ohiofarmer 3,276 #1 Posted January 25 If the headline in this topic appears to clickbait after you read this,I apologize. if my problem helps someone else out, then i guess it's OK Years ago, I learned to carefully scrutinize billing by health care providers and insurance providers. i was insured under my wife's work policy and the company talked us into going with HSA instead of the PPO with much cheaper deductible. Their hook was that they would contribute money each year to build up your HSA deductible. That would have been fine if I hadn't gotten sick and needed chunks chopped out of me to get better.....One month after sign up and dealing with it in the middle of benefit years. So i am a battle scarred veteran in the civilian sense of the phrase.That experience taught me that the easiest way to deal with things is a five dollar a month payment to all the little parties until everything gets fairly dealt with. That tactic protects your credit score and makes you such a bookeeping nightmare that providers really want to resolve the issue. i survived that and it took one year to finally get the billing party to realize they mis coded a procedure so the insurance paid off. So now i am on medicare, and i figure if some old sleeping remnants of the disease comes back, i want lower and in most cases non existent co-pays. this brings me to last week. I notice in one statement of "this is not a bill" variety, that it looks like there could be possibly be a large co-pay coming similar to the old HSA days of a high deductible. Then i look at the insurance provider the hospital sent the bill to. we had not been covered by that HSA since the spring of 2020 when we switched to our Medicare A+B+D+G. It was pretty easy to miss at a glance because both companies had the word "united" as the first word. When I saw that the former employer was listed in the guarantor line i figured out that the hospital billing department just used what we had on file the last time---even after we provided them with current information. So even though i called the hospital the other day and asked how my account was coming and they said "paid in full" ,Then I get this mess today. I just might deliver a single dollar to the hospital's billing department to credit to my account even though the nice man from a far Eastern country is looking into the problem. Now the real fun starts. It appears that there is a possibility that the old insurance company we haven't had for three years could have negotiated some stuff down. I guess it would be easier to be mentally incompetent. Then they would just take the farm if I had not caught the mistake 6 Share this post Link to post Share on other sites
953 nut 55,294 #2 Posted January 25 Even though you are on Medicare it is a good idea to have a GOOD supplement plan too. My brother had an "ADVANTAGE" plan with copays and out-of-network charges. During the last two months of his time on earth the copays, out-of-network and not covered bills came to more than $ 20,000. Be sure you have plan"F" as a part of the supplemental package.It covers nursing homes and other expeses others don't. https://www.forbes.com/health/medicare/medicare-plan-f/#:~:text=According to Medicare.gov%2C Plan,hospice care coinsurance or copayment 2 Share this post Link to post Share on other sites
Handy Don 12,233 #3 Posted January 25 (edited) 1 hour ago, 953 nut said: Even though you are on Medicare it is a good idea to have a GOOD supplement plan too. My brother had an "ADVANTAGE" plan with copays and out-of-network charges. During the last two months of his time on earth the copays, out-of-network and not covered bills came to more than $ 20,000. Be sure you have plan"F" as a part of the supplemental package.It covers nursing homes and other expeses others don't. https://www.forbes.com/health/medicare/medicare-plan-f/#:~:text=According to Medicare.gov%2C Plan,hospice care coinsurance or copayment Completely agree. Understanding one’s willingness (and capacity) to cover copays and maximum out-of-pocket costs is tedious but critical when choosing coverages. Edited January 25 by Handy Don 2 Share this post Link to post Share on other sites
Horse Newbie 7,072 #4 Posted January 25 A lot less painful to just die… I wholeheartedly am convinced that the government’s and insurance companies goal is to make sure you leave earth the same way you came… with nothing! 1 5 Share this post Link to post Share on other sites
Handy Don 12,233 #5 Posted January 25 7 minutes ago, Horse Newbie said: A lot less painful to just die… I wholeheartedly am convinced that the government’s and insurance companies goal is to make sure you leave earth the same way you came… with nothing! There are no pockets in a shroud anyway! 1 1 Share this post Link to post Share on other sites
953 nut 55,294 #6 Posted January 25 6 minutes ago, Horse Newbie said: A lot less painful to just die… I wholeheartedly am convinced that the government’s and insurance companies goal is to make sure you leave earth the same way you came… with nothing! I will keep my mouth shut on that one so I don't get kicked off of Red Square! 3 Share this post Link to post Share on other sites
Horse Newbie 7,072 #7 Posted January 25 2 hours ago, 953 nut said: I will keep my mouth shut on that one so I don't get kicked off of Red Square! I’m done… 1 Share this post Link to post Share on other sites
wallfish 17,011 #8 Posted January 25 1 hour ago, Horse Newbie said: I’m done… I like to use this gify for that statement! LOL 3 Share this post Link to post Share on other sites
Blasterdad 2,692 #9 Posted January 25 My Dads neighbor lived to be 104 years old, still out walking around, out on the dock fishing, ect. One day my Dad asked him what doctor he went to. He scowled at my Dad & replied, "I don't go to no #*%*@*# doctor". Probably why he lived so long. 1 2 Share this post Link to post Share on other sites
Handy Don 12,233 #10 Posted January 26 2 hours ago, Blasterdad said: My Dads neighbor lived to be 104 years old, still out walking around, out on the dock fishing, ect. One day my Dad asked him what doctor he went to. He scowled at my Dad & replied, "I don't go to no #*%*@*# doctor". Probably why he lived so long. My wife’s view of hospitals: “The longer you are there, the more damage they can do." I’m not quite as cynical as there have been some good outcomes, but I get her drift. Share this post Link to post Share on other sites
ohiofarmer 3,276 #11 Posted January 26 18 hours ago, 953 nut said: Even though you are on Medicare it is a good idea to have a GOOD supplement plan too. My brother had an "ADVANTAGE" plan with copays and out-of-network charges. During the last two months of his time on earth the copays, out-of-network and not covered bills came to more than $ 20,000. Be sure you have plan"F" as a part of the supplemental package.It covers nursing homes and other expeses others don't. https://www.forbes.com/health/medicare/medicare-plan-f/#:~:text=According to Medicare.gov%2C Plan,hospice care coinsurance or copayment Share this post Link to post Share on other sites
ohiofarmer 3,276 #12 Posted January 26 So I read about the old plan F which was the most complete gap filler plan available. It seems that our benefits were reduced somewhat on plan G so the kids on CHIP could have some of that savings. Plan G is what I have and is not as good as plan F that is NLA, When our governor Kasich increased Medicaid funding, it disqualified our zip code from Plan F sooner than it would have been otherwise. Every fall leading up to the time when medicare enrollment period ends., the TV is filled with ads about Medicare Advantage plans which is part C..from what I can tell, you trade zero copays for dental coverage and some other things that would have resulted in an HSA plan. After having my pocket picked by those plans pre retirement---No thamks. I cannot perceive being able to certify if all the people involved in whether I would be able to walk again being in an HSA network while either screaming in pain or on morphine Just be aware that you cannot start out on an Advantage [part C] plan and then switch to part G. Those commercials on TV never mention that. Share this post Link to post Share on other sites
JoeM 7,874 #13 Posted January 26 I use a local insurance broker and he is very, very thorough. This guy drilled for info. How long do people live in your family, what types of major medical issues, do you see a dr., how well do you take care of yourself, how are you financially etc. As you said, the plans can be tricky and there are tons of loop holes. Your needs drive the process. I started out researching myself. A friend said I should give this guy a call to have him double check the math. I did and it was very much enlightening. Making a bad choice with something as simple as the drug plan could cost big bucks. Pretty much same story with the financial planner. When I was 50 my boss recommended I see a planner. Okay might give him a look. The guy said I did a good job but lets take a look at these options. I almost had it right and he explained what really should happen. Well....your hired. Share this post Link to post Share on other sites