Medicare

MSLI · Nov 21, 2024

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 · Nov 22, 2024

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 · Nov 24, 2024

So why are there supplementals ?

havasu · Nov 24, 2024

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 · Nov 25, 2024

havasu said:
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 · Nov 25, 2024

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 · Nov 25, 2024

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 · Nov 25, 2024

havasu said:
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 · Nov 25, 2024

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

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