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Doesn't matter. They're feeding, directly, on taxpayer dollars and it needs to stop.
Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
.
Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
.
Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
Well the MA plans are moving primarily to the HMO model, which allows the insurer to really control costs.Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
.
Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
I would have thought it would be more, the margins are slim
Well the MA plans are moving primarily to the HMO model, which allows the insurer to really control costs.Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
I would have thought it would be more, the margins are slim
When they first came out, they used a PFFS (Private Fee for Service) model, which allowed participants to go anywhere. There were no cost controls, and utilization went through the freaking roof. So they finally figured out what worked and ran with it.
.
Yeah, they need to take the time to go through the formulary, especially. That's where a lot of participants get bitten.Well the MA plans are moving primarily to the HMO model, which allows the insurer to really control costs.Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
I would have thought it would be more, the margins are slim
When they first came out, they used a PFFS (Private Fee for Service) model, which allowed participants to go anywhere. There were no cost controls, and utilization went through the freaking roof. So they finally figured out what worked and ran with it.
.
The problem I'm seeing on the ground level is that a lot of agents do inferior leg wok for their clients. They've REALLY got to dig and research the clients physicians and meds
Doesn't matter. They're feeding, directly, on taxpayer dollars and it needs to stop.
For decades, I and thousands of others paid for our own health care through a local, high quality, HMO. It is fantastic. When I reached 65, and went on Medicare, I was able to stay with the same HMO and kept my doctor. How was my HMO feeding on taxpayer dollars?
Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
.
Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
Yep.Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
.
Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
Whoops didn't see this before I posted. But Markle thinks is HMO is free to him, ironic isn't it since he doesn't want anyone else to enjoy what he is. A perfect example of me, me, me.
Yep.Here ya go!None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?
MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.
I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.
2019 Rates - Centers for Medicare & Medicaid Services
Click on the "2019 MA Rate Book" link for a county by county capitation rate. The less healthy the county, the higher the cap rate.
Hey Markle, you can check that out, too. It's the amount CMS pays the insurers by county to run Medicare Advantage plans. AS I SAID.
Not that facts matter to you.
.
Whoops didn't see this before I posted. But Markle thinks is HMO is free to him, ironic isn't it since he doesn't want anyone else to enjoy what he is. A perfect example of me, me, me.
And these folks think they know more than those of us who have trained on it.
.
Because they were lied to. Republicans ran on repealing it. You can fault voters for being gullible, but you can't say they voted for socialism. That's just not so.Millions of Americans want nothing to do with any type of socialized medicineThe Republicans had nothing to do with the ACA.
They just voted to repeal it 62 times...till they got control of both sides of Congress and the White House and then all of a sudden no longer wanted to repeal it...
Yet they keep voting for parties that want it to be expanded. Why is that?
so, can I blame them for being stupid and not paying attention to the last 50 or so years?
The Repubs have been pushing bigger government and more government programs just as much as the Dems.
We do not have a party (outside of the Libertarian party) that is fiscally conservative.
Whatever you'd like.I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.I used to think it was as you say, but I did some research and found this:No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):
33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy
Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.
Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.
In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.
We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.
I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.
I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?
??? Seriously? Wow - you know those threads you start slamming people for wearing partisan blinders? LOL - you go!
Here - read it slower this time: "Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date."
Again, I ask. Are they lying, or just wrong?
Sorry to say Mac, but I thought you were above this. I appreciate when you posts threads slamming blind partisans and their refusal to acknowledge the basic facts of an argument. But you don't seem to be able to take your own advice.
And to your quote above, "the government pays insurance companies to administer Medicare" through Medicare Advantage plans, which take over for Medicare with participants, as we have discussed multiple times on this thread.
People who actually know how the full Medicare system works, know that.
Doesn't matter. They're feeding, directly, on taxpayer dollars and it needs to stop.
For decades, I and thousands of others paid for our own health care through a local, high quality, HMO. It is fantastic. When I reached 65, and went on Medicare, I was able to stay with the same HMO and kept my doctor. How was my HMO feeding on taxpayer dollars?
Doesn't matter. They're feeding, directly, on taxpayer dollars and it needs to stop.
For decades, I and thousands of others paid for our own health care through a local, high quality, HMO. It is fantastic. When I reached 65, and went on Medicare, I was able to stay with the same HMO and kept my doctor. How was my HMO feeding on taxpayer dollars?
I'm talking about the insurance companies who run Medicare, not HMOs. The government doesn't operate Medicare directly, they farm it out - to the same insurance companies people think we'll be avoiding if we get Medicare for All. They'll be laughing all the way to the bank.
I'm talking about the insurance companies who run Medicare, not HMOs. The government doesn't operate Medicare directly, they farm it out - to the same insurance companies people think we'll be avoiding if we get Medicare for All. They'll be laughing all the way to the bank.
Ugh, no they don't. Original Medicare (A &B) are fully Gov. The supplements are private companies.
Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.
Almost everybody on the political left thinks that Medicare is a government plan – one that is completely different from private insurance. Yet that view is wrong.
- 1. Medicare is not really government insurance.
Although Medicare is largely funded with tax dollars, it has never been a strictly government program. Medicare’s original benefit package copied a standard Blue Cross plan that was common back in 1965. And Medicare has always been privately administered – in many places by Blue Cross itself. That’s the same Blue Cross that administers private insurance sold to non-seniors.
Moreover, in recent years, one-third of all seniors – and perhaps as many as half of young seniors – are enrolled in plans offered by Humana, Cigna, UnitedHealth care and other private insurers under the Medicare Advantage program. These private plans are virtually indistinguishable from the private insurance non-seniors have.
You don't want Single Payer. I get it. Neither do I. I have no idea what the rest of this has been about.Whatever you'd like.I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.I used to think it was as you say, but I did some research and found this:No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.
I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.
If you want to think I'm lying or playing games, great.
I have significant professional training and professional hands-on experience on this. Do you?
I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):
33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy
Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.
Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.
In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.
We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.
I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.
I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?
??? Seriously? Wow - you know those threads you start slamming people for wearing partisan blinders? LOL - you go!
Here - read it slower this time: "Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date."
Again, I ask. Are they lying, or just wrong?
Sorry to say Mac, but I thought you were above this. I appreciate when you posts threads slamming blind partisans and their refusal to acknowledge the basic facts of an argument. But you don't seem to be able to take your own advice.
And to your quote above, "the government pays insurance companies to administer Medicare" through Medicare Advantage plans, which take over for Medicare with participants, as we have discussed multiple times on this thread.
People who actually know how the full Medicare system works, know that.
That's not what it says and (I think) you know it. Seems as though you borrowed some of them industrial strength blinders that the Trumpsters wear. Sad to see.
The thing of it is, if this article, and others I've posted corroborating it, are wrong, I'd like to know. But I haven't found anything suggesting they are. All I get are unsupported denials from the Medicare for All crowd. They can't bring themselves to admit that the model for their single payer ambitions is, itself, a sellout to corporate interests. Belief is like that.
You don't want Single Payer. I get it. Neither do I. I have no idea what the rest of this has been about.
