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  • ACA Architect Gruber Insults Voters November 21, 2014
    MIT economist Jonathan Gruber (an architect of Obamacare) has emerged in a handful of videos insulting the American public. In one video, Gruber discusses how voters’ “lack of economic understanding” enabled a politically unpopular tax on “Cadillac” health plans to …
  • Are You Vitamin D Deficient? November 19, 2014
    Many Americans believe they are not at risk for Vitamin D deficiency because they eat D-fortified foods. These foods do not contain enough Vitamin D to benefit your health. Vitamin D is not a regular vitamin, but a steroid hormone …
  • Ambulance Drones Could Help You Survive a Heart Attack November 17, 2014
    Heart disease is the #1 cause of death in the United States. The odds of surviving a heart attack outside of a hospital is only 8%. Four out of five heart attacks occur at home where there is no emergency …
  • Eugenics in America – In the Name of Science November 17, 2014
    Marilyn M. Singleton, M.D., J.D. presents at the AAPS 71st Annual Meeting, September 5, 2014, Charleston, South Carolina
  • Supreme Court to Examine Issue of Obamacare Subsidies November 14, 2014
    The Supreme Court will decide the fate of Obamacare yet again. This new case challenges the key issue of subsidies used to assist in purchasing insurance in the exchanges. This decision to hear the King v. Burwell case has surprised …
  • Apples to Protect Against Obesity November 12, 2014
    An apple a day may be as beneficial as daily statin use. Apples and pears reduce the risk of stroke by more than 50%. A new study has found that the bioactive compounds in apples not absorbed during digestion boost …
  • Diabetes Awareness: Testing & Treatment is Important November 10, 2014
    Diabetes mellitus, known commonly as diabetes, is a metabolic disease where a person has high blood glucose (sugar) because they do not produce enough insulin or the body’s cells do not respond properly to insulin. Glucose cannot enter our cells …
  • Tau Protein Causes Alzheimer’s, Not Plaque November 7, 2014
    A new study has discovered that the protein tau (the “tangles”) is the main cause of Alzheimer’s disease, not plaque as was previously believed. Tau determines how much amyloid protein stays in the cell and how much is secreted outside …
  • Direct Primary Care Reduces Healthcare Costs November 5, 2014
    Direct primary care benefits both the patient and the physician. Many people could afford medication if they could afford the office visit it stems from.  Clinics that take insurance have to hire extra people and invest in special technology in …
  • The Problem and Solution for Our Healthcare System November 3, 2014
    by Timothy D. Wingo, MD; Owner – Atlas Healthcare, PA It is obvious to everyone that the healthcare system in our country is broken and getting worse. What is not so obvious is what it would take to fix it. …
  • 3 Steps to Get Rid of Heartburn and GERD Forever October 31, 2014
    Heartburn and GERD are caused by too little stomach acid and bacterial overgrowth in the stomach and intestines. There are three steps to treat heartburn and GERD without drugs and keep them from returning. Reduce factors that promote bacterial overgrowth …
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 5 of 5) October 31, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 4 of 5) October 31, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 3 of 5) October 31, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • The Wasting of Taxpayer Money October 29, 2014
    by G. Keith Smith, MD If you are looking for proof of the fact that the wonderful folks in D.C. are more interested in lining the pockets of their pals than demonstrating good stewardship of the loot from the robbery …
  • Giving Birth in America is Most Expensive in the World October 27, 2014
    While a woman is preparing for giving birth, one worry she doesn’t want to have is about the cost of delivery. Insured women are finding that some policies do not cover maternity care, services that most often do not have …
  • Physicians are Not Medicine’s Top Earners October 24, 2014
    Physicians are the most highly trained members of the medical industry’s force, yet have median compensation.  The largest salaries go to the Medicrats who oversee the business of medicine. Insurance CEOs average $584,000 compared to surgeons ($306,000) or a general …
  • Health Benefits of Honey October 22, 2014
    Honey has been used as a natural sweetener long before sugar. Bees collect pollen from  plant to plant, which is passed along from bee to bee until it eventually is deposited into the honeycomb. They beat their wings to evaporate …
  • Rotten Food and the VA Hospital October 20, 2014
    by G. Keith Smith, MD Imagine for a moment that you own and operate a restaurant knowing that if you provide spoiled food and rotten service, you will subsequently make more money.  You openly employ strong-arm and intimidation tactics to …
  • Hospitals want patients to pay in advance October 17, 2014
    Hospitals are asking for payments from patients before they leave the facility so they don’t end up with unpaid bills. Knowing the costs before the procedure is important because insurance deductibles are increasing and so are procedure costs. Obamacare policies …

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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