Main Reasons for All of the Complexity with Medicare

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Three Major Sources of Complexity in Medicare

First, Original Medicare (OM) from the Social Security Administration (SSA) only pays for an average of 50% of a retiree’s total medical costs. Premiums, co-pays, deductibles, and especially coinsurance, which is unlimited by the lack of any stop-loss provision in the Original plan, can be far more than any of us anticipate. Coinsurance is one of those market-y terms that our minds tend to skip over without really understanding. Whenever you see it, we suggest you train your brain to convert it instantly to NONinsurance, as in, you have no insurance for it (without a private supplement). Your wallet is the “insurance” company for coinsurance in OM.

Second, private add-ons are an absolute requirement to avoid impoverishment in our later years. Few retirees would be able to painlessly write a check to cover the un-covered part of even a short hospitalization or course of treatment for a common ailment. And OM has virtually no coverageContinue reading

The Maze of Medicare (Part 2)

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Why is this so complicated?

The complexity has everything to do with the nature of politicians, committees, regulators, lobbyists and insurance companies. Put them all together, let them fight and dance for over 50 years, and try to live with the result.

Have you ever heard the old chestnut that “a camel is just a horse, created by committee”?

Take that core idea, times fifty years, divided by political ideology, raised to the power of lobbyists, then cubed by the force of political contributions. What you get is a ridiculously shredded framework of illogical rules, overlapping regulatory fiefdoms, and incomprehensible deadlines, penalties, and acronyms.

It results in so many examples of silliness. We will only pick on one, to get you smiling:  Continue reading

The Maze of Medicare (Part 1)

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It really is a maze out there.

When we reach the ripe old age of 65, the gateway to our “Golden Years”, most of us already know that growing old is not for sissies.

It is not fun. Actually, it really sucks, unless you are lucky enough to have top-notch health.

We have experienced first-hand the profound losses of physical prowess and mental acuity that — when we were thirtyish — seemed things of a distant future that we probably wouldn’t live to worry about.

But one shining beacon of this milestone has attracted us through the many tumultuous years of healthcare changes of the last decades. That beacon has been Medicare, which we have finally earned by living and working for so many years.

Once we made it into the Medicare system, we were led to believe, all of our worries about making expensive decisions for health insurance would become things of the past. We as older Americans would finally get to enjoy the fruits of the world’s most advanced healthcare system, without the pain of monstrous insurance premiums and absurdly high deductibles if we fell ill. It would all be taken care of for us, almost for free, Continue reading