I am writing in order to give some insight into the Medicare system based on both my wife’s and my experience since turning 65 last year. This is focused on Medicare Part B for doctor care and Medicare Part D for drug coverage. There is Medicare part A which covers hospital cost ($1156 deductible) and requires no premiums and Part C that covers “Advantage” programs that you can pick instead of standard Medicare.
Standard Medicare cost each of us $99.90 a month for 2012, plus a $140 deductible or $2677.60 for both of us for the year. This pays for 80 percent of the cost of going to doctors that accept Medicare patients. We pay the other 20 percent and there is no maximum for the amount that we will pay. Medicare does not pay anything for doctors that do not accept Medicare. (Obamacare will reduce the coverage they pay Medicare doctors next year)
For drug coverage we picked a Medicare part D plan that was the least expensive since we only take generic drugs. If you decide to not take Medicare drug coverage when you turn 65 and on Medicare then you will be penalized in later years if you sign up for a Medicare part D drug plan. This plan cost us $531.20 each, plus the $4 cost of the two drugs we take each month for $96 a year. This adds up to $1,254.40 for both of us. This does not count the cost of nongeneric drugs that could cost us 45 percent of the cost of these drugs.
So with one doctor visit for the year we each pay $1,338.90 for Medicare Part B and $627.20 for Medicare Part D with our generic drugs for a total of $3,932 for the both of us.
Plus we have had trouble with Medicare paying for a couple of doctor’s visits. One was that the doctor coded the reason for the doctor visit wrong and Medicare did not pay for the visit. The other time was for an eye infection. We found out that there were not many eye doctors on the Grand Strand that took Medicare so we had to go to an eye doctor that did not accept Medicare.
Based on just this one year experience we are very concerned with Medicare coverage and more concerned when Obamacare adds more than 30 million more people to Medicare in the near future. If you are a member of the middle class and get no additional government assistance like Medicaid then you are at risk of really losing everything if you have a serious illness, and the chances go up as more people go on Medicare and more doctors stop taking Medicare patients.
If you think the middle class is getting a free ride on Medicare, they are not! And whether Obamacare will impact people already on Medicare, only time will tell.
The writer lives in North Myrtle Beach.