ACA Vs Medicare, Is this Fair?

[MichaelB]

My point is EVERYONE should pay their fair share

As the ACA system stands today, folks who can control their MAGI can gain more in subsidies to offset their MONTHLY payments.

These two comments seems to have some inconsistency. Ivinsfan has a point.

One additional comment on Medicare. It is less "equitable" than you represent. People pay far different amounts in payroll taxes but receive the same benefit (Part A). Medicare Part B and D is subject to IRMAA, and premiums can vary by 3X (IIRC).

 

[ShokWaveRider]

These two comments seems to have some inconsistency. Ivinsfan has a point.

One additional comment on Medicare. It is less "equitable" than you represent. People pay far different amounts in payroll taxes but receive the same benefit (Part A). Medicare Part B and D is subject to IRMAA, and premiums can vary by 3X (IIRC).

I agree completely. The system allows it. I do honestly believe a Medicare for all would "help" even it out over time somewhat.

 

[ivinsfan]

You are also focused on FREE. That is NOT my point. How many times do I have to repeat it? How it is measured or calculated is also NOT my point. My point is EVERYONE should pay their fair share (Sort of Like Medicare is today) whatever that may turn out to be, most likely based on income is probably the fairest. I am sorry if I do not explain my points more clearly sometimes.

As the ACA system stands today, folks who can control their MAGI can gain more in subsidies to offset their MONTHLY payments. Yes a lot of us here do that, it is NOT illegal. We still have to pay an OOP and Copays and Co-Insurance, at least we do. Again NOT FREE! Is this right? Not for me to argue. But neither are some other tax loopholes folks take advantage of every year. BTW we do NOT own Dividend stocks, which is irrelevant anyway.

Same as the Canadian and European systems are NOT FREE, even though the uneducated seem to assume they are. In their cases recipients pay tax on, or have paid tax for them on their income, capital gains, dividend or unemployment taxes. Please do not misinform people that Socialized Systems are Free. The load is spread (as it should be) across the country's demographic. Yes, the costs are reduced significantly for those without or with very little means, that is the same here in the USA with Medicaid . We have all also paid Medicare Tax to help offset our Medicare in old age.

Healthcare is NOT FREE anywhere I have lived (6 different countries, 5 of which had a socialized HC system)

To repeat, Medicare for All is probably the most equitable solution IMHO as most have paid, or are paying into it. It may have to be modified in order to make it more equitable and to ensure it is well funded in the future. That is another story.

You say potato I say pototo….so I don't know exactly what type of investment you talked about selling but you said the dividend income would put you over the ACA cliff and you wanted to restructure that income lower so you could get to the lowest bracket of ACA premiums and cost shares. Not just to be under the cliff but to be at the bottom of the cliff.

I simply asked what you meant by everyone paying equally. And only an idiot would say that any county gave people free healthcare. The fact you don't have buy insurance or pay doctor bills directly in other countries mean you pay before the point of care not after..


Final point you do realize Medicare for all isn't going to give people identical coverage for the same % of their income. Sure as shoot, people will be buying subsidies that suit their needs and have different costs and payouts, so the coverage won't be identical

 

[isisdave]

Back to the Part D late-signup penalty. No one ever seems to do the math, but the explanation is more difficult than the calculations. The explanation is here.

My part D is about $20 a month (Walmart Humana) and the average national is about $35. Say you don't sign up for 10 years. You'll save 10 * 12 * $20 = $2400 dollars. Then you want to sign up. You'll have to pay a penalty of 120% (1% * 120 months) times $35 every month (plus the $20) from there. So $42 extra dollars. It'll take 57 months to go through that $2400 you saved, if you didn't spend it on a vacation to Tahiti. By then you'll be 80.

If at some point you need expensive drugs, just sign up, pay the "penalty," and be glad you have it. If you never need an expensive drug, just skip it forever.

The math gets more attractive the more you pay for your part D.

 

[ivinsfan]

Back to the Part D late-signup penalty. No one ever seems to do the math, but the explanation is more difficult than the calculations. The explanation is here.

My part D is about $20 a month (Walmart Humana) and the average national is about $35. Say you don't sign up for 10 years. You'll save 10 * 12 * $20 = $2400 dollars. Then you want to sign up. You'll have to pay a penalty of 120% (1% * 120 months) times $35 every month (plus the $20) from there. So $42 extra dollars. It'll take 57 months to go through that $2400 you saved, if you didn't spend it on a vacation to Tahiti. By then you'll be 80.

If at some point you need expensive drugs, just sign up, pay the "penalty," and be glad you have it. If you never need an expensive drug, just skip it forever.

The math gets more attractive the more you pay for your part D.

say you do this and in March you get cancer or some other disease that requires expensive medication and you have no Part D coverage. What's your exposure for the next 9 months..that's the thing I worry about...

 

[audreyh1]

say you do this and in March you get cancer or some other disease that requires expensive medication and you have no Part D coverage. What's your exposure for the next 9 months..that's the thing I worry about...

Chemo is generally covered by part B.

 

[ivinsfan]

Chemo is generally covered by part B.

Chemo yes but there are other drugs involved that might not be covered chemo is a big one but not the only one.

 

[SumDay]

Medicare is such a good deal for all us that I am not going to complain about such things. The amount we pay for premiums is peanuts compared to the expenses that seniors pile up.

Amen 2x4. DH became eligible this summer, and I'm incredibly jealous. It's a gift and I won't complain at all. Our Part D is $26 a month, and worth the piece of mind should cancer rear it's ugly head again.

 

[MRG]

say you do this and in March you get cancer or some other disease that requires expensive medication and you have no Part D coverage. What's your exposure for the next 9 months..that's the thing I worry about...

That's what happened to my ex-BIL. Waiting for special meds was a bad thing for him and his family.

 

[aja8888]

Aja, I got sweet news today...My long time GF found out her employer allows “domestic partners” to join on to their health insurance plan. She will move in with me within a year or so (no hurry). Anyways through her cafeteria plan after tax break, my health, dental, and vision insurance will be under $200 a month total. And the annual health deductible is $200. It will be like the 1980s again! She has to work 10 more years chasing a pension and that will take me right up to Medicare. I will be able to rid myself of this ACA crap plan and rip off premium for good soon.

I just saw this now.^^..congratulations! But remember (as I still do), when your GF takes up residence with you, you become a "different person" and life will change (for the better, I hope)!

 

[aja8888]

Chemo yes but there are other drugs involved that might not be covered chemo is a big one but not the only one.

DW's Forteo for her severe osteoporosis was was Part D covered @ about $1000/month plus $800 or so per month for the needles. Forteo unsubsidized was told to us to be $4,000/month plus needles. Rough!