John Greaney on Medicare options

[kevink]

Admittedly it dates me to even share this factoid, but as far as I know John Greaney had the first dedicated ER site on the web and 26+ years later he's still at it (though he posts much less frequently) with his mixture of razor-sharp number crunching and boundless irreverence.

Since he's about to turn 65 he's been looking at Medicare Advantage and the various supplement options. I find his skewering of the insurance industry delightful (though he's using kid gloves compared to the way he goes after financial advisors and traditional brokerages elsewhere on the site).

https://retireearlyhomepage.com/medicare2020.html

 

[DektolMan]

Thanks for sharing this. I agree with him and last year took traditional Medicare with Plan G high deductible. My wife will do the same when she applies next year. We have friends who went the opposite route and took the Medicare Advantage plan. They like the zero premium and perks they throw in. I tried to explain that since they travel a lot they might want to reconsider. They don't want to hear it so I never brought it up again.

 

[pb4uski]

... Getting the same three drugs in four 90-day fills and billing it to my insurance would cost $800 to $1,000 per year out-of-pocket since I have a $5,000 annual deductible. There appears to be immense savings in keeping a for-profit health insurance CEO out of your business. ... People don't realize how much they're getting screwed by their for-profit, employer-based health insurance...

John obviously realizes that by law the most that health insurers can charge is 125% of their claims costs... anything they charge in excess of that they later have to refund to policyholders. So the most the health insurer could make on John's $800 to $1,000 prescription is $160 to $200... and that $160-200 needs to cover any expenses other than claim administration, overhead (including the CEO salaries that he seems so wound up about), taxes and profit. $640 to $800 goes to the pharmacy. IOW, the real culprits are big pharma and the middlemen to the pharmacy and not the health insurer and it seems he is focused on the wrong bad guys.

 

[kevink]

I think ALL of those players are "the bad guys" considering the collective feeding at the trough vs. Medicare's admin costs. So Greaney may be inaccurate in how he portions out the blame, but his focus is on getting the most for his money (while showcasing the layers of needless expense and complexity of our uniquely inefficient and expensive health care and insurance system).