Medicare Premiums Update

I just got the billing from 9/1/2020 through 11/30/2020 and it was for $1,388.10 or $462.70 per month. I think it’s the same as what I paid since the beginning of the year. It’s much higher than the base $144/month premium but worth it compared to the cost of dialysis, even at Medicare prices. For comparison, I also got the EOB (explanation of benfits) for May from dialysis:

• Cost without benefits = $32,687.23
• Your plan rate = $4,047,42
• Your plan paid = $810.81

This is from the perspective of Blue Shield, my work insurance carrier. On medicare.gov, I found the same claim and Medicare paid $3,236.61.

Medical insurance is weird in the US. If I didn’t have insurance, my dialysis center would initially charge me the $33k for services in May, but we will probably negotiate that down to some lower number. If my work insurance was paying, then the “plan rate” would be around $26k, and Blue Shield (or ultimately my work) would pay it. With Medicare, the dialysis center only gets $4k of which Medicare pays 80%. Again, with Medicare for All at the current pricing, all hospitals and clinics would go out of business.

So just for dialysis, I’m paying $463 per month and Medicare is on the hook for $3,200. The difference comes from Medicare taxes paid by everyone receiving a paycheck.