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View Diary: HCR Part II:  Where Do We Go From Here, Sweet Child 'O Mine? (53 comments)

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  •  How does this compare to medicare coverage? (2+ / 0-)
    Recommended by:
    jim bow, mahakali overdrive

    One punches you in the nose and the other kicks you in the groin...Axelrod commenting on the right and left

    by Kitty on Sat Jul 03, 2010 at 11:50:58 AM PDT

    •  Excellent question. (3+ / 0-)

      This proposal is much, much more generous than Medicare.  

      Medicare -- when you combine Parts A, B, and D, has around a 76 percent actuarial value.  This proposal has a minimum 90+% actuarial value.  Medicare has a $1,000+ deductible per person, 20% co-insurance for hospitalization, and no out-of-pocket cap.  This proposal has no deductible, $250-$500 inpatient hospitalization, $15 generic drugs, and a $2,000/$4,000 out-of-pocket cap.

      Also, Medicare obviously doesn't cover maternity care, well-child care, and other items not used by the 65+ and disabled crowd.  Obviously current law requires insurance companies to provide some level of coverage of maternity care.

      •  In other words (2+ / 0-)
        Recommended by:
        jim bow, mahakali overdrive

        with Medicare you pay $1,000 up front then 20% of hospitalization no matter how high it goes?

        One punches you in the nose and the other kicks you in the groin...Axelrod commenting on the right and left

        by Kitty on Sat Jul 03, 2010 at 12:06:36 PM PDT

        [ Parent ]

        •  Excuse me (3+ / 0-)
          Recommended by:
          Kitty, sherijr, mahakali overdrive

          I really, really miswrote there.  I meant physicians for part B -- not hospitalization.  If hospitalization costed that much, then the actuarial value would be much, much higher.  Thankfully, we don't treat our nation's seniors and disabled anywhere near that poorly:

          Per wiki:

          Part A — For each benefit period, a beneficiary will pay:

          A Part A deductible of $1,068 (in 2009) for a hospital stay of 1–60 days.
          A $267 per day co-pay (in 2009) for days 61-90 of a hospital stay.
          A $534 per day co-pay (in 2009) for days 91-150 of a hospital stay, as part of their limited Lifetime Reserve Days.
          All costs for each day beyond 150 days[33]
          Coinsurance for a Skilled Nursing Facility is $133.50 per day (in 2009) for days 21 through 100 for each benefit period.
          A blood deductible of the first 3 pints of blood needed in a calendar year, unless replaced. There is a 3 pint blood deductible for both Part A and Part B, and these separate deductibles do not overlap.
          Part B — After a beneficiary meets the yearly deductible of $155.00 (in 2010), they will be required to pay a co-insurance of 20% of the Medicare-approved amount for all services covered by Part B with the exception of most lab services which are covered at 100%. They are also required to pay an excess charge of 15% for services rendered by non-participating Medicare providers.

          The deductibles and coinsurance charges for Part C and D plans vary from plan to plan.

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