How Can I Choose The Best Health Care Plan For Me?

When it comes to selecting a health insurance plan, premium is the most important factor for many shoppers (and especially those who are currently healthy). But price shouldn't be the only factor upon which you base your selection – even if your primary concern is financial (as opposed to things like provider networks, drug formularies, and quality ratings).

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“While Republicans have been busy tearing the Affordable Care Act to shreds, the Center for American Progress has been working on a proposal to go in the opposite direction. 

     It’s not the single-payer approach advocated by Senator Bernie Sanders, I-VT, and it keeps, rather than discards, the roles played by employer-provided health care and the insurance industry. But it is more ambitious than just that, providing employers and individuals a choice but not an obligation to join Medicare Extra. 

     Under the proposal, the report says the Medicare Extra would use Medicare’s money-saving payment system ‘as a framework to pool working-age people and their families, low-income people now covered by Medicaid and seniors.’

     At a moment, there is no cost estimate for the plan, although its authors say one is in progress. And a nonpartisan expert who reviewed the medicare Extra plan independently has said it could give Democrats a middle way to bring about coverage for all. Medicare Extra’s main features include automatic eligibility for coverage for all U.S. citizens and lawful residents, as well as free preventive care, treatment for chronic disease and generic prescription drugs. Dental, vision, and hearing services would be included. 

    Low-income people would have no premiums or copays, while income would decide premiums and copays for all others. Employers could not participate or not, while employees could choose Medicare Extra or stick with their employer’s plans; tax-free status of employer-provided health care would remain, subject to a limit. 

     Last but not least, the government would negotiate prices for prescription drugs, medical devices and medical equipment. Taxes would be higher, of course, and the government would play a more prominent role in health care, but some of the options identified in the report as possible ways to pay for it to include a rollback of some of the recently GOP tax cuts for corporations and upper-income people, raising Medicare taxes on upper-income earners and tax increases on tobacco and sugary soft drinks.”

(2/22/2018. Marlene Satter.) 

The Wall Street Journal (2/22, Tergesen, Subscription Publication) reports that beginning in 2019, Medicare beneficiaries with high incomes must pay a larger share of their medical costs. This article says this is another attempt to transfer more Medicare costs to the wealthiest seniors. The piece adds that as of next year, beneficiaries who have incomes of $500,000 or more and couples with the income of &750,000 or more will be placed into a new category and asked to pay 85% of what their parts B and D benefits cost. At present, they are paying 80% of those costs.

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