Insurance and how it should be...as I see it!

First of all, I would like to thank you for at least looking at my opinion.  I know everyone has one.  I invite you to respond in the arena of insurance. I am a life and health insurance broker that has seen things go from bad to worse and we need a drastic change.  I have never blogged before in my life, however, I feel this is an important issue and the next in line to crash if things continue as they are.

We need an injection of funding to the medicare system. We need to change the way consumers are contacted in the medicare field.  I, as an agent can not approach you, the consumer, to offer a medicare advantage plan or a part D, it is consumer initiated only. I'm a sales agent (that's like petting a cat's fur the opposite direction.)

As far as the Health Care Reform Bill...atleast there is an attempt to fix the issue.  One of the problems that I do see is that Americans are not given a choice. It's a mandate with a penalty and to me that is communist thinking.

This is what actually needs to happen...within the reform bill you can remain on your parents group health insurance until age 25.  Then you are on your own, to try to find an insurance company, to try to get a good rate, to try to get good coverage, you go through an extensive (application), just to find out that you don't qualify...you're not employed and there is a state policy but you don't qualify for it because you are not within a certain income bracket and you have to spend down to even get coverage through a state program and you can have no assets.  How is that helping people? Just a question. 

Within the reform bill needs to be an additional section!!! WHAT you say? ha ha ha ha the evil insurance agent is at it again!!! MORE?!!!

No, seriously people, there is an age group that is ignored (for the most part) I have personally sat across from hundreds of people at their kitchen tables or in their back yards. I meet these people in their homes because that is the only way I feel I can truly understand you the client and my ability to help you. That age group is from age 26 to 64 and a half.  I don't know how many times I have heard "I can't wait til I qualify..." or things like "I wish I could sign up for that too..." or "I can't wait til I can get that low of a rate."  To put it lightly, if you ask a medicare eligible person that is aging in if their spouse/partner also qualifies; they don't. They then spend one to fifteen years or more (Depending on the relationship.) This person that doesn't qualify because of age has to sign up for an individual policy...this could be anywhere from double to triple the rate the medicare eligible person is paying and that's if they qualify.

So my proposal to you fine Americans is this...
Keep in mind Part A is hospitalizations and Part B is doctors office visits and Plan D is for Prescriptions and Plan C pulls it all together. OK so the idea is this...(and I have called the whitehouse comment line twice and e-mailed the president as well, alas with no response...yet but I'm gonna keep pushing...hard)

Make Medicare Part A available for purchase at $304 and Part B a sliding fee for ages 64 and a half down to 26. That's $3,648 PER PERSON ANNUALLY into the Medicare system for the Part A alone! REMOVE $700 mandate
This would come with a monthly expense summary. Anything over and above Medicare and Medicaid goes DIRECTLY to the national debt and no where else! No Bi Partisan No Ear Marks No "fix this part first" arena. If you give Americans the chance to choose I bet they choose to get us out of the national debt First!


Excuse me...but we are Americans we do not like the "communist" get health insurance or be penalized. (Why when I haven't seen a doctor since I was 25? and I am a Homeopathic person with no insurance coverage for that)

From age 26 (when you can no longer be on your parents group insurance)
Through to age 64 and a half...(People who can not and don't currently
qualify simply because of age.) These people need another option! Take Fica out of paychecks as it isn't large enough of a payment for premiums now that the babyboomers are aging in this is the next crash. Give people the option to purchase a (Blanket type) insurance and all the government would have to do is to EXPAND the
medicare elibility to those that currently don't qualify for purchase on the Part A and for sliding fee on the Part B.

Not only that but all the unemployed people are not paying into medicare as well as the self employed.  Just ask anyone on the street. How much did you pay into medicare last year?  If they earn a paycheck I don't think they know and if they work as a 1099 contractor it's not paid until the end of the year, and YET the medicare balloon is here! The babyboomers! Yep! That's right. So now, you got twice the amount of people aging in to medicare and half the amount being paid into medicare. the Fica system will no longer work and then you got medicare bankruptcy. NO benefits even though you paid in. How about paying in and getting the benefit too?

Here's what it would do for employers...It would put them in a different tax bracket as this option can be paid list bill. (Before taxes are taken out of a paycheck) It will also lower the group insurance if people also have the option to choose the medicare to purchase bill.  What it would do for the employee...standardized rates and benefits.
What will it do for the self employed. (They could actually afford health insurance because they are in control of their own income you get what you put into it)

The people choosing to purchase the part A and B and Plan D and C would have access under the medicare system for the health care.
Some people can choose to stay with a private insurance and then there would be the group insurance that they could stay on. What ever make sense to each person on an individual basis...the after age 26 would have medicare as another option to group or private individual if they so choose.

Not only that but the funding would be such a balloon it would flood and make fluent medicare and medicaid. Instead of cuts to these programs offer it to the people at a purchase price. (New source of funding for medicare) "universal care" that's what I hear over and over I want universal health insurance. sooo this is it.

Did you know that a health insurance quote it isn't just about your health? It's where you live, demographics, and statistics? My plan takes out the rate up for pre-existing, covers presciptions, it doesn't matter where you live or if your male or female. You pay the same rate. Fair and equitible. It's Equitible in the fact that it pays into medicare and medicaid at an accelerated rate. FICA you paid how much in last year? Me I only pay once a year because I am 1099 self employed so medicare doesn't get my payment throughout the year. (My total IRS bill was $53 dollars I wonder what they did with it?)

Cost difference to joe consumer: let's say Joe works for a company that offers group insurance where the company pays and he pays $200 per pay check!(ouch) That's $400 per month! Oh my! out of Joe's Check and another $400 that his company is paying. If Joe chose the Medicare Buy In Option...That's $400 he is saving his company per month and a savings of $33.00 (what do you think joe is going to do with that $33 dollars? That's right! He's gonna spend it either on himself or a date or whatever! Or he could put it in a savings account and start saving to purchase something else. Either way he is purchasing and that is good for the economy.  $33 x 12 months = $396 in savings!
Medicare Part A $304 and joe makes apprx 25k per year at 3% his B would cost $62.50
That's a total of $366.50 Monthly for joe consumer

This policy costs a person non smoking person born in 1957 the monthly rate quote (which might go up after application has been processed) $573 per month

Plan Type

PPO

Office Visit for Primary Doctor

$30 Copay, deductible waived

Office Visit for Specialist

$30 Copay, deductible waived

Coinsurance

30% after deductible

Annual Deductible

Individual:$1,500

Separate Prescription Drugs Deductible

None

Prescription Drugs

Generic: $10 Copay (Unlimited). 30-day supply

Brand: 30% Coinsurance ($3,000 maximum per calendar year). 30 day supply

Non-Formulary: 50% Coinsurance, 30-day supply

Annual Out-of-Pocket Limit

Individual:$8,000
Includes deductible

Lifetime Maximum

Unlimited

Health Savings Account (HSA) Eligible

No

Out-of-Network Coverage

Yes  (Details in plan brochure below)

Out of Country Coverage

Yes. Call for details 

Physicians

• Primary Care Physician (PCP) Required
• No
• Specialist Referrals Required
• No

Preventive Care Coverage

• Periodic Health Exam
• No Charge
• Periodic OB-GYN Exam
• No Charge
• Well Baby Care
• No Charge

Prescription Drug Coverage

• Generic Prescription Drugs
• $10 Copay (Unlimited). 30-day supply
• Brand Prescription Drugs
• 30% Coinsurance ($3,000 maximum per calendar year). 30 day supply
• Non-Formulary Prescription Drugs Coverage
• 50% Coinsurance, 30-day supply
• Mail Order for Prescription Drugs
• Generic: $25 Copay (Unlimited). 90-day supply
• Brand: 25% Coinsurance after deductible ($3,000 PCY limit). 90-day supply
• Non-Formulary: 45% Coinsurance after deductible, 90-day supply
• Days Supply: 90
• Separate Prescription Drugs Deductible
• None

Hospital Services Coverage

• Emergency Room
• $100 Copay per visit (waived if admitted), plus 30% Coinsurance after deductible
• Outpatient Lab/X-Ray
• 30% Coinsurance after deductible; No charge for Preventive Screenings
• Outpatient Surgery
• 30% Coinsurance after deductible
• Hospitalization
• 30% Coinsurance after deductible

Maternity Coverage

• Pre & Postnatal Office Visit
• 30% Coinsurance after deductible
• Labor & Delivery Hospital Stay
• 30% Coinsurance after deductible

Additional Coverage

• Chiropractic Coverage
• $25 Copay, deductible waived, 12 Visits PCY
• Mental Health Coverage
• Outpatient: $30 Copay per visit, deductible waived
  Inpatient: 30% Coinsurance after deductible
• Substance Abuse Coverage
• Not Covered

Out-of-Network Coverage

• Out-of-Network Authorization Required
• No
• Out-of-Network Deductible
• $3000 individual
  $9000 family
• Out-of-Network Coinsurance
• 50% after deductible
• Out-of-Network Out-of-Pocket Limit
• Unlimited

OK so my point is this:  There are options...yes, but this option is the best because it not only gives people an option rather than a mandate, it also saves the consumer money that they can spend on other things which is good for the economy, it also makes fluent medicare and medicaid and after they are fluent all over payments would be placed toward the national debt.  We also should keep government in check by a mandated summary on a monthly basis as to P/L and where the overflow paid toward national debt. YEP I want documented proof on a monthly basis that the money is going where it should.  This Medicare Purchase Option Bill is not a free wallet for the government but a small band aid to help with the bleeding. We need to, as americans, audit our government on a monthly basis.