“Private” Medicare plans are no deal for seniors–or taxpayers
When the federal government implemented the Medicare prescription drug, or Part D, plan in January 2006, the focus was to provide beneficiaries with drug coverage, something previously available only through private supplemental plans. But the government also allowed private insurance companies, approved to sell Part D, to sell their own comprehensive health plans that replace traditional Medicare. Last winter, when an agent selling private Medicare plans called Perkins’ mother, Gertrude Jenkins, who was then living athome, Perkins listened to the agent’s spiel. “They said they could give her a good break if she took the Part D and the medical,” he recalled. His mother, 88, also of Fort Wayne, was taking only a few medications at the time. The $12 monthly cost for Part D “looked really good,” Perkins said. Her co-pay for doctors’ visits was just $20.”So I signed her up,” he said. But in October, his mother broke her hip, requiring surgery, hospitalization and rehabilitation. Perkins was then told the hospitalcould not get the private Medicare company to approve in-hospitalrehabilitation, something traditional Medicare covered when she brokeher other hip a few years back.
So it was off to a nursing home for rehabilitation. That’s when thereal shocker came, Perkins said: “There was only one nursing home inFort Wayne that was in (the company’s) network.” It was not the one he wanted to take her to, “but I had no other option,” he said. If he moved her to an out-of-network facility, any one of AllenCounty’s 24 other nursing homes, the out-of-pocket cost for his motherwould be $150 per day, or 10 times the cost of the in-network one. If his mother had kept the traditional plan, Medicare would havepaid all costs for the first 20 days in the nursing home, and all but$124 a day after that. Medicare pays part of the cost up to a possible100 days for a nursing-home resident who comes directly from thehospital.”
Ed: the taxpayer cost-per-patient for private Medicare plans is 20% higher than traditional Medicare.