Medicare Advantage Plan 2014 info now coming out (blood, MRI, prescriptions)
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Well, mine came in the mail today. Monthly premium is now $59.23.
Inpatient hospital care went from $200 to $275 for the first five days.
Outpatient surgery went from $165 to $250----I called and asked if that was correct and yes, it is. I asked if that meant that if you go to a dermatologist and they burn a mole off your skin it's $250 and they said yes. I said that going to a dermatologist and getting checked for skin cancer (especially here by the ocean) is always recommended and a good prevention. They said, yes it is.
Seems counter productive to make people pay this much to have a skin problem taken care of. Will cost the insurance co. a lot more if this person develops cancer.
I'm going to look into a Blue Cross plan for the state of Mass.
I just had outpatient surgery....$95,000 worth...$250 really is NOT bad. Most traditional plans you would pay a heck of a lot more than that in deductibles and co-insurance...and your premiums are a LOT more than $54/month.
Most insurance companies will not cover having your moles checked, even if you are not on medicare. Its not part of preventive care, no matter what age. I dont agree with this but thats how it is right now.
I know the drug costs don't, at this point, mean anything to Escort Rider, but if my husband had that policy, just the increase in 1 Tier 4 drug would mean an extra $420 a year.
$250 increase on other drugs
$40 increase for his average hospital stay if only once.
Conservatively figuring an increase of $710 a year.....not insubstantial and not counting lab work at $10 more each time which would be, at minimum, 4 times.
While I have no direct personal experience, I have read that you cannot enroll in a plan unless you live in the designated area which the plan serves...
I have Kaiser at my place of employment here in SoCal and have been very satisfied with them. In planning for my retirement years, I recently asked my local Kaiser front office lady where Kaiser facilities are located in the Pacific Northwest. I know that there are some Kaiser facilities in the Portland/Vancouver area and wanted to know if there was one in Spokane/Coeur d'Alene.
She couldn't really answer and said that Northern California and the Pacific Northwest were a "different" Kaiser than they are. I'm not sure what that means, but she seemed to indicate that they were different systems and that I cannot just transfer.
I have Kaiser at my place of employment here in SoCal and have been very satisfied with them. In planning for my retirement years, I recently asked my local Kaiser front office lady where Kaiser facilities are located in the Pacific Northwest. I know that there are some Kaiser facilities in the Portland/Vancouver area and wanted to know if there was one in Spokane/Coeur d'Alene.
She couldn't really answer and said that Northern California and the Pacific Northwest were a "different" Kaiser than they are. I'm not sure what that means, but she seemed to indicate that they were different systems and that I cannot just transfer.
They share the same name but they are separate entities much in the same way the Blue Cross/Blue Shield in each state is it's own entity but they are still BC/BS. They have their own networks, own leadership, etc.
Original Medicare will only pay for mole removal if a biopsy is done and it's cancerous - that's what Robyn posted quite a while back - irrc. So, Medicare doesn't pay for preventive mole removal at all.
I'm on Advantage and my doc (in his office) used liquid nitrogen to remove a whole bunch (just like my deceased aunt, I'm getting the darn things everywhere). I've got a whole bunch of new ones that need to be removed, now. UHC paid him $165, I paid $40. That was it. There is nothing in my plan changes for 2014 about outpatient surgery, at all. Don't know how I never had to pay for this, but I didn't.
Well, for zero premium, I figure I'll have to pay for some things. That, or go on a Medigap at a cost of $2500/yr, minimum, or a HD-Plan F for $700/yr, with a $2,050 deductible. Somehow, paying $200/mo. for a Medigap plus $105 for Part B doesn't appeal. Nor does $700/yr, and still be exposed to $2,050 oops.
There's no free lunch when it comes to health care.
Nope - I didn't say anything about moles (I have a few small ones - but I've never had one removed). I did have skin cancer surgery (Mohs) pre-Medicare - and my insurance covered that. I've had non-cancerous sebaceous cysts removed post-Medicare (by a plastic surgeon) - and Medicare covered those procedures (based on the size/locations of the cysts - they were painful and somewhat debilitating). Guess the issue for any type of insurance is whether you're doing something for cosmetic reasons (not covered) - or non-cosmetic reasons (covered).
FWIW - although this technically doesn't deal with Advantage plans - it's a good idea to take a look at Part D plans for 2014. One of the drugs I take (Premarin) is being kicked up from a Tier 3 to Tier 4 drug under the UHC Part D plan. Robyn
Original Medicare will only pay for mole removal if a biopsy is done and it's cancerous - that's what Robyn posted quite a while back - irrc. So, Medicare doesn't pay for preventive mole removal at all.
Nope - I didn't say anything about moles (I have a few small ones - but I've never had one removed). I did have skin cancer surgery (Mohs) pre-Medicare - and my insurance covered that. I've had non-cancerous sebaceous cysts removed post-Medicare (by a plastic surgeon) - and Medicare covered those procedures (based on the size/locations of the cysts - they were painful and somewhat debilitating). Guess the issue for any type of insurance is whether you're doing something for cosmetic reasons (not covered) - or non-cosmetic reasons (covered).
This was the post I recollected:
Quote:
Originally Posted by Robyn55
Note that with something like removal of moles - it could be coded/viewed as a cosmetic (not medical) procedure (unless there was something like a biopsy that might indicate a cancer or pre-cancerous condition). If considered cosmetic - it wouldn't be covered by any type of Medicare - or any other type of medical insurance for that matter. Robyn
But, I didn't irrc, exactly, clearly. Medical vs. cosmetic. Got it.
Quote:
Originally Posted by Robyn55
FWIW - although this technically doesn't deal with Advantage plans - it's a good idea to take a look at Part D plans for 2014. One of the drugs I take (Premarin) is being kicked up from a Tier 3 to Tier 4 drug under the UHC Part D plan. Robyn
So, what does this mean for your cost? There was a time I took Premarin - but not for the past 9 years. Premarin cream is listed as Tier 3 in my 2014 formulary, but the pill isn't listed at all. Tier 3 is listed as $45, Tier 4 is listed as $95 per prescription - I assume 3-mo. supply. A bit pricey. Can't remember what I paid back in the day.
Last edited by Ariadne22; 09-27-2013 at 03:10 PM..
...So, what does this mean for your cost? There was a time I took Premarin - but not for the past 9 years. Premarin cream is listed as Tier 3 in my 2014 formulary, but the pill isn't listed at all.
I don't know what it means. Like I mentioned in another thread - I'm in "pay mode" on a supplemental policy until the end of 2014. That policy covers me 100% in terms of "out of pocket" costs. Also - I recall there are changes coming up in terms of the drug "doughnut hole" - but I can't remember what they are (can anyone off the top of his/her head ?). Think this is the kind of thing I'll put on on my pop-up calendar to review with 60-90 days notice at the end of 2014. If I tried to solve all this stuff in advance - I think I'd go totally nuts . Robyn
I think it is outrageous that an insurer would consider "burning off" a mole (presume that means freezing it) as out-patient surgery. It takes just a few seconds! At Kaiser that is all part of the office visit ($5). To me out-patient surgery means something like a hernia operation or cataract (eye) surgery in which there is some complex procedure involved. The common denominator for out-patient surgery seems to be simply that they do not keep you overnight, but that it is still "real" surgery.
I would be up in arms about calling burning off a mole "out-patient surgery". What an abuse (of the English language, for one thing)!
I think it is outrageous that an insurer would consider "burning off" a mole (presume that means freezing it) as out-patient surgery. It takes just a few seconds! At Kaiser that is all part of the office visit ($5). To me out-patient surgery means something like a hernia operation or cataract (eye) surgery in which there is some complex procedure involved. The common denominator for out-patient surgery seems to be simply that they do not keep you overnight, but that it is still "real" surgery.
I would be up in arms about calling burning off a mole "out-patient surgery". What an abuse (of the English language, for one thing)!
I think you're reading too much into the terminology. "Out-patient" is simply the opposite of "in-patient" (the latter involves a hospital stay). And surgical care/procedures are simply the opposite of medical care/procedures. Anything that involves cutting/freezing/etc. would be surgical (as opposed to medical). Something doesn't have to be big (or even medium) deal to be considered "surgical". Robyn
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Medical vs. cosmetic. Got it.
?). Think this is the kind of thing I'll put on on my pop-up calendar to review with 60-90 days notice at the end of 2014. If I tried to solve all this stuff in advance - I think I'd go totally nuts 
. Robyn
Removal of skin growths
