Medicare question

daisy.girl · 09-02-2012, 11:13 AM

Yes, I understand this....I am just wanting to know if you all will share what you pay...the 20% if you do not have a secondary insurance.

Right now, I have private insurance, and I pay my neuro a $40.00 co-pay each visit.
If I elect the Medicare part B, with no secondary ins; what (on average) would my cost be for each office visit?

And what is the deductible to Medicare B?

Kitt · 09-02-2012, 11:21 AM

Quote:

Originally Posted by Meowkitkat

Actually the quote of medicare going up to $240 in 2014 is incorrect. According to FactCheck.org its a inaccurate email that has been floating around for quite a while. The link that supports this is http://www.factcheck.org/2011/04/pre...e-on-medicare/

That is correct.

Kitt · 09-02-2012, 11:24 AM

Quote:

Originally Posted by doydie

Daisy girl you get Medicare and either he A or the B comes automatically. I can't remember which. You can opt out of the other. I took both of them. When my husband retired and I no longer had his company insurance as my primarey I had to depend on Medicare only. So there are all kinds of Medicare supplements sold. At the time I was picking Medicare Advantage was one of the big ones. I think it is manged by the government but lets all sorts of insurance carriers sell it. I got mine through Anthem Blue Cross. At the time I got it I got it for $14/month which also covered, now don't get confused here, Medicare D which was a pharmacy plan with it. Medicare by itself does not have a pharmacy plan except for a very few medicines. And I mean very few. the advantage plan covers wellness issues mainly, things to keep up with to maintain your wellness. If you have, like my Mom, a lot of medical issues you pay out the wazoo! She still paid the $14/month.We did not know that at the time. Our agent dfidn't tell us

I think she was just so glad to get two clients in her office at one time she sold my Mom the same thing as me.

I fear that the wonderful price of $14/month may be in the past though. I sure hope not. I haven't seen what it is. There have been just rumors. One good thing the Advntage plan had was a free Silver Sneakers membership to whatever gym in your area had Silver Sneakers. I chose the YMCA. It's free!!!! My water therapy, gym access, anything you want to do plus the Silver Sneaker programs have little get togethers.

I hope I cleared up some things.

Part A is automatic.

EddieF · 09-02-2012, 12:20 PM

If you're paying $40 for neuro followup, sounds like your 20% costs will go down. I pay $25-$30.
A dr's quality/performance/record might dictate the amount medicare approves. A top notch surgeon i've seen gets alot approved.

jprinz99 · 09-03-2012, 12:26 PM

some of the questions you need to consider:
Medicare:
do I want part A (automatic get this, covers hospitalization needs) with or without part B (which has a base premium, covers non hospital charges such as MD visits, medical equipment, lab fees)

do I want part D (Medicare Drug Plan,covers drugs) or no part D *caution: if you do not sign up for a part D plan when first eligible there is a penalty assessed later, based on how long you waited. Most states have at tleast one part D plan that is free/super cheap compared to eventually having to pay the penalty forever

do I want Medicare (part A, B &D) or Medicare Advantage plan (all cover A&D, check if it includes part D coverage or not)

I often find the easiest and smartest thing to do is to go through my local AAA or SCHIP counselors -> they are paid by the federal government to impartially advise those eligible for Medicare on which plan is best for you, based on your needs and "comfort level" with expensses & coverage. You can also search plans & coverage online at medicare.gov

Note: you are comparing apples to oranges. Remember that every single one of us has different plans (even if called by same name, like Anthem BCBS) based on where we live AND what we need/can afford/can risk

jprinz99 · 09-03-2012, 12:33 PM

and to answer your original question:

my neuro charges 120.00 for a regular visit. He "Accepts Assignment". This is important to also ask as many doctors take Medicare - the BIG question is if they "Accept Assignment" (which means they agree not to balance bill the patient.)

This year I have choosen a Medicare Advantage plan that includes D (the drug coverage). I pay a $45 copay for each visit to my neuro or any other specialist and that is all I pay him. Primary care visits (to my Int med MD) are $15.00.

I used to have traditional Medicare, parts A, B and D. Some years the D was free/no monthly premium & other years it was a monthly premium. Part B premium comes straight out of my SSDA check.

I went to Med Advantage plans 3 years ago and it has prooved the cheapest option {for me} at the end of the year. My current M.A. plan is Anthem BCBS Medicare Premium- Virginia. I pay $112.00 month, my husband has the standard Anthem BCBS Medicare- Virginia plan for no monthly premium. Based on our estimated expensses and medical needs we both had to choose different plans.

Are you brain fried yet

daisy.girl · 09-03-2012, 01:24 PM

eddie and jprinz....
thank you; this is exactly what I was asking.

I am on disability, so I get medicare part A, I have the option to choose B for 99.90 taken out of my disability check each month.

Is there a deductible with part B too?

Or, I can opt out of the part B, and stay on my husbands insurance. It costs me $300 a month to be on his plan. But the coverage is good. I only have copays. $40 for a specialist and $20 for a regular doctor visit.

So, Jprinz; you are saying that even if I choose part B, I have the 99.90 taken out of my disability check, and then I would have to pay an additional monthly fee depending on whether I choose an Medicare plan like Advantage.

One more question, so if the doctor accepts assignment, you do not have to pay the 20%? I am a little confused by this, as you said you pay $45 copay.

thanks so much

Kitt · 09-03-2012, 03:40 PM

Does this help. You still need a supplemental plan to pick up the difference if you have Part B. At one point I was going to opt out of Part B but was advised not to. It could have cost me lots of money if I had any medical crises. So I still carry Part B taken out of my SS. Part A is automatic. I do not carry Part D as I do not have any prescription drugs and hopefully never will.

http://www.medicareplanstoday.com/me...dicare-part-b/

daisy.girl · 09-03-2012, 04:48 PM

so, you can't just have medicare? you have to have a supplemental plan??

Kitt · 09-03-2012, 04:55 PM

You need a supplemental plan to take up what Medicare doesn't pay. That will also depend on how much your supplemental plan will pay. Mine pays it all that Medicare doesn't pay. And I have found that if Medicare does not allow anything for a procedure my supplemental plan won't pay anything either.

Perhaps you could go on the Medicare site and explore. Or ask the insurance company to explain what a supplemental plan will do. There are several supplemental plans depending on which company you go with. Example: Blue Cross Blue Shield. There are many supplemental plans and it certainly can be confusing and it takes some research into it. Not every plan or supplemental plan works for everyone. You have to decide what will work for you.

Of course none of it is cheap in this day and age.

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