Did you notice charges for aspirin or Tylenol. I did and it was freakin outrageous. Next time we will bring our own.

 

Rick's primary is with a healthcare for profit system. I have no use for that practice. I left when they refused to let me see a Boston doc for my shoulder issue. The doc was in my HMO network, and still they refused. When I was still a patient of the "for profit" practice, I needed some physical therapy. I had to request permission to see someone affiliated with the local hospital who was in my HMO network. He had been Rick's PT for his shoulder issues years prior, had a wonderful reputation and we both liked him. I was allowed to see that physical therapist who was rather surprised to see me given my primary and my HMO. He told me that generally the practice only sent them the patients who were on Medicare/Medicaid. You know, those for whom the reimbursement would be less $.

Another time this practice called to urge Rick to come in for a visit as his BP had been on the high side at a previous visit. I took the call and was actually told the insurance company wanted him to be monitored. I made a call and it was confirmed that was total BS. The practice was just trying to fill empty appointments around Christmas time. Rick did not accept an appointment, we told them he was monitoring his BP at home. Had I been Rick I would have been out of there at that point. However, he really likes his primary and the office staff. His choice.

 

Reminds me of when our son was born almost 47 years ago. I was in the hospital only about 10 minutes before he was born, and I had natural childbirth with no drugs.

In looking at the itemized bill, I noticed a charge for the pharmacy. I inquired about it. I said that I had not taken any drugs or pills. She asked me whether I was asked if I wanted any painkiller pills after he was born. I said yes that I was asked but I said that I didn’t want any. She said, well we still have to charge for the pharmacy since someone asked you.

This was in 1974, and as I recall the bill was about $250. I think our insurance paid for all of it except $6, if I remember correctly.

 

Wow! I guess we are lucky. With my Medicare and my supplement I can go to any doctor or hospital (and the Cleveland area has some of the best in the world) of my choosing. I still have a deductible as does Patty but we have no problems in getting world class healthcare.

 

I find it strange that we rank so low but when any dignitary from around the world needs health care they come to a hospital in the USA.

 

FYI, I copied this and emailed to myself. Thank you.

 

We went that route as well. $203.00 annual deductible for doc visits/tests, and around $1500.00 in hospital deductible. That deductible can kick in every 60 days and there can be other co-insurance charges for longer stays. If we had health issues, we'd upgrade to a better supplement which would be about $100.00/month more, and that can be done any time of the year, effective the next month. This is with Blue Cross of MA, not all plans offer upgrades during the year. You'd have to wait for open enrollment.

We pay $148.50/month for Part B with Medicare, approximately $100.00/month for the supplement. We opted for inexpensive Part D coverage as all meds are generics, if not we use Good RX or shop it around.

So for just over $250.00 each I'm not unhappy with our coverage at all, though there are doctors who don't accept Medicare and others who can send you a balance bill for what Medicare didn't pay, based on some kind of formula. However, as mentioned, meds can really be pricey, there is the donut hole and so many other issues if you get into the higher cost drugs. There are Part D plans that range from $ to $$$. Again, homework is required to see what works for you. However, compared to paying $750+/month for a single plan, which was my premium on COBRA, Medicare is a huge bargain!

Patricia, keep in mind the coverage has to start within a certain time from when you reach age 65. And no one should opt out supplemental coverage and Part D. If you don't purchase when eligible, there is a penalty when you do purchase, based on how long it's been since you should have purchased the coverage, and that penalty does not go away. It's yours forever. If you opt for Advantage plans there may be some drug coverage, and if you are covered in retirement by your previous employer, your options will vary.

 

I'm with Lainey and Scoots. I have Medicare with a supplemental plan that costs me about $228 a month. I have no co-pay and my deductible is paid by my supplemental plan. So for medical I pay Zero. And my infusions cost between $20,000 and $40,000 each one! Now, that's full retail, as if I walked in off the street and had no insurance. What the hospital gets is closer to 6 grand for each infusion. Part of that is one shot which retails about 5 grand alone. The two surgeries I've had (so far) were half a million retail as well. I can't complain. All the hospital care was excellent, at two different hospitals.

 

Another thing to keep in mind is that not everyone pays the same Medicare Part B premium. There is something called Income Related Monthly Adjustment Amount (IRMAA). This is an amount added to the basic premium based on income. There is also IRMAA for Part D (drugs).

Patricia, are you currently covered under a private plan or is it, by any chance, a plan related to some benefits related to your ex-husband, employee, retiree, etc.?

Since you use an expensive drug, Enbrel, coverage for that would probably be a very important consideration for you.

 

Yes, I forgot about that as it doesn't apply to us.