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Post by liftlock on Oct 6, 2023 1:01:04 GMT
Medical billing is a joke. But those not covered by ANY insurance are screwed - they don't get that insurance discount. Several years ago I had a spinal nerve block performed at an outpatient surgical center which I suspect was physician owned. I was there for about 2 hours. The facility billed Medicare about $20,000 excluding Dr. fees. Medicare allowed something like $1,000 to $2,000. The imaging facility I use for MRI's and CT scans charges more than 10 times what Medicare allows. The patient without insurance is in a world of hurt. |
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Post by gman57 on Oct 6, 2023 1:16:54 GMT
Medical billing is a joke. But those not covered by ANY insurance are screwed - they don't get that insurance discount. Several years ago I had a spinal nerve block performed at an outpatient surgical center which I suspect was physician owned. I was there for about 2 hours. The facility billed Medicare about $20,000 excluding Dr. fees. Medicare allowed something like $1,000 to $2,000. The imaging facility I use for MRI's and CT scans charges more than 10 times what Medicare allows. The patient without insurance is in a world of hurt. Yup, big time.... who hasn't heard of the stories of hospitals billing $20000 for a procedure and the insurance company paying $2500. It's crazy but that's what we get for having a for profit middle man (insurance companies) in the picture. When I was a kid you went to the doctor and you paid him just like you pay for a loaf of bread when you go to the grocery store. There was no middle man and the enormous administrative burden that involves to jack up the cost of everything. How much of our medical bills pay for all the insurance company employees, their real estate, all the admin doctor/hospitals etc... have to have to deal with all the different insurance companies and the multiple plans each company offers etc... it's crazy IMHO. |
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Post by anitya on Oct 6, 2023 6:15:52 GMT
When two principals do not trust each other or one of them plays unfairly with the other, it increases agency costs and that is what the insurance companies fill in. If doctors / providers want, they can eliminate the middleman. Kaiser Permanente is both the insurance company and provider.
As to for profit vs non- profit does not matter when it comes to awful customer experience, which is driven by company culture. Lots of big box providers are non-profit. Vanguard is a type of non-profit too. In my experience, a higher percentage of non-profits I have dealt with provide inferior customer service than the for profit companies I dealt with.
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Post by anitya on Oct 6, 2023 6:37:31 GMT
As Yogi said, never leave a credit card on file or give your credit card at the time of service. Ask them to bill you so you have a chance to dispute.
I made the mistake of letting Quest diagnostics have my credit card on file. They charged my credit card a few hundred dollars for performing lab tests prescribed as part of my annual preventative screening which is required under any insurance in the US to be 100% free. Quest, insurance company, and provider bounced me around by pointing finger at the other when I tried to sort it out and I gave up.
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Post by FD1000 on Oct 9, 2023 20:26:20 GMT
A friend of mine has seen 1-2 MDs but could not get what she needed. I told her to call an excellent Ortho group that I know can help her. This group has about 40 Orthos. None will accept NEW Medicare patients. Most MDs that you have seen prior to joining Medicare will accept Original Medicare, only some MDs will accept several top MAs. The top 2-3 Orthos have not accepted any Medicare in the last 10 years. This is exactly where I think Medicare is going to be in years to come.
Why would the top specialist MDs accept Medicare when they can make 3 times more?
Only answer could be...because they would like to help patients.
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Deleted
Deleted Member
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Post by Deleted on Oct 9, 2023 21:40:56 GMT
A friend of mine has seen 1-2 MDs but could not get what she needed. I told her to call an excellent Ortho group that I know can help her. This group has about 40 Orthos. None will accept NEW Medicare patients. Most MDs that you have seen prior to joining Medicare will accept Original Medicare, only some MDs will accept several top MAs. The top 2-3 Orthos have not accepted any Medicare in the last 10 years. This is exactly where I think Medicare is going to be in years to come. Why would the top specialist MDs accept Medicare when they can make 3 times more? Only answer could be...because they would like to help patients. Just and anecdote........ I recently had a knee meniscus tear and I have two friends going through knee replacements. We all have different orthopedists and we all think ours is the best in the city. Just sayin. |
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Post by FD1000 on Oct 9, 2023 21:49:11 GMT
A friend of mine has seen 1-2 MDs but could not get what she needed. I told her to call an excellent Ortho group that I know can help her. This group has about 40 Orthos. None will accept NEW Medicare patients. Most MDs that you have seen prior to joining Medicare will accept Original Medicare, only some MDs will accept several top MAs. The top 2-3 Orthos have not accepted any Medicare in the last 10 years. This is exactly where I think Medicare is going to be in years to come. Why would the top specialist MDs accept Medicare when they can make 3 times more? Only answer could be...because they would like to help patients. Just and anecdote........ I recently had a knee meniscus tear and I have two friends going through knee replacements. We all have different orthopedists and we all think ours is the best in the city. Just sayin. That's not the point. My point was that one of the biggest Ortho group in my area doesn't accept new Medicare patients. |
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Post by Chahta on Oct 14, 2023 12:21:19 GMT
“Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $174.70 for 2024, an increase of $9.80 from $164.90 in 2023. The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023.”
Quoted from yogibearbull’s weekly Barron’s report. This is an increase of nearly twice the percent increase of the SS COLA at 3.2%.
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Post by steelpony10 on Oct 14, 2023 12:46:00 GMT
“Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $174.70 for 2024, an increase of $9.80 from $164.90 in 2023. The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023.” Quoted from yogibearbull’s weekly Barron’s report. This is an increase of nearly twice the percent increase of the SS COLA at 3.2%. It’s going broke faster then SS being the $ amount is really inadequate to keep the program solvent. The Feds sure don’t know how to run anything efficiently. Imagine the current house of clowns considering a fix for either Democratic program? The quality of governance is going down just like the quality of the workforce in that generation. My poor kids and grands. Glad I have one step out the door. ✌️ |
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Post by Chahta on Oct 14, 2023 12:59:17 GMT
steelpony10, there has been a lack of quality governance for decades. SS and Medicare should never have been born. If the politicians weren’t panderers and too comfortable stealing and spending our money we could do it on our own. Just like inflation, they caused it and we pay the price. I suppose the democratic fools will wait until the wars are over then have all the money they need to plug the holes in SS and Medicare.
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Post by yogibearbull on Oct 14, 2023 13:13:37 GMT
Keep in mind that Social Security and Medicare belong to the MANDATORY part of the US spending. No use crying about them now. We are all on the hook, whether we like them or not, so it's time think about FIXING them. www.cbo.gov/publication/58889Only discretionary spending are in the annual fiscal budget that the DC is getting twisted over. www.cbo.gov/publication/58890 |
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Post by anitya on Oct 20, 2023 19:06:21 GMT
yogibearbull , (No Quick Tag for you in this thread!) "The 2022 net worth data for U.S. households: 25th pct = $27,000 (was $12,410 in 2019) 50th pct = $192,700 (was $121,760)
75th pct = $659,000 (was $404,100)90th pct = $1,936,900 (was $1,219,500) 99th pct = $13,615,400 (was $11,121,100)" Note my highlights (bold) - I thought the net worth for those cohorts would be much higher. So, looks like Medicare has a lot of outlays ahead of it for long term care. As an aside, I noticed the percentage increase between 2019 and 2022 - even the 90% percentile increased by more than 50% (I am clearly underperforming!). For members who wish to nerd out, the twitter account below also has the breakdown by Age and Education level. link
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Post by yogibearbull on Oct 20, 2023 19:16:29 GMT
I think I am up against 30-day/30-thread limit mentioned by the PB Support. big-bang-investors.proboards.com/post/42804/threadAlso, X/Twitter links/URLs auto-open at PB. To avoid (or control) that, use PB Link-Tool (9th from right) for Twitter links. On the other hand, X/Twitter image-links don't auto-open and PB Image-Tool (7th from right) must be used. |
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Post by anovice on Oct 28, 2023 15:04:07 GMT
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Post by anovice on Nov 13, 2023 19:27:50 GMT
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Post by FD1000 on Nov 13, 2023 22:10:35 GMT
I'm only in Medicare about 1.5 years. I went with Original Medicare because of the above and other stuff. I was debating with myself last year, but this year was a slam dunk. Several of my best specialists don't accept most advantage Medicare, maybe only 1-2 of them. Last year they accepted 5-7 of them. When I asked the person who files the claim, she told me the Doctors in her office are sick with the extra hassle and time consuming for them, and their staff. I know it's only local but if it happens in my big metro, it probably happens in other cities. |
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Post by anovice on Nov 27, 2023 11:32:22 GMT
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Post by anovice on Dec 3, 2023 21:02:14 GMT
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Post by anovice on Dec 5, 2023 15:42:42 GMT
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Post by anovice on Jan 1, 2024 14:37:54 GMT
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Post by anovice on Jan 6, 2024 19:59:25 GMT
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Post by archer on Jan 6, 2024 20:44:14 GMT
I don't expect to have any care denial problems with Kaiser advantage plan, but if I needed to change to regular medigap plans, due to moving out of a kaiser covered area, it looks like there could be a problem obtaining coverage. Kaiser has been very slow over past decades in expanding to additional states. |
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Post by anovice on Jan 19, 2024 13:26:39 GMT
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Post by anitya on Jan 19, 2024 19:54:35 GMT
When I become eligible for Medicare, if I am living in a foreign country, can I sign up for it but not choose a Medigap plan or an Advantage plan so as to keep my options open?
Instinctively, I would not have signed up for Part B and pay the premiums but too many folks have told me the penalties if I later change my mind and want to sign up for it. So, I figured, I will take SS simultaneously and pay the Part B premiums from the SS cash so I am not out of pocket for the Medicare Part B premiums.
It would be great to hear how US citizen posters who primarily live outside the US are approaching their participation in Medicare.
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Post by yogibearbull on Jan 19, 2024 20:18:08 GMT
Don't know about SSA/Medicare site, but posters have reported problems doing serious bank or broker transactions from foreign IPs. Entering trades or checking balances are fine, but not much else.
One trick to remember is to signup for SSA BEFORE 65. Then, Medicare signup is automatic - Medicare Card is just mailed to your address on record, and if you don't want to start then (say, covered by ACTIVE job), you can decline and return the Card. If you are overseas, make sure a trusted relative or friend can check your mail.
My Medicare signup was MESSY and required several trips to the local SSA office. I don't think those issues could be resolved if I was out of town or country. As my wife had signed up for early SSA start (seeing what a mess I had to go through), she just got her Medicare Card in the mail.
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kent
Ensign
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Post by kent on Jan 20, 2024 2:17:24 GMT
Don't know about SSA/Medicare site, but posters have reported problems doing serious bank or broker transactions from foreign IPs. Entering trades or checking balances are fine, but not much else. One trick to remember is to signup for SSA BEFORE 65. Then, Medicare signup is automatic - Medicare Card is just mailed to your address on record, and if you don't want to start then (say, covered by ACTIVE job), you can decline and return the Card. If you are overseas, make sure a trusted relative or friend can check your mail. My Medicare signup was MESSY and required several trips to the local SSA office. I don't think those issues could be resolved if I was out of town or country. As my wife had signed up for early SSA start (seeing what a mess I had to go through), she just got her Medicare Card in the mail. , "One trick to remember is to signup for SSA BEFORE 65" How far in advance a person should signup for SSA few months or more? |
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Post by FD1000 on Jan 20, 2024 22:19:02 GMT
This is exactly what I did, signed for SS 3 months prior to age 65 and this process included Medicare. I always think how the Gov can screw things up and try to avoid it.
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kent
Ensign
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Post by kent on Jan 21, 2024 3:21:07 GMT
FD1000, Thanks, I am trying to get an idea how long ahead of Medicare I should sign up for SSN.
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Post by FD1000 on Jan 21, 2024 3:55:43 GMT
FD1000, Thanks, I am trying to get an idea how long ahead of Medicare I should sign up for SSN. Already posted it...3 months prior to age 65. I was at age 65 on May. I filed online for SS on February. |
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Post by yogibearbull on Jan 21, 2024 11:47:47 GMT
kent, Medicare signup window is +/- 3 months around the 65th birthday and the signup is through SSA. There are penalties per late month of signup. So, If you are on the SSA books at least 3 months ahead of the 65th birthday, you should be OK. My point was that then you don't have to do anything additional to signup for Medicare - one day, a Medicare card will just show up in the US Mail. BTW, most popular ages for SSA signup are 62 (early), 66 (FRA), 65 (bit early). There have been extensive discussions about when to sign up but at the end it's just a personal matter. ybbpersonalfinance.proboards.com/post/1167/threadybbpersonalfinance.proboards.com/thread/187/medicare
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