Life with MS

“Medicare for All” May Come With Unexpected Costs

By Cherie Binns
I am hearing more and more talk about "Medicare for All." It seems that many people are under the impression that Medicare is free healthcare, but it is not! Let’s clear up how it works.
            All of us who qualify for Medicare get hospitalization covered at no cost to us, but nothing else (Medicare Part A). If we decide to purchase Medicare Part B (at a standard cost of $135.50 a month for 2019), we are granted access to doctor’s appointments and lab work, X-rays and MRIs, and required durable medical equipment at 80 percent of the cost – meaning we are still responsible for 20 percent of the cost. If a doctor’s visit costs $100, we are responsible for paying the doctor $20 of that and Medicare Part B pays the other $80.
            If we want further coverage to pick up that 20 percent that we are responsible for, we can buy a Medicare Advantage or Supplement Plan. That can cost $100 to $200 more a month, but will cover all copays for doctor, lab, X-ray, and durable medical equipment. But wait, these plans do not cover prescription medications unless they are administered while you are in a hospital. So we may also choose to buy a Medicare Part D plan, which covers part of our medication costs.
            The average cost of a Medicare Part D plan is $33 a month. However, Medicare Part D plans work on a tier system to determine how much is covered. For many high-cost conditions (such as multiple sclerosis, rheumatoid arthritis, lupus, cancer), all drug treatments available are in the highest tier of copay, which means we pay 40 percent of the cost of the drug. For some of these medications, that can be thousands of dollars out of pocket a month.
            Clearly, Medicare is not free healthcare. As working adults we pay into Medicare over the years of our employment, or self-employment, by law. We continue to pay premiums for that care once we qualify for Medicare. On Medicare, my husband and I pay approximately $9,000 a year in premiums for the two of us, but that is still far easier to manage than the $2,900 a month that we were paying in premiums for private insurance and we are grateful that we have that care when we need it.
            Please have a dialogue with your member of Congress about what they are talking about or what comes to their mind when they hear “Medicare for All.” What needs to happen to make this level of care available to all? What will it cost us out of our pockets (in premiums or increased taxes)? We have a little more than a year and a half before the next election to learn about – and come to understand – the issues on the table and need to not rely on emotional pleas and speeches to “inform us.” Please take this time to educate yourself on what the terms used will mean for you and your family, in terms of outcomes and costs, and be an informed voter and active citizen.