Had to pay up front for a test at a clinic

debodun

debodun

SF VIP
Location
way upstate in New York, USA
My doctor sent me to have some tests. Most medical facilities do not ask for a payment after a visit - they submit their bill to Medicare, then what Medicare doesn't pay for is sent to my MediGap insurance. When the dust settles, they send me the balance to pay. When I went to this clinic, they asked a $25 payment even before I was seen. Has that ever happened to any other board members?
 

Not to me, but wonder if you will get a refund check from insurance when it all settles. A few years back, I was charged a co-pay for a procedure my insurance should have covered. I got a refund check a few weeks later. After the weekend, check with the provider you saw.
 
There are hundreds of variations of Medicare Advantage/Medigap. Most require some sort of Co-Pay "up front" when you go to virtually any doctor or specialist. Most reasonably priced plans Do require a small co-pay....only the more expensive ones cover nearly everything. Personally, I'd rather make a small co-pay to the doctor than lining the insurance company executives pockets on a full coverage plan.
 
Don M. said:
There are hundreds of variations of Medicare Advantage/Medigap. Most require some sort of Co-Pay "up front" when you go to virtually any doctor or specialist. Most reasonably priced plans Do require a small co-pay....only the more expensive ones cover nearly everything. Personally, I'd rather make a small co-pay to the doctor than lining the insurance company executives pockets on a full coverage plan.
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Actually, there are only a few variations of Medigap Plans. Some do have a share of cost for Part B benefits, but I know of virtually no one is most states that have standard plans to have a copay for lab work. In fact, if you have Plan F, G, or N there would not be any cost for lab or x-ray. Of those 3, Plan N is the only one that even has a charge of up to $20 for office visits (but this is almost always the best value).

If you have a Medigap (supplement) plan I don't see how any lab can send you a bill for anything.

Of course, Medicare Advantage is a different animal and in that case there can be a copay.

I suggest that debodun make sure it's an actual supplement not a "secondary" as from a retirement plan, or a Medicare Advantage plan.

Rick
 
Have a Humana Medicare Advantage PPO plan and have never paid for lab work. It is in the coding of charges. I questioned the amount of blood work my PCP ordered and he said it was in the coding. He was right as the extensive tests I had were covered without a problem and no charges for me. Good coders can make really good salaries and are in great demand. They can make or break a practice.
 
I though when I qualified for Medicare, I would not have to pay for anything. I have Plan A and Plan B with The Empire Plan (United Healthcare) as my secondary and the prescription drug plan is SilverScript which I carried over from my employment. The drug plan is good - I only have to pay a few dollars each for the two meds I take, but I still have to pay anywhere from $25 to $40 as a co-pay for medical services no matter what.
 
debodun said:
I though when I qualified for Medicare, I would not have to pay for anything. I have Plan A and Plan B with The Empire Plan (United Healthcare) as my secondary and the prescription drug plan is SilverScript which I carried over from my employment. The drug plan is good - I only have to pay a few dollars each for the two meds I take, but I still have to pay anywhere from $25 to $40 as a co-pay for medical services no matter what.
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It sounds like your supplement must also be from employment and those plans will deviate from the standard (retail) plans. And this is likely why you have copays for many services.

I almost never recommend leaving an employer sponsored plan but if you'd like to know what a standard plan would cost please send me a private message with your phone number.

Rick
 
Butterfly said:
I have an Advantage plan and have no co pay at all for lab work or x-rays.
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Out of curiosity, what would be your cost should you need chemo? Most advantage plans are 20% of cost to policy maximum.

In Los Angeles and Vegas that maximum is usually around $1,200 for HMO. For PPO it's $6,700. And that's of course if you stay in network.

I'm not familiar with (as Bug's Bunny called it) Albacracky.

Rick
 


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