What Seniors Think About Medicare and Health Insurance

I recently read an article from AHIP (American Health Insurance Plans) about what seniors thought about Medicare and health insurance in general. The information was taken after an article with Alignment Health (only 5-star plan in Nevada for Medicare)

The article interviewed 2200 seniors, and they were asked several questions. The first one was do you want to live independently, and the response was 64% did. 60% had issues accessing health care and 27% had financial issues. What this is saying is that more than half of seniors have issues accessing health care services and 1/4 have financial issues.

This is a sad commentary about our country and seniors. Many cannot afford groceries or other necessary items, yet they must pay for Medicare Part B. When I started selling Medicare the cost of Part B was only $55.00 per month.

Today it is $185.00 per month. In 23 years, inflation has increased that premium by $135.00 per month. Too many seniors have trouble paying that amount and some don’t have enough money for food and other necessities. Each year Congress raises the cost of the Part B premium with no concern for the seniors that must pay it. They are looking at the financial cost only.

Congress, you see, doesn’t have to worry about Medicare or Social Security either as they are not on either of these programs. I suspect if they were, the cost would be much less. Self-preservation is alive and well in our country, especially in Congress.

We need to figure out a way to get Congress on these programs and I would almost guarantee you that these issues would be addressed and solved.

I think having Robert Kennedy as head of Health and Human Services which oversees Medicare will help but his time in office is too short to determine that for sure. He has made some significant decisions but not long enough in office to make a real difference yet.

The real issue is that seniors who don’t have a lot of money are hindered because of that, and Medicare is a great way to eliminate part of the problem. The Medicare Advantage plans offered by private insurance eliminate many of the issues related to Original Medicare. Medicare Advantage, by law, must have a maximum out-of-pocket while Original Medicare does not. How crazy is that? Original Medicare is the only insurance in the United States that doesn’t have a maximum out-of-pocket. For many seniors with little or no money for health insurance these Medicare Advantage plans help them navigate the healthcare maze. Most Medicare Advantage plans have no monthly premium and have low maximums out-of-pocket ranging from a low of $800 per year to around $6000 per year. Each insurance company decides what the plans will pay for and what they won’t and decides on how much to charge for each procedure. (each plan must be approved by CMS) Since competition is fierce, the costs are relatively low. In Clark County alone there are 85 different Medicare Advantage plans.

Seniors who don’t have much money can qualify for help via Medicaid assuming they qualify financially.

So, having both Medicare and Medicaid and an Advantage means that almost all their medical expenses are covered. The real benefit of the Advantage plans is they have many extras that benefit Medicaid recipients. Then they have very little out-of-pocket costs and get taken care of medically.

Those individuals above the Medicaid financial levels have Medicare Advantage plans, as well. Those who are sick with a chronic disease can opt for the SNP (Special Needs Plans offered through Medicare Advantage plans). There are specific medical conditions covered and if you have one of those covered illnesses, then you would qualify for these special plans. These plans are designed to offer the most help medically, based on your disease. The overall out-of-pocket costs are very low and help these seniors significantly.

While in the long run, these plans do take care of our seniors, and these plans are designed for specific diseases and help keep that senior healthy, with very little out-of-pocket costs.

My major concern is the ever-rising cost of Medicare Part B. As I stated above, the cost rises annually and while I understand why it keeps rising, the result is many seniors have little or no money for life’s needs. After each rise in premium, the senior has less money for other necessities. These issues need addressing.

I’ve tried to stay impartial, but it is difficult knowing the whole picture as I have served seniors of 23 years and am concerned that we have not adequately addressed those needs.

As I have mentioned in previous blogs the solution is to force Congress members onto both Medicare and Social Security. Does anyone believe that if Congress was on both plans, like all Americans that there would be financial concerns. Do you think Congress would keep borrowing from the social security trust fund. I think not. The only way for this to happen is through what is called a Constitutional Convention which can be called if 35 states approve it. Currently there are 26 states who have approved of the convention. The convention allows these states to amend the US Constitution by having term limits and eliminating the lifetime salaries of Congress members even if no longer in Congress. Not 1 in 100 Americans are aware of this rule approved by Congress for their own benefit.

If Congress people were on both Medicare and Social Security, both programs would become solvent, and any issues would be addressed immediately by Congress.

This blog has covered several items, and I want to leave you with the notion that only you can change things and that is by contacting your Congress person and informing them you want these items addressed.

1. Fix Social Security and stop borrowing from the trust fund

2. Fix the issues with Medicare and put a maximum out-of-pocket on Original Medicare

I hope this information is useful and if anyone has questions, please contact me via phone or email and I will respond quickly.

Also, you may want to take a look at Medicare 2025 Information. 2026 Medicare Information coming soon.

The Barend Agency Inc.

Len Barend, Broker

Cell:702-250-2200