9 Dec 2024 6:25 pm
You can't tell me that there isn't an army of administrative personnel in a for profit health insurance corporation that suck a ridiculous amount of revenue from healthcare for salaries and expenses that have NOTHING to do with the delivery of medica care. Since the inception of ocare the number of doctors in practice has remained stable while the administrative side has tripled, while the cost of medical care has gone up 10 fold. Does that money go to the providers or for administration expenses?EDC4ALL! » 09 Dec 2024, 3:50 pm » wrote: ↑ Why would a supplement get paid a reimbursement? Supplements are strictly regulated. Everything is based off of the areas Medicare Re-imbursment rate. The Part A deductible is set by the Feds. It's $1632 per medicare benefit period. THAT is what your supplement pays. Medicare Part B pays 80% of the Medicare APPROVED amount. That can vary by region. Your Supplement pays the othe 20% of the Medicare approved amount. Insurance companies don't get paid a re-imbursment rate. Providers do!
You all need to get more edjumacated before you talk about things you really don't know much about.
Notice I'm not calling people names. I'm just educating you with my 22 years in da biz!
You are correct Buff. The 20% for little **** is nothing. That is why some people drop their supplement and go to Advantage. They actually look at their EOB, and see how little it pays. A Hospital stay if you are just on Medicare will cost you the $1676 in 2025. If you you have a long stay (rare for Seniors) then this applys.
Does Medicare cover 100% of a hospital stay?
Days 1–60: (of each benefit period): $0 after you meet your Part A deductible ($1,632) ($1,676 in 2025). Days 61–90: (of each benefit period): $408 ($419 in 2025) each day. In Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days.
Where a Supplement policy earns it worth is if you need a Part B drug or extensive outpatient treatments. These are cancer infusions (chemo) and treatments for infusions for Crohns, RA, and other autoimmune system problems.
The word "Advantage" In Medicare Advantage doesn't mean the advantage over Original Medicare and a Medicare Supplement, it means the whats the advantage of a Medicare Advantage plan over Original Medicare. For starters, Original Medicare doesn't have a maximum out of pocket. Get cancer and you could be out tens of thousands of dollars. Advantage plans are nothing more than a private insurance company administering Med A, B, and usually D. They all cover EXACTLY the same thing. They all get paid by the Feds the EXACT same amount per month per enrollie based on region (approx $700-$800 in Wisconsin, $1300 for chronic illnesses), and they all keep the maxiumum amount of .15 on the dollar to pay my comission, adminstration, and marketing. If one plan has really good dental ($3500-$5000 in benefits) the plan will always make you pay more somewhere else to offset the dental bennies.