Letters

Medicare and Medicaid: not the same thing

Editor:

I seem to be missing something when considering Wills v Foster, 372 Ill App 3d 670, 867 NE2d 1223 (4th D 2007) ("Collateral source rule and med bills - plaintiff's, defense bar each win one," LawPulse, July Journal). The majority refers to "Medicare or Medicaid, which provides health benefits to certain needy individuals" and to those individuals, "like plaintiff here, covered by Medicaid or Medicare do not make 'expenditures' and have not bargained for their coverage," and to "Medicare and Medicaid recipients, who lack the funds to acquire insurance, are placed at a disadvantage from those who are financially able to secure insurance."

The dissent refers to a "Medicare or Medicaid recipient....[who is] a needy person who did not have the ability or resources to acquire private insurance." As Gershwin wrote, "It ain't necessarily so." Medicare is not the same as Medicaid.

People covered by Medicare get their coverage in three parts. Medicare Part A covers blood, home health services, hospice care, hospital stays, and skilled nursing facility care. It's true that "Most people automatically get Part A coverage without having to pay a monthly payment, called a premium." But it's not because they are poor or needy. "This is because they or a spouse paid Medicare taxes while working." Medicare and You 2007, Centers for Medicare and Medicaid Services (the "Book") at page 8 [on the Web at http://www.medicare.gov/publications/pubs/pdf/10050.pdf ] . Indeed, I've been covered by Medicare for more than four years and I'm still paying Medicare taxes.

Medicare Part B covers medical services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. You pay a premium each month for Part B coverage. Book at page 10. Starting January 1 of this year some people pay a higher premium, depending on their income. Book at page 11.

The third part of Medicare, prescription drug coverage, is Part D, and you either pay a premium or join a Medicare plan (like an HMO or PPO) that provides the coverage. Book at page 43.

Medicare recipients are not "needy individuals" "who lack the funds to acquire insurance." They are people who have paid Medicare taxes and are paying Medicare premiums for their coverage. Indeed, many Medicare recipients are also paying premiums for a supplement policy that covers some of the holes in Medicare coverage.

Benjamin H. Cohen

Chicago


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