That's an out of pocket cost of $6550! Not to mention the $1068 deductible for the Part A insurance, and the $135 deductible for the part B insurance. Let's add in these deductibles...your out of pocket costs are $7749!!!
OK, after your child leaves the hospital, you need Gleevec. Gleevec costs $3126 per month. You didn't buy part D insurance! You better hope Novartis pharmeceuticals is kind and will give the stuff to you. Lets say you did purchase part D insurance. You will still have that donut hole. You will still have to pay $156.50 per RX in the "catastrophic" portion of the part D insurance.
Is this adequete coverage for you? I'm guessing many of you will say no. What if the Medicare reimbursements are too low? You will have high out of pocket costs. What if you pass laws that prohibit excess billing to the medicare beneficiary. Doctors will refuse to accept Medicare. What if you drop the reimbursements and force doctors to accept payment?
That's the situation that will happen. Doctors will get mad.
I'd like to say that arguments about how efficiently Medicare runs are probably not accurate. CMS spends a lot of money enforcing Medicare law. I suppose the question I'm asking is, what level of benefit is acceptable? How do you pay for it? What if the doctor's will not accept your payment rate?
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