medicare or private insurance (medical, plan, hospital, doctor)

[rollie11]

hello everybody:

here is my situation that i need some help with. i have been on ssdi for quite some time. a few years ago i discontinued my part b medicare, the part that covers doctor's visits, i still have part a which covers hospital services - but with the deductible.

i am considering going for a round of medical tests and also possibly surgery as the tests will likely indicate surgery.

so will i have to sign up for part b under medicare again to go through with this plan, or is it possible to do all of this via outpatient hospital services.

also, is it recommended or possible to just sign up for private health care in order to take care of surgery. i know this was not even on the table before the health care law changes, but wondering if this is a possibility now.

[golfgal]

It will be possible after Jan 1st. Policies enrolling for Jan 1st can start taking applicants Oct 1st so you can compare costs that way and see what works best for you. It's really not wise, as you have found out, to skimp on your medical insurance though.

[reed303]

Originally Posted by rollie11

hello everybody:

here is my situation that i need some help with. i have been on ssdi for quite some time. a few years ago i discontinued my part b medicare, the part that covers doctor's visits, i still have part a which covers hospital services - but with the deductible.

i am considering going for a round of medical tests and also possibly surgery as the tests will likely indicate surgery.

so will i have to sign up for part b under medicare again to go through with this plan, or is it possible to do all of this via outpatient hospital services.

also, is it recommended or possible to just sign up for private health care in order to take care of surgery. i know this was not even on the table before the health care law changes, but wondering if this is a possibility now.

Originally Posted by golfgal

It will be possible after Jan 1st. Policies enrolling for Jan 1st can start taking applicants Oct 1st so you can compare costs that way and see what works best for you. It's really not wise, as you have found out, to skimp on your medical insurance though.

1. Are you sure Part A will cover outpatient services ?? Just because a procedure is done AT a hospital, that does not automatically make it eligible for Part A coverage.

2. Under ACA, if you are eligible for Medicare, can you be issued private coverage instead??

[texdav]

I don't think you likely will qualify to buy thru the exchanges if qualified for Medicare and certainly not get any subsidy. just as income level can mean not being allowed to buy in exchanges and being placed on Medicaid for younger people .You then will be charged a penalty for every year since 65 you did not participate in the part B pool. As to outpatient only your doctor can advise that.

[golfgal]

Originally Posted by reed303

1. Are you sure Part A will cover outpatient services ?? Just because a procedure is done AT a hospital, that does not automatically make it eligible for Part A coverage.

2. Under ACA, if you are eligible for Medicare, can you be issued private coverage instead??

I guess I was responding to getting a private plan with a pre-existing condition after Jan 1st, not so much in-patient vs out-patient treatments.

[texdav]

You actually can apply for pre-existing right now has its been available since last year under ACA. But one thing about that I learned its first requirement is to be denied coverage based on the pre-existing condition. Since part B does not deny based on pre-existing condition; that disqualifies OP.

[old_cold]

As far as I know, if you are eligible for Medicare, no companies are allowed to sell you a policy(except for supplements and employer/retiree plans excluded)
I don't believe this changed under the new health care act.

[golfgal]

Originally Posted by texdav

You actually can apply for pre-existing right now has its been available since last year under ACA. But one thing about that I learned its first requirement is to be denied coverage based on the pre-existing condition. Since part B does not deny based on pre-existing condition; that disqualifies OP.

You have always been able to apply for coverage with a pre-existing condition, accepting your or not excluding you from coverage for that condition is what is changing.

I'm not sure on the 'law" about having a private plan being Medicare eligible. I know most companies don't sell them because they are not popular and premiums are very high, but possibly because they can't. I don't know why you would opt for a private plan vs Medicare and a MA though. The private plan would be MUCH more expensive.