Medicare

[MSLI]

Ok boys, I’m joining the last milestone. First the drivers license, then voting, then drinking, now Medicare ….. What Plan should I get ? I see stents, bypass, and joint replacements in my future. Should I get Supplemental D, G, K, L, M, or N ? or pass altogether on them and just stick with the basic A + B ?
Thx !

 

[havasu]

Just get A and B.
I have a Blue Cross Platinum PPO as my supplemental, which for some stupid reason is changing to Blue Shield Platinum PPO in January. The cost is $400, but going up 31% in January. Remember, since Obama changed the rules, there is no more 80/20% with PPO, and your primary is Medicare, snd your supplemental is your secondary. Lastly, if Medicare doesn't cover it, your secondary insurance also will not cover it.

 

[MSLI]

So why are there supplementals ?

 

[havasu]

Because for example, a doctors appointment may cost $250. Medicare approves it, but will pay a maximum amount of $110. Your secondary insurance then will pick up the additional $120. This leaves a balance of $20. The rule for Medicare to be accepted at your doctor's office, they must be willing to accept a cheaper amount of payment, so the doctor adjusts his office visit down to $230, so the visit costs you $0 out of pocket.

 

[MSLI]

Because for example, a doctors appointment may cost $250. Medicare approves it, but will pay a maximum amount of $110. Your secondary insurance then will pick up the additional $120. This leaves a balance of $20. The rule for Medicare to be accepted at your doctor's office, they must be willing to accept a cheaper amount of payment, so the doctor adjusts his office visit down to $230, so the visit costs you $0 out of pocket.

So is it safe to assume, that if you pass on secondary insurance they would lower the bill to 130.00 ? ( 110.00 Med. 20.00 you ?)

Sounds complicated and with this successful lying in business thing, we have no insurances what insurance is wise or overkill….. I heard, if you don’t get the supplemental in the beginning, chances are an underwriter gets involved and the rate becomes unaffordable.

 

[havasu]

I have found that money is sometimes king, but asking for a cash price, the doc would maybe take $220, but won't go less.

 

[havasu]

My neighbor has Kaiser as his Medicare provider. He also doesn't have a secondary. Every visit has a co-pay of $60, a cat scan is $500, and an MRI is $600. He gets "Nickeled and dimed" on medical treatments.

 

[MSLI]

Just get A and B.

So wait a minute , The neighbor only has A + B and has lots of out of pocket medical expenses, but you’re still recommending no supplemental insurance ? ….. I’m missing something here and obviously a little slow from the safety solvent.

 

[havasu]

No, for Medicare, just get their A&B. Get the supplemental elsewhere. It's cheaper that way.