In the continuing series of bad information from United States Public Broadcasting System's web site, the biggest errors start with PBS's actual descriptions of what Medicare is. PBS says
- "Part A:The hospital deductible will be $1,260 for each benefit period There is zero coinsurance for the first 60 days of a hospital stay, $315 a day for days 61-90, and $630 a day for days 91-150. Nursing homes have zero coinsurance for the first 20 days and $157 a day for days 21 to 100."
- But PBS gives no explanation that these $630/day days are lifetime reserve days which can only be used once and the term "nursing homes" is wrong. Part A covers skilled nursing facilities, not nursing homes; and the days covered are not automatic; you must be in the SNF for a specific purpose and achieving that purpose.
- "Part B: The standard monthly premium is $104.90 for those with taxable incomes of $85,000 or less ($170,000 for joint filers) and rises along with income levels to a maximum of $335.70 for anyone making more than $214,000 a year ($428,000 for joint returns). The Part B deductible is $147 a year. Most people’s Part B premiums are paid out of their monthly Social Security, so it’s important to look for changes in your Social Security and make sure they’re accurate."
- I wonder why PBS mentions the Part B surtax that affects about 20% of seniors on the high side but does not mention the Medicare Savings Program, that reduces premiums -- sometimes to zero -- for 20% of seniors the low side.
- "Part C: This is the part of Medicare that deals with Medicare Advantage plans, private insurance that contracts with Medicare to offer Part A, B and, usually, D programs. They were subsidized by the government to encourage private insurers to offer and manage basic Medicare insurance plans. Because of the subsidies, these plans usually offered enhanced benefits at no extra cost to consumers and have thus become increasing popular. Even with recent cutbacks in their subsidies, the plans have gained users and now are chosen by about 16 million beneficiaries."
- Part C plans are not private and work just like Parts A and B in that private insurance companies – sometimes the same companies – are “subsidized” to manage claims and similar functions. There is no difference except for type of insurance – FFS vs. capitated -- which has nothing to do with Medicare.
- "Part D: More than 38 million people were enrolled in Medicare drug plans at the end of last year, including about 23 million in prescription drug plans and the rest in Medicare Advantage plans. The annual maximum deductible for drug plans in 2015 will be $320. For the next $2,640 in drug expenses, members pay a 25 percent co-pay. Once expenses hit $2,960, you’re on the hook for the next $3,720 in drug costs. Under the Affordable Care Act, the donut hole will be phased out by 2020."
- There are so many misleading statements in the Part D section that let me simply say
- Most plans do not have a deductible
- The donut hole does not go away (and very few of you will be affected by it anyways)
- As is always the case, try generic drugs first
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