Let's say the government can pay for it. OK, with a sweep of their pens the new progressive world of Medicare for all becomes law in the US. A little more imagination required...
Let's imagine that Congress says that public employees, like themselves, will be bound by this new Medicare for all, and not in the "exemption" way they participate in Obamacare bypassing income limitations for premium assistance from taxpayers, (we pay around 72 percent of their premiums), and no special public employee plan offerings (like the 'gold' level options available to public employees only). Let's say it's really Medicare for ALL, not just us, for whom Congress considers it good enough while reserving their own superior benefits. A little more imagination required...
Let's also imagine that public employee lifetime publicly paid for superior benefits also go away and older public employees are on Medicare for all as well, instead of continuing to reap public employee permanent benefits off taxpayers' backs. Just a little more preliminary imagination...
Finally, let's imagine in this magical world of Medicare for all that private insurance is only available to individuals who can purchase private insurance on their own. No vouchers, no employer insurance, no public employee exemptions, no additional assistance to the poor…The SAME MEDICARE FOR ALL, where ALL actual comes closer to meaning everyone unlike what we have now.
OK, so assuming that Medicare for all resembles its forerunner and current program, Medicare, here's where we stand. We pay into Medicare all our working lives, and of course, younger workers will have paid less since their working lives have been shorter, so they're getting a deal right off the bat. If we cover non-Americans and anyone else who wants to partake, naturally, they'll have paid nothing at all, an even better deal. This is what we get.
Medicare Part A: Congratulations, you have just voted on PLAN LIMITS for all. Many of you are unfamiliar with plan limits, but Medicare's got them. This is the top amount of coverage you will get during a benefit period, NO MORE regardless of your medical expenses.
Take hospitalization. A benefit period for hospitalization is 60 days. OK, you're young, you don't anticipate needing 60 days of hospitalization, but then again, if you're healthy it doesn't matter how bad your health insurance is. Let's remember, even if you're a young Medicare for all patient you might be in an accident, suffer from a debilitating disease, or have a premature or medically needy baby where those 60 days in the hospital get eaten up pretty quickly.
Plan limits and the benefit period: Under Medicare Part A you get 60 days of hospitalization during a benefits period. That means from the day you're admitted to the hospital your benefits period begins. If you're released from the hospital before day 60, your hospital expenses will be limited to the $1,364.00 deductible. You did know that Medicare has deductibles, right?
If you remain hospitalized, you are responsible from day 61 to day 90 for $341.00 per day. And if you, during the benefits period, or your baby are hospitalized for more than 90 days during a benefits period you must dip into your LIFETIME RESERVE, a one-time only and forever resource of 60 days for which you pay $682 a day.
Benefits Period is any continuous period of time you're in the hospital from day 1 to day of release and INCLUDES time spent in a skilled nursing facility. So if you spend 7 days in the hospital and go into skilled nursing, you're on day 8 of your benefits period. A new benefits period only occurs if you remain OUT OF THE HOSPITAL for a period of 60 days after release.
While you're in that skilled nursing facility, you'll get 20 days covered by Medicare. After that, day 21 through day 100 you're responsible for $170.50 a day. After day 100, you get nothing. YOU are responsible for all costs. You CANNOT use your lifetime reserve days for a skilled nursing facility.
If you stay out of the hospital for at least 60 days, you can start all over again EXCEPT for the LIFETIME RESERVE 60 days which however many you've used at $682 a day are gone forever. OK, so you've embraced lifetime PLAN LIMITS on the number of days you can get hospitalization coverage for.
(Don't forget, Medicare offers no protection from balance billing if you see non-Medicare physician providers). That's right balance billing is still a risk for patients under Medicare for all.
Let's move on. If you're a Medicare for All voter you have just voted to remove out of pocket maximums. That's right, these maximums which currently are absurdly high $7,900 for an individual and $15,800 for a family are completely gone under Medicare for all. Sky's the limit, there is no MAXIMUM for your out of pocket expenses. OK, so you've embraced the end of out of pocket maximums.
You'll need some SUPPLEMENTAL plans to help cover other costs, after all, you didn't think you got everything under part A did you? A deals with hospitalization, but how about those physician visits?
Medicare Part B: Congratulations as a Medicare for all participant you just purchased Part B for costs of premium, deductible and coinsurance, for some of your physician visits. Many laboratory tests and routine blood work are not covered, so you'll pay for those too. For the physician visit if you use a Medicare physician, you'll pay 20 percent in coinsurance. If your physician is not a participant, you'll pay more.
Medicare Part D: Congratulations, as a Medicare for all patient, you'll need to buy prescription coverage. Another premium, more deductibles and varying formularies (drugs covered) at various costs and increasing drugs completely excluded from coverage. Combined with no out of pocket maximum, this could be an expensive one. As a matter of fact even CNN reported on 3/26/2018 about how the cost of many drugs has gone up 10 times the rate of inflation, in the years since Obamacare (see CNN for this one 3/26/2018).
As a Medicare for all voter, remember you'll be a Medicare for all participant and it's unlikely your ideologically self-righteous candidate will join you in that experience, just like what happened with Obamacare.
