medicare records ? (parent, aging)

[illtaketwoplease]

new to medicare and dealing with an aging parent who is seeing many Drs. and specialists for a variety of conditions. heart stent procedure scheduled in 2 weeks that might wind up being open heart surgery. everywhere we go they tell us that they will file with medicare. is there a website for personal medicare records of what they have paid in the past and what they will pay? again - this is all new to us so don't know how it works. tks

[lchoro]

Set up an account on medicare.gov. You can retrieve claims history. Even without the online account, Medicare will send an EOMB (Explanation of Medicare Benefits) letter which details what was billed, what was paid, and what may be billed to the secondary insurance or your parent.

[illtaketwoplease]

Tks.

[moon2]

If your parent does not have secondary insurance and you're wondering what the bill might be for a new procedure, so to estimate the 20% co-insurance, I can tell you it's nearly impossible.

You can call Medicare directly, tell them what the upcoming procedure will be (get the codes from the docs/surgeon), and they will tell you what they allow the provider. Sounds straightforward but it's not, because there are so many ancillary charges.

With something like stents or heart surgery, hopefully your parent has secondary insurance that will cover the copay.

[need4speed2012]

Set up an account at https://www.mymedicare.gov/ but be ready to answer the questions correctly the first time or you'll be locked out for 24-hours !!

Also in order to talk to Medicare on behalf of an elderly parent, a caregiver must be appointed as an official representative.

To obtain access to your parent's Medicare records, you have to fill out an Appointment of Representative Form.

Been there and done this for both parents.

[lchoro]

The claims get posted to medicare when they're paid and the insurance companies pull down the claims from medicare to figure out how much of the billed amount has been approved and how much they have to cover. Unless you've had the procedure before, you won't be able to tell how much the procedure will cost. You can only pull down your own claims history, not a history of what they've paid out for a procedure. Your best source is your doctor, hospital, and people who've had the procedure. I've heard surgery for inserting one stent and the followup costs the patient between $2,500 and $6,000 after insurance has paid out, depending on how long you have to stay in the hospital. It depends on your secondary insurance.

[illtaketwoplease]

The whole insurance system is setup to baffle you with BS and not give you the information needed to make an informed decision. My experience dealing with an elderly parent who is seeing many doctors has been an eye opening education into our convoluted health system.

If the number of boomers and elderly that I see waiting to see specialists increase, and medicare is paying the lions share of the cost, we are in serious trouble as a nation. Somethings going to give eventually. Did find a site called healthcarebluebook.com that lists average costs.

Tks for the info on procedure cost - learning as we go...

[DanBev]

I had open heart in Nov 2010 and one very important thing is rehab,18 days paid by medicare,very,very important.Patient has to go straight to rehab,otherwise not paid.
It was a blessing,worked me pretty hard.
I considered not going and thankfully my brother inlaw forced me.
The cost for all,32 doctors and offices involved,for me was minimal,still cannot believe it.

[illtaketwoplease]

The cost for all,32 doctors and offices involved,for me was minimal,still cannot believe it.

Someone has to pay it. While it may be great for you - it's not for those that have to pick up the tab. Cost is getting passed onto kids who have no say in the matter and that is unfair and immoral IMHO. System is unsustainable.