Avoiding MediCare

Posted by $ jlc 7 years, 2 months ago to Economics
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I would like some help from folks here in the Gulch with respect to untangling the intricacies of Social Security and MediCare...and how to avoid them. Here is the best summation of my current view of the situation:
"For all of America's cherished belief in choice and freedom, it remains an astonishing fact that the U.S. government forces citizens over the age of 65 into a subpar health plan of its choosing. And so it is with some hope that we greet a new federal lawsuit (Hall v Sibelius)* that aims to allow senior citizens to flee Medicare...

The suit comes courtesy of Kent Masterson Brown, a lawyer who has previously tangled with the government over Medicare benefits. Mr. Brown represents three plaintiffs who are suing the federal government to be allowed to opt out of Medicare without losing their Social Security benefits.

Amazingly, this is not currently allowed. While the Social Security law does not require participants to accept Medicare, and the Medicare law does not require participants to accept Social Security, the Clinton Administration in 1993 tied the programs together. Under that policy, any senior who withdraws from Medicare also loses Social Security benefits."

*(The Supreme Court refused to hear the abovementioned suite.)

Since there are a number of people in the Gulch who exceed me in years, I am wondering if someone has found a work-around for this. Grist for the mill: I would prefer to stay in the US; I do not intend to retire.


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  • Posted by Itheliving 7 years, 2 months ago
    As a retiree as of 3/5/15 I am now a Medicare user. My best plan is to stay healthy and avoid the pitfalls. The more I learn about them the more I can help out. We did not have these problems in the days of Lincoln.
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  • Posted by CircuitGuy 7 years, 2 months ago
    A few years ago when I helped my mother with this, there was the option of Medicare "Advantage" plans. There was a long list of insurance-company plans, and Medicare would pay some of the premium. If the premium is more than Medicare pays, you pay the difference.

    You could also just enroll in some plan that doesn't cost anything to you and then just pay for your own medicine with cash. My wife and I are 40 y/o, and this is our plan. We save the max amount each year into an HSA. We don't take money out for our expenses, but rather let it grow inside the HSA in a diversified portfolio of stocks and bonds. We hope between this and other wealth we're building we'll be self insured.
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  • Posted by j_IR1776wg 7 years, 2 months ago
    I am enrolled in Medicare Part A & B and have a supplement with Genworth with a high deductible ($2000) in case of catastrophe.

    Asking the government to ease up on the controls is like asking a rattlesnake not to inject the venom after it has already sunk its fangs into your leg. It's just not going to happen.
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  • Posted by khalling 7 years, 2 months ago
    can you be specific as to why you want to avoid it?
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    • Posted by $ 7 years, 2 months ago
      Certainly. Many doctors refuse to take Medicare patients. There is good reason for this: Medicare pays a below market value level for procedures (I know a fair amount about laboratory billing to Medicare, Medicaid, Insurance, and Patient/Client., so my answers are based on this model.); MediCaid pays _below cost_ for the same procedures. If a doctor takes Medicare, he is also obliged to take Medicaid. The only way he can make ends meet is by having enough Insurance patients to offset the loss generated by Medicaid and the barely-break-even payments made by Medicare. The Medicare payments do not allow enough profit for, for instance, the purchase of a new analyzer or growth of the lab.

      As a matter of fact, the better a doctor is the more likely he is to refuse to take government insurance. Does this make me want to be on Medicare? Additionally, there are a lot of things that my insurance will pay for that Medicare will not.

      My company insurance plan provides good coverage, and since I do not intend to retire I can keep using it indefinitely.

      Do I want my medical care to be run by the people who manage the DMV and the IRS? No.

      khalling - I was specifically hoping that you would respond (thank you). I know that one can avoid the ACA by moving outside of the US. Can one avoid Medicare by doing so?

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      • Posted by khalling 7 years, 2 months ago
        I was unaware that we were not subject to the penalty for ACA. So, what I read was a couple of things. 1. if you hadn't yet enrolled for SS, then there is a place in that enrollment to decline Medicare Part B. (you can add it back at another time) if you are still working and have a group plan. However, your group plan has to be a "primary" insurer. meaning that it would always pay first against any claims and medicare second. but I did see a gotcha about group insurers of under 20 employees. I assume you have already looked into that and asked your group insurer? Most people where I live pay out of pocket for care while they are down here-significantly less expensive than the US. but they do tend to go back to the states for complicated procedures or as their health declines enough that they want to be closer to supportive family. This is the part I don't get. If it's just old age, frankly, the people I know who have brought mom or dad down to live them, can easily pay for fulltime nursing/cooking/cleaning care. The culture I live in is VERY centered on appreciating the elderly and this works out well. But someone in their 60s-70s who needs a special heart med or special pharm, things are a little different and you may not be able to get that drug down here. You can certainly get drugs mailed. My experience with doctors here has been very positive, along with other people and everyone is shocked that it makes sense just to pay out of pocket for most things. Others have an international type of health insurance, or maintain insurance in the states (that's getting harder) and purchase life flight insurance.
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        • Posted by Mamaemma 7 years, 2 months ago
          Doctors and hospitals have depended a long time on private insurance to make up the deficit caused by government plans. Unfortunately a lot of private insurance is beginning to pay at the same rate as the government. I don't know what will happen next
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