors, labs, radiology, and pharmacies that will accept Medicare. I'll stay with the plan until and unless it becomes unaffordable. Because the plan has a huge number of subscribers, its costs might stay relatively low.

      The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

      by SoCalSal on Sat Aug 18, 2012 at 10:49:18 AM PDT

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      •  Thank you for your well thought out comment (1+ / 0-)
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        that is good information to know from someone with experience in using MAs.

        •  Thank *you* for the diary. (0+ / 0-)

          Sarah Kliff is a great resource for health care info. She distills info from other resources and presents that info in an easily understood post.

          Several people have commented that the ACA eliminates MAs, so I wanted to clear up that misconception. In theory, MAs could provide comprehensive, coordinated care at an overall lower cost than Medicare alone. That has yet to be proved in practice, but I see some effort with my MA.

          Here's a quick explanation of how MAs work, in case you're interested: Overview of Medicare Advantage Plans

          with this quote from that page:

          If you are enrolled in a Medicare Advantage plan, you may have to pay a higher premium or deal with reduced benefits. However, these plans cannot reduce any of the benefits that you would normally receive from traditional Medicare.

          The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

          by SoCalSal on Sat Aug 18, 2012 at 02:57:37 PM PDT

          [ Parent ]

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