hospitals can be a train wreck for Medicare patients

[ohiofarmer 3,265]

 I had motorcycle accident ,23 May of this year

 With Medicare supposed to pay for 80 percent of the hospital costs all the hospital has to do is not admit you but place you under observation. Imagine the surprise when I got a giant bill once my auto policy was used up

 They are required by law to inform you that you are under observation before 24 hours have passed. Did not happen. I also wanted to go home at least a day and a half before the doc released me because he was too busy.

  So just Google Medicare not paying for observation and educate yourself.as for me, I will fight tooth and nail and just keep paying ten dollars a month to keep it away from the bill collectors and maintain my credit score.

 Pretty much healed up so thankful for that.

[AMC RULES 37,129]

Definitely seems the whole medical system is set up...

to separate you from your life savings before you go.  

[JoeM 7,871]

You almost have to have an attorney on speed dial when you use heath care!

 

I watched the heath care insurance system change over the last ten years dramatically. With the introduction of the affordable heath care act it allowed the insurance people to really take charge. They manipulated their cost structures, allowing reduced coverage and higher deductions. A married couple no kids needs heath insurance. If their monthly gross income is 5500$, their monthly premium for a bronze plan level of insurance is just north of 1200$. If you do a little math, that is 21 plus percent of their income, affordable hardly. A real issue, for sure. Oh, and by the way, try to use the insurance, the first 7k is on you and it will take three weeks for pre approval!

 

Farmer you mentioned Medicare, it is scary how they are running around touting "Medicare for all". If the ACA is any indication of what can happen, any good left in the Medicare system certainly will be washed away.

The result of "ruling a country you don't live in."

 

 

[squonk 41,028]

What you need is a job with good health coverage. My heart attack cost me $1200 out of pocket. My back surgery $200. If it wasn't for the coverage provided, I'd be retired.

[The Tuul Crib 7,336]

My wife is a home health physical

therapist and what she tells me that the 

insurance companies what you to die

so that dont have to pay out anything !

lts said we all work hard all through life

to hopefully get an early retirement only 

to get hit with this! @ohiofarmer l feel for 

you and hope it works out! We all 

need to fight this before it really gets out

of hand! God bless us all!!

[peter lena 8,582]

my wife worked in nursing homes as an office mangier, more than 30 years , the insight that she has on the entire medical  set up is amazing , she can very quickly decipher any code and routing issue , that typically is the set up to trip you up. its a shame to have to deal with this , but thats how it is . the other thing is trying to deal with a family ,that does not have a clue , regular arguments  are quickly taken out of the billing cycle , other wise nothing gets accomplished . the only thing i can say is to try and stay in touch with someone that is savvy to the technical speak in today's world.  pete   

[ohiofarmer 3,265]

 I went to two hospitals over this issue. The first hospital nearly killed me by over medicating me. i collapsed to the ground with a systolic BP of 70 and diastolic number not recorded. My heart rate went from 85 on admission to 30. 'Patient's skin turned grey" was what the report said.  I also have a close relative who was in high levels of administration, and he said that medicare modifies how hospitals treat the financial side of admissions by reward and punishment, to put it diplomatically.

 I went in with three policies. Medicare, private health insurance, and med payments for the motorcycle. Hospital #1 has been paid all but 200.00  for a $17000 dollar bill. For nearly Killing me.

 

 The second hospital was a level I trama care center, and even though I advised them to obtain the tests of the first hospital, they did some of their own testing. They also made all kinds of threats that we needed to disclose immediately all our insurance coverage or face having to pay all the bill. What an absolute mess. I have yet to receive a bill from hospital #2, except that the one I was told to ignore. Maybe my private insurance company thinks that holding me three days for observation and creating a huge billing event is not the thing to do.

 I guess I will keep checking Credit Karma to make sure none of this stuff has been declared in arrears.

[squonk 41,028]

I've had Blue Cross/Blue Shield for what seems like forever. Only issues I've ever had were because of doctor's offices screwing up the paper work. I've called BCBS more than once and they have always gotten to the bottom of the issue and got it taken care of.

 

I worked in a hospital for 14 yrs. The amount of money lost the hospital has to write off is staggering. There is so much oversight now that missing one little item will send the hospital bill into the ins. co. abyss. I have AFLAC  disability when I had my back done. Because 1 date was messed up on the paper work I was denied coverage. Lucky for me the lady at the local AFLAC office knew the drill and after resubmitting the paperwork correctly I had a check in a week.

Edited September 22, 2019 by squonk

[formariz 11,987]

Lets see if I can keep this from going political which sometimes I may sound like but am far from being, since I am really passionate about this but here is my take on it. All our lives here we have been lucky over insured, since I belonged to the NYC United Brotherhood of Carpenters and my wife to Teachers Union .We have never paid one single dime for anything with the exception of $5.00 for any prescription drugs. Both "Gold" or "Platinum" type plans. What one did not cover the other one would pick up in full. Today for the newer generations coming into those two unions, its still great as far as today's standards go but nothing like it used to be. Luckily we are Grandfathered into the system.  Nevertheless I know that that is not the case for most of us. Case and point one of my sons who does not work for a Union or employment that regularly provides medical insurance. So he gets his insurance which  now mandatory through the Marketplace. Market place help? Zero because they consider that he makes enough money to pay for it himself.Cost for a plan that will somewhat give him halfway decent coverage $800.00/month.  I will not go into the specifics of out of pocket and deductibles so I don't get depressed.  Just for reference rent in this area $1800.00/month. You now can do the arithmetic. Question for those that know. What is someone specially our younger generation supposed to do? Go without it and hope for the best it seems to be.

 

The majority of people in this country are not as fortunate as I am. Is it also right that one basically needs to hire an attorney when presented with the unfortunate event of hospitalization to deal with the insurance companies?

Just a little comparison now if I may.

200 pills of Celebrex here in the US  $400.00+/-  ( same thing in Portugal  $35.00 Euros).  Where is Celebrex made?????

Typical MRI in US? Do I have to tell you?             (same thing in Portugal  125 Euros.)

The above examples are of course paying yourself for the services without using their social medical system. What is wrong with these numbers?

How much money is given in aid to anyone out there many of which can not stand us?

Why can't we take care of our own?

I was also thought early in my life that the needs of the many outweigh the needs of the few and always lived by it. So since I am a lucky one and therefor one of the few, i have no objections in not being so lucky so many more can live their lives with dignity and not be burdened with the mental and physical anguish of not being able to care for themselves and their loved ones because that cost is a problem. This is not about political ideologies, but about human conditions and doing what is right. The constant mentioning about costs involved to do the right things is nothing but insulting when one looks where much of the money goes.

 

 

 

 

Edited September 22, 2019 by formariz

[JERSEYHAWG / Glenn 4,497]

Re MEDICARE. IMHO I think its wise to have a secondary plan that covers the 20 percent that is not paid for by MEDICARE. Many of my friends and family members picked up the secondary coverage through AARP. So far from what I hear that seems to work out pretty good. I am on MEDICARE myself and I am one of the fortunate few that has lifetime coverage from my job when I retired. That covers the 20 percent.  Seems that is very hard to come by today. As we get older medical insuarance becomes so important. Just putting in my 2 cents. The medical industry today seems like a pack of thieves. To much dam paperwork and billing involved.

 

Glenn

[shallowwatersailor 3,213]

Unfortunately the ACA was watered down from what was originally proposed. After what was finally adopted, it has been dissected numerous times throwing the power to the insurance companies once again. Medicare is not allowed to negotiate the cost of drugs meaning that the drug companies set the price. 

 

[ohiofarmer 3,265]

   I do agree with most here about the system being broken, so maybe i can offer some insight. There is only one hospital in my county and the largest town is the county seat. This is the hospital they took me to, but i will never go there again. i figure that with all the passed out opioid abusers they take in that they are forced to overcharge the insured customers by a factor of ten if they can get by with it. Then there is Medicare. If medicaid is funded by the same pool of Federal money as medicare ,then they are pretty much gonna throw the old guys under the bus. They did this [to me in this situation] by declaring my three day hospital stay as an outpatient event, without telling me so even though it is required by law to inform me after 24 hours.

 The hospital and Medicare can point fingers at each other as to who encourages this behavior--according to a retired CEO of a hospital who i know personally., both Medicare, medicaid, and private insurers had him dancing on a string with almost no idea if they could keep the place operating for a few years there. Medicare wins big on the three day thing because after three days as a patient and not an outpatient, I would have qualified for skilled nursing care in a qualified nursing home for up to 21 days, if needed..I have an 80 year old buddy who has a completely crushed ankle and they put a halo around it  until surgery could be performed. if anyone qualified for this benefit, he should have. Nope, he did not get it. Of course it got infected and it cost more in the long run.

 

 But i had both private insurance and auto med payments policy. With all this insurance I should have had all bills paid with the 2  insurance companies and Medicare sharing the cost..So i guess the young and addicted take precedence over the old people who have worked all their lives and paid into Medicare and other government services.  Not to say that we as a people should have no compassion for them, but not at the expense of cheating those paying the bills and attempting to live our lives by the rules.  not mentioning political parties here, but just a moral perspective.

 

 My wife will soon be retiring, so we need to get our crap together on Medicare parts b,c d,and g. I know they have a bunch of stuff more than part A. All I can figure is the more they cheat you out of using part A, the more you will have to pony up to protect yourself from that..

 

  If i ever get in an accident again, i guess that I will refuse treatment and tough it out at home and be seen later by a family doctor. That way, he can order appropriate testing that I can get competetive pricing on. As it turned out, the expenses were all incurred by medical mistakes and my body had to heal itself anyway.

 

.

[Stormin 9,981]

 All I can say is, after reading all of that, thank goodness we have the National Health Service.

[ohiofarmer 3,265]

 I just paid the last of the bills. it looks like about 650.00 total as I met the deductible on some other stuff.  It looked like 6 grand would be the total for a while. The wife and i just signed up for medicare part B. There will be furthjer discussions with a Medicare part D or something insurance advisor. 

 

 There is still no excuse for this. I had some highly skilled surgery which went through the pre-approval process, and they spent twice as long in a full blown OR as the little country hospital did for about the same money in a non-sterile environment.  I  have come to the conclusion that when you are in an accident that the medical care system treats it like Christmas morning for their bank accounts.

 

 I got off pretty lucky , i guess. Now i must go into grief mode about losing out on riding motorcycles. I could ride today, but there is the matter of being responsible to taking care of my wife in case she needs care with a medical issue.I cannot do that if i wind up with a permanent disability from a crash.  We pretty much need each other as our daughter is becoming more of a world traveler in her education and employment.

 

    I know one thing for sure. I pretty much know all the tricks the medical system uses to maximize profits from private insurance.and Medicare. i intend to be on my guard from now on and assert patient rights to the maximum.