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Medicare changes and reforms are being debated in Congress.
Part of the changes include a permanent "doc fix" which will finally fix how doctors are paid by Medicare.
The "doc fix" has been tossed around now several times and only patch fixes have been installed, the permanent fix that is now on the table is that doctors would be based on value and quality verse volume which is what it is based on now.  The old formula and payment system 
has been flawed since inception and nothing but patches have been applied since 1997.  Medicare Reform has to happen, I think everyone agree's with this, but how and when to do it has been and will continue to be a battle.  Simply put, upsetting seniors is not a good political move and nobody wants to be the bad guy making the tough decisions.  One of many Medicare reforms on the table is a change to Medicare Supplements or Medigap plans.  The change that is being discussed is the elimination of the "first dollar coverage" plans that many senior citizens have.  In Wisconsin the part at issue would be the Part B Rider that is attached to the base plan which covers the $147.00 deductible of Part B, for the rest of the country this would be a Plan F.  This Medicare reform or Medigap reform is not set to be implemented until the new plans being issued for 2020 and would only affect the new retiree's.  Some people will scream and yell that the sky is falling and that this is a tragedy, but lets take an objective look at the facts before you decide.  Most people that are now retiring and entering Medicare have had deductibles and copay's from their employer based group health plan, the days of 100% coverage have been over for a long time, so this idea of a small deductible is nothing new for them.  Second, the Part B deductible which is currently $147 is a very small amount when you consider that most of us have been paying deductibles in the $4-5,000 range for years, remember once the Part B deductible is paid for the year you will be 100% covered.  There is some talk about the deductible being raised to $250.00, and I am almost positive this will happen, but even at that amount most new retiree's wont be shocked.  

Only three states have the Medicare Supplements standardized like WI, the rest of the nation has plans A - N, and the plan with the biggest premium increases year to year is the Plan F or first dollar coverage plan.  The plan that has the lowest premium increases and even a decrease occasionally is the plan G which covers everything except the pat B deductible, so as it stands right now you are much better off paying the part B deductible out of pocket then having the higher premium and having the insurance company pay it for you.  Make no mistake the part B deductible is being paid, it is just being paid by you out of pocket or the insurance company and to pay the insurance company $180.00 a year to pay a $147.00 deductible doesn't make financial sense.  

What we have is two completely different groups of seniors, the older crowd that had most if not all of their medical expenses paid while working and the incoming retiree's that are accustomed to paying copay's and deductibles.  The older crowd will still be able to keep their first dollar coverage if they are willing to pay the higher premiums and when the next generation ages in to Medicare they will have a small deductible when they visit the doctor which will be just business as usual. 

We here at LJM Insurance fully believe that these changes are not only necessary but a good thing for the future cost containment of Medicare.  Let us know what you think.
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