Health insurance for Green card holders

by Guest » Mon Jul 12, 2010 12:12 pm
Guest

My parents are both in their late sixties and looking for insurance as green card holders. Thanks for any advice.

Total Comments: 20

Posted: Tue Jul 13, 2010 08:57 am Post Subject:

Check out with AARP, ask whether they'd refer a company that covers people beyonds 64. Try- 1(866)270-8022.

Posted: Wed Jul 14, 2010 06:11 am Post Subject:

If your parents are age 65 or older, they may apply for Medicare. If they are not qualified for "premium-free" Part A, they will have to pay a premium for both Parts A & B, up to about $550 per month each for both. Once enrolled in Medicare, they may be eligible for a Medicare Advantage plan in their area, which substitutes Parts A & B for HMO or PPO coverage.

Posted: Wed Jul 14, 2010 10:57 am Post Subject:

$550 a month seems a bit expensive for them, but then it's about their health. Will the benefits under HMO or PPO be the same as that of Parts A & B?

Posted: Wed Jul 14, 2010 05:04 pm Post Subject:

And what would you expect a privately issued HMO or PPO plan to cost an individual age 65+? At least as much, if not a whole lot more.

Benefits under a Medicare Advantage HMO/PPO program are generally MORE COMPREHENSIVE than "Original Medicare" which is full of exclusions -- such as routine physical exams. We've grown up in America being told, "See your doctor once a year." What for? Just to make sure something bad hasn't begun to grow, right?

Well, Medicare pays for each new beneficiary to have a "Welcome to Medicare" general physical exam. A one-time-only event. No other general wellness exams are covered. So Medicare beneficiaries "learn" that to see the doctor once a year, just to make sure nothing bad is growing, they must have some "complaint" when they go to the doctor's office, like a cold or the flu.

Medicare excludes coverage for "symptomatic complaints of the feet" ("Geez, my feet are killing me!") What old person in America doesn't have that complaint? That's why it's not covered. My mom has severe deformity of her toes due to an arthritic condition. It is a covered condition under her Medicare Advantage PPO that was never covered by Medicare, unfortunately, because of the government's failure to cover it when she would have benefitted from the surgery years ago, it has progressed beyond the point of surgical intervention today (she has only been in the Med Advantage PPO since her first eligibility three or four years ago).

In many areas of the US, such as most parts of California, there are no additional premiums for participating in a Medicare Advantage HMO/PPO beyond that paid for Medicare (Part A and/or Part B).

In other areas, such as the Portland, OR/Vancouver, WA where my 86-year-old (reasonably healthy) mother resides, her Blue Cross Medicare Advantage PPO plan's premium this year is about $90 per month in addition to her Medicare Part B premium -- the premium has varied each year due to claims experience, but not as the result of her age or her specific claims. I pay her PPO premium so she doesn't have to dig deeper into her meager Social Security payment.

You can find more information on all of this at www.medicare.gov

NOTE: Looking back on my original reply, I misstated the following

a Medicare Advantage plan in their area, which substitutes Parts A & B for HMO or PPO coverage.


Should have read: A Medicare Advantage plan substitutes HMO/PPO coverage for Original Medicare Parts A & B.

Posted: Fri Jul 16, 2010 06:32 am Post Subject:

Try to contact the people who can give you the best suggestion.



Ahhhh . . . that would be a local insurance agent.

Posted: Fri Jul 16, 2010 07:02 am Post Subject:

At least as much, if not a whole lot more.


Yeah, I got that.

In other areas, such as the Portland, OR/Vancouver, WA where my 86-year-old (reasonably healthy) mother resides, her Blue Cross Medicare Advantage PPO plan's premium this year is about $90 per month in addition to her Medicare Part B premium -- the premium has varied each year due to claims experience, but not as the result of her age or her specific claims.


So, the premium has been increased with each passing year, am I right!

Posted: Fri Jul 16, 2010 02:48 pm Post Subject:

Jeremy . . .

If you're asking about the premium for Medicare Part B, the anwser is, mostly, yes. There was no premium increase for Part B in 2010 over 2009, except that anyone who did not pay a Part B premium in 2009, pays a slightly higher premium [$110.50] for it than those who paid a Part B premium in 2009 [$96.40] (how's that for confusing? Courtesy of the US Congress).

Since January 1, 2007, persons with higher incomes pay even higher premiums for Medicare Part B. There are now five income bands, based on AGI two years prior. The highest premium for 2010, per person, is $353.60 for persons with 2008 AGI of $214,000+.

For those who are not fully-insured under Social Security (less than 40 credits by age 65), there are two bands of premiums for Medicare Part A -- 30-39 credits [$254.00] and 0-29 credits [$461.00]. There may also be additional "penalties" for late enrollment in Part A and Part B.

Now, if you're asking about the premium for my mom's Medicare Advantage premium in Washington state, that's a different story. The first year (2007), the monthly premium was something like $70. In 2008, it went up about 35% (poor assumptions in the first year). In 2009, it went down about 20%, and this year there was a small increase of about 6-8%. As the actuaries get a better handle on the real cost of doing business under Medicare, I'm guessing the rate changes that can be expected each year will be less roller-coaster-like.

However, the BIG PROBLEM with Medicare and all the subsidiary programs is that Congress keeps ignoring the inevitable . . . that the system is underfunded. There was supposed to be a (cumulative) 28% DECREASE in compensation to Medicare providers -- doctors & hospitals -- for 2010, due to the fact that for the past 5 or 6 years, each time the formula Congress enacted (in 2003 or 2004) has required a decrease in payments, Congress has voted to suspend the decrease (to a later year).

Well, this time, the Trustees came to Congress and said, "All those decreases, plus this year's, now adds up to 28%, so it's time to make the reductions." And Congress said, "But don't you know there's a recession in progress . . . we can't do that now. So we'll ignore our own law again and just continue to spend money we don't have, will never be able to raise, and it will eventually be someone else's problem after the 535 of us are all dead."

And even though the "Part C" Medicare Advantage plans are saving the government money and providing better benefits to those who participate compared to those stuck in Original Medicare, Obama wants to do away with them because they're run by insurance companies (who can do it and make a profit at the same time).

Heaven forbid the US Government ever figured out how to do something at a profit (or at least at no loss).

Posted: Sat Jul 17, 2010 07:05 am Post Subject:

An increase worth 35% seemed too much for me. You've rightly pointed at our underfunded system. Can the recession be the only cause for such suspension!

Posted: Sat Jul 17, 2010 08:31 am Post Subject:

Can the recession be the only cause for such suspension!



No, but this time around it was the primary reason. Even in years past, when times were better, the "formula" may have required up to 8-9% decreases (which are based largely on inflation/CPI rather than the actual cost of care), and Congress tooled them back to just 1-3%. Congress understands that the cost of medical care is rising, but they refuse to do the right thing and raise the "premiums" (which most people think of as a tax), which is what an insurance company would do.

Instead, Congress repeatedly chooses to ignore the formula it agreed to abide by: "It's not fair to ask doctors and hospitals to accept less money." While it may not be fair to them, it's even less fair to the American public that believes Social Security and Medicare are going to be there for them when they get to age 65.

This is the same fiscal irresponsibility that I believe we can expect to attach to the Obama health care legislation. The peril for Medicare is that failure to properly fund ultimately means scaling benefits back or delaying eligibility for benefits. Proper funding means raising the contributions to Medicare from the current 1.45% of gross pay to something more like 4-5% (or more). It would be considered a tax increase, and no legislator wants to vote for that.

In 2006, the Social Security Trustees announced that by 2042, if Congress did not make fundamental changes in funding and/or benefits, there would be an $87,000,000,000,000 combined future funding shortfall in Social Security Retirement and Medicare benefits ($14,000,000,000,000 Retirement, $73,000,000,000,000 Medicare). Congress has done nothing in these last 4 years, and now the Trustees' Report indicates that "doomsday" has moved up to 2040 (probably even earlier in their next Annual Report for 2010).

All of the tinkering with reimbursements to doctors and hospitals has led to an increase in overbillings, over prescribed care, and overpayments to those providers. As I write this post, in fact, on the news they just reported the $280,000,000 Medicare fraud investigation that was announced on 7-16, which resulted in the arrests of more than 95 or more individuals -- do the math . . . that's about $3,000,000 per provider in fraudulent claims.

Blame that on Congress, too, for their "head in the sand" attitude that keeps kicking the ball down the road. If you or I tried that with our bills, we'd either find ourselves in bankruptcy court or in prison.

Consider this . . . if an insurance company is losing money in a line of insurance, it either raises rates or exits the line of insurance . . . or it becomes insolvent. Social Security and Medicare rates have not be raised in years, even though claims are rising and the system is genuinely "losing" money. Our politicians continue to talk about "strengthening" Social Security rather than eliminating it, but none of their rhetoric ever includes raising rates or cutting back on benefits. So, if you won't end the programs, or don't raise rates, and/or you don't decrease (or delay) benefits, the only alternative is insolvency. That day is now less than 30 years away (and maybe only three or four).

No one in office wants to talk about it, and the American people truly don't know about it. It's a classic case of CONCEALMENT, except that the numbers are actually in print, which really means it's MISREPRESENTATION. Someone (or 535 someones and a president or two) should be in jail because of it.

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