The bills are starting to come in

I think the doctors' offices' personnel get pretty overwhelmed trying to keep up with the zillions of different plans and what they do or do not cover, so I wouldn't blame her. From the dates on the bill, it looks like maybe they sent it to Empire first, and they didn't pay because Medicare hadn't paid anything yet. Who knows, but it's only a glitch and will get straightened out one way or another. This is why we all need to pay attention when we get those bills.
 

Medicare is my primary, BC/BS is my secondary. Between them, they have nearly everything covered. Often, I get a statement from Medicare saying I owe (x amount) to the doctor, above and beyond what they are paying. This is before BC/BS has a chance to kick in. I always just ignore it. I don't really owe it.

Sounds like you are also in that in-between period. Just wait; don't pay anything!
 
Sunny said:
Medicare is my primary, BC/BS is my secondary. Between them, they have nearly everything covered. Often, I get a statement from Medicare saying I owe (x amount) to the doctor, above and beyond what they are paying. This is before BC/BS has a chance to kick in. I always just ignore it. I don't really owe it.

Sounds like you are also in that in-between period. Just wait; don't pay anything!
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Best Medicare advise I have gotten... DON'T PAY ANYTHING until Medicare weighs in and you get a bill that correlates to what Medicare and your Supplement agree you owe.
 

Lolly said:
As far as I know Plan F is the only supplement that pays the deductible..


Who pays Medicare deductible?



Before Medicare pays anything under Part B medical insurance, you must pay a deductible amount of your covered medical bills for the year. The Part B deductible amount is currently $183 per year (in 2017).
Part B Medical Insurance: What You Pay | Nolo.com

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

Part B deductible and coinsurance$183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.
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I have Mutual of Omaha and it does pay deductible.
 
I pay $125 for my Medicare Part B and nothing for my supplemental which so far has been excellent. I may get it for free because I'm on widows benefits only.

I pay nothing at my drs office for a visit. My X-ray and MRI cost me $5 and my prescriptions are usually $5. So far I haven't had to pay for anything Ive had done.

I have a mammogram scheduled for Nov 8 and that will cost me $5 also.

I always make sure I ask what something is going to cost me out of pocket BEFORE I have it done.

Obviously I can't do that in an emergency situation but so far so good.

only negative to my supplemental is that I have to have things done in Fresno and I live alone so my daughter will have to drive 3 hrs to stay a day with me when needed. She's very busy so that won't always be easy.
 
AZ Jim said:
I have Mutual of Omaha and it does pay deductible.
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It does if you selected Plan F.. I have plan G and it does not pay the deductible but the difference in my premiums between Plan G and Plan F makes me better off paying the deductible than paying the higher Plan F premium. I actually save money.
 
Plan G in most areas is a great value. My clients almost never choose Plan F when we go over how much you must pay an insurance company to have you avoid the $183 Part B deductible.

I also use Plan N much of the time. Since excess charges are only an issue about 4% of the time, the differential between G and N can be $40-50 a month in exchange for paying up to but never more than $20 for an office visit.

Rick
 
GreenSky said:
You don't have a supplement. You have a Medicare Advantage HMO.

Rick
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I think that's where people who have the Medicare Advantage plan HMO's get confused.. They signed away their Medicare and have opted for a plan administered by a private insurance company. They do not have Medicare.... There part B premium is sent directly to the HMO provider...
 
Lolly said:
I think that's where people who have the Medicare Advantage plan HMO's get confused.. They signed away their Medicare and have opted for a plan administered by a private insurance company. They do not have Medicare.... There part B premium is sent directly to the HMO provider...
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Actually, the entire average cost for someone on Medicare in their area is sent to the insurance company. It's more like $1,000 per month.

I help people with Medicare Advantage (HMO and PPO) if that's what they want. For me, I'll go with Medicare and a high deductible Plan F in a year.

Rick
 
GreenSky said:
Actually, the entire average cost for someone on Medicare in their area is sent to the insurance company. It's more like $1,000 per month.

I help people with Medicare Advantage (HMO and PPO) if that's what they want. For me, I'll go with Medicare and a high deductible Plan F in a year.

Rick
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I figured that more was sent to the Insurance company... like the money to cover Part A.. hospitalization, but I didn't know the dollar amount. I completely agree with you.. I will stick with traditional Medicare.. I think that in the long run and particularly if a person is stricken with a major illness like Cancer... Traditional Medicare is better coverage.
 
MelissaKay said:
I don't know if that's true regarding "the doctor eats it." If Medicare doesn't pay the doctor is allowed to charge up to a certain percent of the total charges, this is called Part B excess charges. Your Plan G does cover these extra charges, I believe Plan F does as well.
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That's not what excess charges mean at all. Excess charges only come in to play with about 4% of doctors when they don't accept assignment of the claim. So neither Medicare nor any supplement will pay the doctor directly but will pay the patient only. If Medicare doesn't allow a procedure nothing will pay on behalf of the patient.

Plan F & G do pay excess charges. I have hundreds of clients with Plan N (which does not pay excess charges) and not one of my clients has ever had a provider legitimately charge them.

Medicare really isn't rocket surgery but I find in general that when people do their own research and/or just call a few insurance companies they wind up paying more than necessary. It may not be easy to find an independent agent that really specializes in Medicare but that's really the best way to do things. There is no cost to use a professional.

Rick
 
GreenSky said:
That's not what excess charges mean at all. Excess charges only come in to play with about 4% of doctors when they don't accept assignment of the claim. So neither Medicare nor any supplement will pay the doctor directly but will pay the patient only. If Medicare doesn't allow a procedure nothing will pay on behalf of the patient.

Plan F & G do pay excess charges. I have hundreds of clients with Plan N (which does not pay excess charges) and not one of my clients has ever had a provider legitimately charge them.

Medicare really isn't rocket surgery but I find in general that when people do their own research and/or just call a few insurance companies they wind up paying more than necessary. It may not be easy to find an independent agent that really specializes in Medicare but that's really the best way to do things. There is no cost to use a professional.

Rick
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I agree.... when my husband and I were first approaching Medicare age we attending a seminar sponsored by a local agent specializing in BC/BS.. This is our first full year on Medicare and so far.. we have been happy with our plans..

As far as charges go... If a provider agrees to accept Medicare... either an MD or a hospital... they agree to accept what Medicare pays.. They cannot bill a patient for the difference...
 
Lolly said:
I agree.... when my husband and I were first approaching Medicare age we attending a seminar sponsored by a local agent specializing in BC/BS.. This is our first full year on Medicare and so far.. we have been happy with our plans..

As far as charges go... If a provider agrees to accept Medicare... either an MD or a hospital... they agree to accept what Medicare pays.. They cannot bill a patient for the difference...
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Since we all know that the only difference between companies writing the same letter plan is the price, I hope you not only shopped pricing when you bought your plan, but you do it every year.

BTW, excess charges as rare as they are only apply to Part B. Hospital charges are Part A and there is no excess charge.

Rick
 
GreenSky said:
Since we all know that the only difference between companies writing the same letter plan is the price, I hope you not only shopped pricing when you bought your plan, but you do it every year.

BTW, excess charges as rare as they are only apply to Part B. Hospital charges are Part A and there is no excess charge.

Rick
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That is correct... because if a Hospital agrees to accept Medicare.. they must accept what Medicare pays... they cannot bill the patient the difference.
 
A little piece of Medicare supplement history: I was THE first Medicare supplement department. The whole department. Me. I took a part-time job at Blue Cross while I was in college and on my first day, they ushered me into a room with what looked like a zillion boxes of postcards and a whole room full of file cabinets. Our particular office was setting up the first Medicare supplement plan and so far it had only got as far as people sending back the cards that had been mailed out all over creation and indicating that they were interested in joining. Blue Cross was the first provider to offer Medicare supplements.

For the sumptuous sum of (I think) $1.65 an hour, I got to alphabetize and alphabetize and alphabetize. AND I had to stamp something (I think it was the date) on each one in green ink. I had a perpetual green right elbow because I kept putting my elbow down on the stamp pad. I swore then and there I would work hard in college so that I could get a job that didn't include "alphabetizing" on my job description. I didn't work hard enough and ended up doing a lot of things that weren't much more interesting than alphabetizing.

When I left the job several months later, there were over 40 people working in the department.

And now.....I HAVE Blue Cross Medicare supplement. How's that for karma? I think my karma ran over my dogma.
 
debodun said:
I had a Medicare wellness visit with my GP last week and already received a bill fro $170 for it from her. I have Medicare and supplemental coverage. Why am I being billed? Do I have to pay this?
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as i just learned last week when i got a bill , the medicare wellness visit is not a comprehensive exam . they cover a few things but it is mostly a questionnaire and health evaluation . i went on medicare in october , had my annual exam in october and got a 146 dollar bill because i did not meet my deductible on the uncovered items in the wellness check . i have a high deductible f-plan so i have to pay this .

the unfiar part is medicare has no carry over or pro-rating of the deductible. i have a new deductible as of today . they really should have provisions for those going on in the last 2 or 3 months not to have a full deductible again 60 or 90 days later.

here is what a wellness exam covers , you can see it is not an annual physical exam .

https://www.medicare.gov/coverage/preventive-visit-and-yearly-wellness-exams.html
 
The annual "Wellness" exam seems to be little other than an annual "paperwork" update. Our Humana Advantage plan covers the cost...with only a $20 co-pay, so we usually go in every Spring for it. I generally use it as a means of scheduling any "specialist" treatment I might require....this year, I have a small cyst developing on my thumb...probably a small bone spur which will require a minor surgery...so I will get that taken care of in March or April...$20 for the doctor co-pay, and probably $50 co-pay for the minor surgery. My retiree benefits cover the insurance premiums, so our annual out of pocket costs are usually no big deal.
 
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