The reality is Medicare is funded by the government but the delivery of services is accomplished privately for healthcare (Part A and Part B) and prescription medicine (part D).

The implication that Medicare in our country is run like healthcare in other countries, like Canada or countries in Europe, are inaccurate.  Canada and Europe have government run healthcare.

An example of government run healthcare in our country would be the Veterans Administration.  The VA is government run healthcare for our Veterans.  The government provides the funding and the hierarchy of management.

Medicare provides funding for “private” companies to administer Medicare. An example of this would be Medicare Advantage Plans (MAPD).


The facts are most people will have no problem locating providers who accept Medicare. Statistically speaking, less than 2% of people have had trouble locating primary care doctors and specialists that did not accept Medicare.   That being said, there are concerns about the overall shortage of primary care doctors in general. This is something that is being closely monitored by the Medicare Payment Advisory Commission (MedPAC)

Another thing to keep in mind is that Medicare is a form of currency for the doctor.  If you look at it logically, if doctors do not accept Medicare, they are turning away a lot of business.  Doctors have bills to pay, just like you and me!


Medicare has conducted means tests since 2003, under the Medicare Modernization Act.  This act established higher premiums for Parts B and Part D for those who make over a certain dollar limit. As of 2016, if you are single and earn over $85,000 or married and earn over $170,000, annually, you will pay a higher Part B premium and you will also pay an additional premium for your prescription drug coverage.

For example, I you earn over $85k if you’re single and $170k if you a married, as of 2016, your Part B premium will be $170.50 per month, as opposed to $121.80 for those who make less. In fact, if your income is above $214k if single and $428k if you are married, your Part B premium will be $389.80 per month, as of 2016.

When it comes to Part D Prescription drug plans, if your income is above these income limits you will pay an adjusted amount over and above the Medicare plan premium.  Using the income figures from above, if you are single and earn over $85k and are single or over $170k, if you are married, you will pay an additional $12.70 per month over and above the Part D plan premium. For example, if you choose a Part D plan and the premium is $30 per month, if your income is above the above income levels, you will pay an additional $12.70. So your plan premium will be $42.70, under this example.  If your income is over $214k and single or $428k and married, you will be charged an additional $72.90 plus your plan premium. Under the $30 plan premium example, your premium would be if you exceed this income level would be $102.90 per month.  These adjusted premium amounts for Part D are current figures as of 2016.


People are living longer. There is no doubt about that. The big cost to people as they get older is nursing home care. Medicare does not cover nursing home care (That’s a myth also. Many people think that Medicare covers nursing homes. This is not true.  The only vehicle that will cover nursing home care is having long term care insurance or using your own resources to pay for it.)

Nursing home care is a huge expense. This burden generally falls to Medicaid (once you spend down your resources or if you have none), which is state run, unlike Medicare, which is federal.  Nursing home care is one of the, if not the largest, financial burdens of the entire Medicaid system (Not Medicare).

Studies have shown the cumulative healthcare costs stay at pretty consistent level after age 80. Although Medicare covers hospital confinement, these studies have shown that there is a greater need for nursing home care and less care at hospitals as you get older.