9 Dec 2024 2:50 pm
Buffalo » 09 Dec 2024, 2:12 pm » wrote: ↑ What the **** is wrong with paying for the 20% that Medicare does not cover out of your own pocket. The medical procedures I have had since turning 65 (hernia operation, heart sonogram, heart catheterization, lung x-rays, 2 ER visits, $625 visit to a heart specialist, plus regular visits to my doctor), I paid for the part that medicare did not cover at $10-$20/month out of my own pocket. Right now I owe $77.00 and will have everything paid off. Providers cannot refuse to take your payments!!! WAAAAY cheaper than a Medicare supplement that may or may not cover the costs. Before that as a self employed individual, there is NO WAY I could have afforded the ridiculously high premiums insurers charge with a high deductible to boot. So I paid for my medical care out of my own pocket.
My CPA told me long ago that health insurance corporations take your money betting you don't use more that you pay in, you pay that health insurer betting that you will get sick...who has more money?
Medicare supplements are a rip-off of taxpayer money because of the higher reimbursement rated to them. Health Insurance is not health care!!!
Since the inception of magic negro care (obamacare) the number of practicing doctors has remain about the same while the number od those in administration have tripled. What does that say about why the cost of medical care has gotten so ridiculously high?
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.