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  • Canadian Cancer Patient Says Korean Surgery Saved His Life May 22, 2015
    Gerd Trubenbach of British Columbia was diagnosed with cancer, as a huge tumor was growing in his neck. His family doctor suggested that the tumor could not be removed and there was nothing else that could be done. The wait …
  • How to Prevent Hemorrhoids May 20, 2015
    Many people have hemorrhoids at some time, and they are a common problem. Hemorrhoids are swollen veins in the anal canal, which can be painful but not usually serious. They are caused from too much pressure on the veins in …
  • Emergency Room Visits Increase with Obamacare May 15, 2015
    Obamacare predicted that expanding health insurance coverage for the poor would reduce costly emergency room visits. A new study has found that newly insured people are actually visiting the ER more often, 40% more often than those who are uninsured. …
  • Transparency: Changing the US Healthcare System May 13, 2015
    Ralph Weber, President and CEO of MediBid, is interviewed by David Saltzman of ShiftShapers. Mr. Weber has been in the benefits business since the mid 1990s, serving clients in the US, Canada, and around the globe. A lack of information …
  • Appalachia Sees Increased Cases of Hepatitis C May 11, 2015
    Infections of Hepatitis C, a contagious liver infection spread by blood contact, has more than tripled in Appalachia – Kentucky, Tennessee, Virginia, and West Virginia – fueled by prescription drug abuse in rural areas. About 73% of patients are under …
  • An American Response to Losing ObamaCare Subsidies May 8, 2015
    by Jane Orient, MD This summer, the U.S. Supreme Court could, in King v. Burwell, uninsure 8 million Americans by finding that subsidies are illegal outside State Exchanges. Some Republicans are saying “Let it burn.” For Democrats, it’s “ObamaCare or nothing.” Can …
  • Arthritis Awareness – May Lab Specials May 6, 2015
    Nearly 53 million adults and 300,000 children in America have arthritis. By 2030, 67% of the population will suffer from one type of arthritis.  Arthritis, joint pain or joint disease, is the leading cause of disability in the United States. …
  • American Women are Drinking More Heavily May 4, 2015
    Barbara Feder Ostrov, Kaiser Health News Whether quaffing artisanal cocktails at hipster bars or knocking back no-name beers on the couch, more Americans are drinking heavily – and engaging in episodes of binge-drinking, concludes a major study of alcohol use. …
  • Shortage of Available Surgery Causes Deaths Worldwide May 1, 2015
    Millions of people die worldwide with treatable conditions because of the lack of routine surgeries, more than from malaria, AIDS, and tuberculosis combined. Five billion of the seven billion people in the world cannot get needed surgery or pay for …
  • Cleaning Tips for a Healthy Home April 29, 2015
    Cleaning your home not only makes it look and smell better, it also can improve your family’s health.  Here are some activities you may not have thought of that will make you and your home healthy and safe: Dust Everything …
  • Using Mobile Devices at Night is Bad For Your Brain April 27, 2015
    Dr. Daniel Siegel, a psychiatrist from UCLA, states that staring into a glowing screen late at night is harmful to your brain and body. Staring at any screen at bedtime, be it computer, smartphone, or ipad, is worse than previously …
  • Few Patients Use Quality, Price Information To Make Health Decisions April 24, 2015
    by Jordan Rau, Kaiser Health News Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for …
  • Shopping Tools Save Patients Cash on Medical Care April 22, 2015
    Vicki Burns of New Mexico needed a total hip replacement in 2012, but could not afford the hospital’s non-negotiable cash estimate of $79,000. Within two days of placing a patient request on MediBid, she received two bids. She chose a …
  • Hysteria’s History Episode 3 April 21, 2015
  • 20th Century Experiment Attempts to Turn Back Time April 20, 2015
    Ellen Langer, a Harvard psychologist, conducted a radical experiment in 1979 – the results of which were never published. Last fall, this study was featured in the New York Times. The study examined how aging’s effects could be altered or …
  • https://youtube.com/devicesupport April 17, 2015
  • Make Spring Cleaning a Workout April 17, 2015
    Chores you do around the house and garden can burn calories and stretch and tone muscles if done correctly. Short episodes of mild exercise can improve your fitness level if done with intensity and speed. Adding 30 minutes of chores …
  • Provisioning for the Opt Out Journey April 17, 2015
    Ophthalmologist David Richardson, MD on how to prepare for opting out of Medicare. From AAPS 70th Annual Meeting, September 2013, Denver, Colorado.
  • What America’s Decline in Economic Freedom Means for Entrepreneurship and Prosperity April 16, 2015
    The United States was once considered the land of opportunity where entrepreneurs such as Henry Ford, Ray Kroc and Steve Jobs contributed to a flourishing economy by providing new products and services at prices people were happy to pay.Today America’s …
  • Obamacare Fines Debut This Tax Season April 15, 2015
    Taxes for 2014 are due this week, and your tax bill could be affected by your health insurance. If you had insurance during the entire calendar year of 2014 through an employer, a state exchange, or Medicare Part A, you …

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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