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  • Medical Debt Still a Problem for Those With Health Insurance January 23, 2015
    by Adrienne Snavely Medical debt can affect anyone of any age in any state in any income bracket. Medical debts account for more than half of debt collections on credit reports. One in three Americans struggle to pay medical bills, …
  • Q&A with Direct Pay Physicians January 22, 2015
    Direct pay physicians answer colleagues’ questions about third-party-free medical practice. From January 9, 2015, New Orleans AAPS workshop.
  • Ralph Weber Talks MediCrats with FreedomWorks – Part 2 January 21, 2015
    The pitfalls of Obamacare are that it makes healthcare affordable to the employee, yet unaffordable to dependents. Some plans cover children, but not spouses. This means less options for families. The independent physicians are being bought out by hospitals and …
  • Cash and out-of-network: good for medicine as free agency is for sports January 21, 2015
    Andrew Schlafly, J.D., General Counsel, AAPS, opens the 21st Thrive, Not Just Survive workshop held Jan. 9, 2015 in New Orleans, LA.
  • Opting Out of Medicare January 20, 2015
    Lawrence Huntoon, MD, PhD, presents via Skype at the AAPS 21st Thrive Not Just Survive Workshop on Third Party Free Practice, January 9, 2015
  • Say Goodbye to 3rd Party Medical Payments January 19, 2015
    Obamacare is increasing costs, restricting access to care, and putting Medicrats in charge. Out of this adversity comes innovative physicians who are changing the world of medical care. Doctors know what is best for their patients, so they must be …
  • My Direct Pay Practice January 19, 2015
    Brenda Arnett, MD http://arnettmd.com, talks about why and how she launched a third-party-free internal medicine practice. From January 9, 2015.
  • AtlasMD: Direct Pay Primary Care better for patients and physicians January 18, 2015
    Dr. Josh Umbehr, founder of http://atlas.md speaks at AAPS XXI Thrive Not Just Survive Workshop, January 9, 2015 in New Orleans, LA.
  • Epiphany Health, Affordable, high-quality direct primary care January 17, 2015
    Lee Gross, MD, Founder, Epiphany Health http://www.epiphanyhealth.net & President, Docs 4 Patient Care Foundation http://www.d4pcfoundation.org addresses the AAPS Thrive Not Just Survive XXI conference, January 9, 2015, in New Orleans, Louisiana.
  • Ralph Weber Talks MediCrats with FreedomWorks – Part 1 January 16, 2015
    Wayne Brough of FreedomWorks interviews MediBid’s CEO, Ralph Weber, about Obamacare and Weber’s book MediCrats. Weber has found innovative ways to bring the free market to healthcare. MediCrats, by definition, are medical bureaucrats who add administrative burdens and increase costs. …
  • Third Party Free Specialty Practice January 16, 2015
    Gerard J. Gianoli, M.D., F.A.C.S. of The Ear and Balance Institute, Covington, Louisiana, http://EarAndBalance.net speaks at the AAPS Thrive, Not Just Survive workshop held January 9, 2015 in New Orleans.
  • Stop the Interstate Licensing Compact January 15, 2015
    Dr. Ken Christman explains how the FSMB’s proposed compact is a backdoor for MOC and MOL. January 9, 2015, New Orleans, LA.
  • Update on AAPS Legal Initiatives in War on Doctors and Patients January 15, 2015
    Andrew Schlafly wraps up Thrive XXI with a look at ongoing and future AAPS legal initiatives to protect patients and their physicians.
  • The Answer to American Medicine is NOT Coming from DC January 15, 2015
    … it is coming from physicians who are kicking ObamaCare and insurance OUT and working directly with their patients, explains AAPS Executive Director, Jane M. Orient, MD. From AAPS Thrive, Not Just Survive XXI, Jan. 9, 2015, New Orleans, LA.
  • The End of the 10-Minute Doctor’s Appointment January 14, 2015
    The patient-physician relationship should be balanced, not one-sided with physicians skimping on visit time and not allowing patients to ask enough questions or explain their symptoms well. Eighteen seconds is the average time a patient is allowed to talk before …
  • The Physicians Declaration of Independence in 2015 January 14, 2015
    We need a critical mass of truly independent doctors and core who will pass along the art of medicine to the next generation, explains AAPS President Richard Amerling, MD on January 9, 2015 at talk to colleagues in New Orleans, …
  • Physicians & Patients: Take Your Power Back January 14, 2015
    Dr. Elaina George explains that it is crucial for patients and physicians to work together outside of ObamaCare and insurance-dominated system. She discusses alternatives to ObamaCare such as health care sharing programs like Liberty HealthShare: http://LibertyOnCall.com
  • Self-Funded Awareness & The Movie “Dune” January 7, 2015
    by G. Keith Smith, MD “The sleeper has awakened.” Anyone who has seen the movie “Dune” knows the scene where Paul Atreides proclaims his new awareness. Having recently attended the annual meeting of the Self-Insurance Institute of America I was …
  • Perils of Obamacare Reenrollment January 5, 2015
    Obama has come up with the 95% solution to make reenrollment figures look good: A senior federal official told CNBC that an estimated 95 percent of HealthCare.gov enrollees—some 5.1 million people—will be signed up for the 2015 plan year and …
  • Chris Hobbs on MediBid’s Value-Based Medical Care December 31, 2014
    Chris Hobbs, CFO of MediBid, spoke with David Saltzman on ShiftShapers podcast about how MediBid works. As a former banker and recent immigrant from Canada, Hobbs sees the free market as the solution to the current broken system in delivery …

Medicare Alternatives

by Tess St. Clair

People ask me all of the time about alternatives to Medicare. With the $700 billion dollars in Medicare cuts looming on the horizon as a result of PPACA, seniors are legitimately concerned.   Do yourself a favor, BEFORE you become Medicare eligible and fall victim to the system, and read the Medicare doctrine!

Once you are eligible for Medicare, your premium for Part A (Hospital coverage) is taken right out of your Social Security Benefit. Part B (Doctors’ Office Coverage), however, is voluntary. On the surface, one would think that Plan B covers less risk, but in a case of Chemotherapy, the risk covered by Plan B is substantial.

There are GAP policies available to cover excess charges to a set limit, which can help as well.  However, more and more, these policies are getting so expensive, makes you wonder why you should feel compelled to buy one, if Medicare is so great.  I mean, in a traditional PPO with 80/20 co-insurance, do we buy GAP policies to pay for the additional 20%?

Insurance brokers are required to take the course on Medicare, and believe me, I’m glad I did.  What I learned is that Medicare does not resemble the same Medicare from 1980’s.  It looks more like Canada Health, under which it is illegal for patients to pay a doctor!  Doctors’ hands are tied under Medicare, and they are not allowed to discuss medical options that are not covered by Medicare.  So, if you find a lump in your breast, get ready for a mastectomy because lumpectomy may not be covered!  Furthermore, with reimbursement levels so low, many doctors have stopped taking new Medicare patients and are slowly getting out of their contracts.  I can’t say I blame them.  It’s not just about how little they’re being paid, it’s that they can’t do their jobs and focus on true healing.  It is about being a government servant, not even a public servant, but a government servant!  They cannot be real doctors; they can only do what the government tells them they can, and face the consequences if they dare do otherwise!

By FAR, the best alternative to Medicare is to have private coverage, but not all private plans are “first payers” before Medicare. Generally your employer health plan must have 20 or more employees on it, and your employer must have chosen to have the plan as first payer before Medicare.

If you belong to a professional association that offers members the luxury of an Association Health Plan (AHP), they can design the plan so that it is the first payer, and Medicare is second.  I say “luxury” because AHPs allow bundling of many small employers with large employers of the same profession, and so you all get the benefit of large group rates and a great deal of financial freedom because these plans are not administered by third-party payers like Blue Cross, Aetna, and UHC.  Rather, the claims are managed by Third Party Administrators (TPAs). These plans almost always have substantially lower administrative costs.  By substantially, I mean 7% compared to 20% for small group plans.  Additionally, they are not governed by the State Department of Insurance; they are governed by ERISA, a Federal law, because these plans may cross state lines.  WOW!  Talk about buying insurance across state lines!

If you belong to a professional trade association, and they don’t offer you the luxury of a multi-employer, refund-of-premium plan as one of the member benefits, it could be because of the state that the association is located in or because the association is not a Federal 501 non-profit organization (state not for profit doesn’t count) that has been in existence for more than 3 years.  Other than that, there’s hardly any reason for your association not to have an AHP, or at least to look into it.

These plans are true insurance, not these pre-paid health plans that most people are familiar with.  The formula looks like this:

Pure cost of insurance + administration + commission = premium

At the end of the year, whatever is left in the Pure Cost of Insurance fund is reimbursed or rolled into the next year to pay premiums.

Tess St. Clair is the VP of Benefits Administration at Route Three Life Health Disability, Inc.



At MediBid, we restore market forces to medical care. Doctors get to set their own rates based on their training, experience, and outcomes, and patients get to shop for medical care across state lines and international borders. Many times with MediBid, you will find procedures that are more effective than procedures allowed, or covered by health plans. Transparency and competition are the only way to achieve reasonable costs. Many of our employer clients offering group health insurance through MediBid save $5,000 per employee per year. Those are substantial savings. Patients are saving an average of 48% vs. insurance discounted rates, or 80% vs. retail. Contact us for more information.
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