[daisy.girl]

Can anyone that is on medicare B, tell me what you pay out of pocket for a visit to your neuro's office? I know it can be different depending on what is done....but I mean an average neuro appointment?

thank you

[Dejibo]

I have a 2ndary (and 3rd) insurance so my circumstance is different.

I know my MD will charge like $57 to get a plain office visit check up without nothing special and medicare will pay him $7. The rest gets pushed to my 2ndary.

My normal nothing fancy neuro is $197 Medicare pays $32 and the rest gets pushed to my 2ndary.

You have to remember the deductible for medicare as well. if you have not met it yet, they will take a portion of the bill and not pay it and use it as part of your deductible. If you have met it then carry on.

Since my MDs are hospital MDs they accept medicare because their hospital accepts federal funds, so they are forced to take the plan. Many private MDs who are in a private office will refuse medicare or medicaid patients. Some have even stopped taking any insurance. you pay cash and then YOU bill your insurance company. It saves them a bundle in office hours, staff pay and so forth. For that $7 my MD gets he probably had to pay his staff $30 to go chase it. He was telling me how much he was losing to accept insurance.

[daisy.girl]

thank you so much....

I am currently covered under my husband's insurance; and recently received disability. I opted out of the part B; however my husband's insurance is going to be changing in October, so I wanted to check and see if it would be more beneficial for me to sign up for the part B. My husband is covered at no cost, but to add me is $300 a month.

But with that I only have a copay for dr visits of $15 and specialists (NEURO) of $30. I would have a deductible of $500 for MRI, outpatient, and hospital visits.

Part B is around $100 a month....then I have to worry if my doctors will even take medicare!

Trying to compare is sooo difficult....my head is spinning!!

[Dejibo]

medicare is about to take a HUGE price jump so be aware. Its going to be $120 in 2013 but it will double in 2014 to $240! so be aware.

Many MDs are opting out of the program, but if you go to these major clinics that accept federal funds they MUST accept medicare and medicaid. This is why the ER is always so full. Its so hard to find an MD who will take medicaid and if you can the wait list is very long, so off to the ER you go! common colds, rashes, boo boos and the like instead of using the ER for emergencies its clogged with common care. Many ERs have opened an "urgent care" side to the clinic to take care of colds/flu and the like while true emergencies can be handled with the big guns. The cost is less, but the care is still good. good luck finding a dentist who takes medicaid.

I would call your husbands insurance company. Sometimes they demand that if you qualify you MUST take medicare or they will place you on the equivalent program thru them. if it wouldnt be covered under medicare they wont pay for it either. I would ask a patient benefit co ordinator to help you decide. another good advocate is your pharmacist as they are really good at the plans.

Please know that if your spouse is working medicare would be your 2ndary insurance. Once both of you stop working, medicare goes to the head of the line. (that one killed me) and the normal rules apply, but you have the back up of medicare. Normally once you say NO i dont want medicare as part of SSDI they dont normally give you a second chance unless you turn 62. it was highly reccomended that I take it and be triple covered instead of not taking it and missing out. Please call 1 800 medicare and ask if you turn it down, can you reapply in a year or will it cause you to be denied till you are 62.

insurance can be such a mess! good luck.

[missj]

For comparison's sake and the craziness of it all

clinic charges 523
medicare approves 121
medicare pays 97
secondary pays 24
my out of pocket- zero to clinic but premiums to insurers

[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/

[doydie]

I'm trying to write this my memory instead of checking my Medicare Advantage card, which is different than just Medicare. My family doctor I pay #25 and a specialist I believe is $40. It's just according to what your helth care needs as to whether Medicare only is better than a Mdicare advantage program. Both my Mom and I got the Medicare advantage plan. It suited me very well. It was terrible for my Mom. Most of my charges arew for medicine. I normally see my family doc once a year and mny neuro once a year. I don't need that many labs or xrays. But my Mom had numerous medical needs, lots of doctor visits, lots of xrays and labs. So she paid a huge out of pocket. Our insurance agent got Mom to drop the Advantage Plan and just go with Medicare. She already had A and B. It helped immensley. So it's acording to what kind of health care you need. Advantage plan is geared towards staying healthy, medicare only is to take care of older sicker people.

This year may be a whole new story for me. I've had a lot of other issues, not MS related and I've to pay a lot of co pays. But I will take them off my taxes.

[daisy.girl]

wow!! now I am more confused when I asked the question!!

Ohh insurance and what to do!?!

[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.

[BAnna]

Originally Posted by daisy.girl

Can anyone that is on medicare B, tell me what you pay out of pocket for a visit to your neuro's office? I know it can be different depending on what is done....but I mean an average neuro appointment?

thank you

The docs can charge anything they want, but there are standardized medicare payments for each billing code with some minor deviations for local areas. By law, the patient is responsible for that 20% copay which may be assumed by the secondary. The doctor may elect to forgive the copay but must do so on an individual basis for each patient with documentation on inability to pay.