Almost every article you see during so-called Medicare open enrollment claims that Medicare is "taxpayer funded."That's true of course because you -- the Medicare beneficiary -- are typically the taxpayer that funded it. But after all your 50 years of taxes and your monthly Part B premium once on Medicare, you keep on giving via out of pocket (OOP) costs. For example:
- Traditional fee for service (FFS) Medicare Part A -- even with most Medigap plans -- has life-time and per-incident (not annual) payout limits on the most costly major medical services (acute care hospital admission and skilled nursing facility care).
- On the other hand public Part C Medicare Advantage supplements have annual OOP spending limits no higher than $6700. But that does not apply to Part D however, whether on FFS Medicare or Part C. Part D provides unlimited catastrophic coverage but the beneficiary always pays 5% (again, unless a low income senior in which case you effectively pay nothing from the first dollar of expense. Low income seniors should thank George Bush in their prayers every night.)
- Part B for observed acute care hospitalizations and most surgery costs while admitted and many outpatient medical services lacks coverage for vision, hearing, dental, acupuncture, cosmetic surgery and -- of course -- custodial care (which typically what is happening in a skilled nursing facility after a week or two)
Finally, the Patient Protection and Affordable Care Act does not "plug" the donut hole as the Obama administration often propagandizes (not that the donut hole matters very much since less than 10% of the people on Medicare are affected by the donut hole and only a few percent are totally affected by it and no low income seniors is ever effected). It is still there but until Congress changes the Medicare law again, and it always does, you simply pay a 25% co-pay OOP in the donut hole instead of a 100% co-pay.
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