Part A — Hospitalization coverage (what we used to call major medical) You are automatically covered when you turn 65 if you are an American citizen. Everyone is covered under these conditions. You must have paid into the fund for a minimum of 10 years but can be purchased also.
Pays only 80% of care and has a deductible which is variable and based on hospitalizations rather than time.
No prior authorizations (a new program is rolling out in a few states, and it’s controlled by AI)
If a doctor orders the work and the patient agrees the work is done.
FEDERAL GOVERNMENT OWNED AND OPERATED
Part B — Covers outpatient care, imaging and bloodwork. Part B premiums are deducted from your Social Security check and it is $202.90, with an annual deductible of $283. Normally you will pay this insurance premium no matter what type of insurance you pick.
What percentage does part B pay, 80%? Coinsurance is 20%
FEDERAL GOVERNMENT OWNED AND OPERATED
Supplemental Medicare — Medigap will pay for what Medicare does not pay, for example, the Medicare A and part B copay of 20% for hospital stays and outpatient care. It covers a portion of Part B based on what plan you have purchased. Medigap is only available through for-profit private companies.
PRIVATE FOR PROFIT COMPANY OWNED AND OPERATED
Part C — Medicare Advantage Plans — Covers all health care, like employment-based care
BUT it is profit based and
those profits are made by slowing down care by forcing patients to get prior authorizations and/or downright refusing care.
Often, salespeople will not tell you your options, but will only explain Part C as if it is real Medicare. Part C is NOT real Medicare. Salespeople make money if you purchase Part C.
PART C is profit based and they are making billions from the Federal government. The profit is made by providing subpar care, delaying care or refusing care to the patient.
Copays can be extremely expensive. For example, radiation treatment for cancer patients, (in some cases has a copay of $80). But radiation treatment lasts for 25–50 treatments. Making out of pocket costs a minimum of $2,000.
If you become sick, it is very difficult, if not impossible, to switch back to regular real Medicare. Medicare covers all care equitably, not so with an insurance company. (This is not something that the salesperson explains to you when you purchase your first plan.)
PRIVATE FOR PROFIT COMPANY OWNED AND OPERATED
Part D — pharmacy only and it is required if you have original Medicare, it is not required if you purchase Part C Medicare because (theoretically) your medications are covered by Part C.
PRIVATE FOR PROFIT COMPANY OWNED AND OPERATED
The bottom line is that Part C is a very cheap option at first, but only as long as you are healthy. Once you get sick it is an awful bargain and depending on your health issues can bankrupt you.
You can’t switch back from Part C to original Medicare unless you are healthy for several consecutive years. As you get older this becomes impossible.
As with all things “health care in America” illness will bankrupt you very quickly and for 25,000–45,000 Americans annually, will kill you.
