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Gosh - there's all kinds of surgery. Maybe Grade I (like freezing off a mole) to grade 1000 (like an organ transplant). And everything in between. Doesn't that make sense to you? Like with medical stuff. You can see a doc for high cholesterol - or if you have acute congestive heart failure. Or anything in between.
There's surgical - and there's medical. And each has 50+ Shades of Gray IMO. Robyn
Sorry, but freezing off a mole is not surgery. Family docs do it too. There is no cutting, no suturing, and you don't even really need to put a Band-Aid over it. Hell, in some practices physician assistants do it too!
Yesterday in the mail I received my 2014 renewal information for my Medicare Advantage Plan (Kaiser in Los Angeles and Orange Counties). There were some increases in co-pays, but for the most part theywere not draconian and they were not across-the-board. I considered it pretty good news overall, even though some of the increases were more than negligible, and I hope the "good news overall" will be the same for other people with Med. Advantage Plans across the nation. I list the details below in case anyone is interested, but I realize that other plans may have different results. The 2013 information is listed first, followed by the 2014 information (or perhaps the notation "no change").
Monthly plan premium: zero (no change).
Doctor visits, including specialists: $5 (no change).
Lab work per encounter: $20 - increased to $30
Tier one drugs: $3 (no change)
Tier two drugs: $7 - increased to $10
Tier three drugs: $40 - increased to $45
Tier four drugs: $60 - increased to $95
Tier five drugs: 25% of cost (no change)
Tier six drugs: zero (no change)
Inpatient hospital stays: $170 per day for days 1-10 per admission (free thereafter) - changed to $210 per days for days 1-7 per admission (free thereafter).
Maximum annual out-of-pocket amount: $3,400 - increased to $5,900
MRI's: $170 - decreased to $150
Outpatient surgery: $125 - increased to $210 (Four years ago this was $50!)
Emergency room visits: $75 - decreased to $65
I have not listed everything, but I tried to get the commonly used items. It is really a mixed bag - no changes for some very reasonable costs, large increases for a few things, and even some decreases. I don't pretend to understand Kaiser's reasoning.
Your benefits are not really affected as much as other parts of the country. this is because LOS ANG county gets a relatively high capitation from Medicare and the variety of highly star rated plans in So Cal. Kaiser has a 5-star rating, while others have 4s and 3.5s. In fact, I'm surprised that Kaiser doesn't offer you way richer benefits than what they're doing. All you have to do is check out the competition and you would see what I mean.
Back in my native San Antonio, Tex, the only plan that was able to offer nearly the same benefits was Humana Gold Plus. they've been cutting off the overutilizing docs and double verifying all of the doctor referrals. They now have a rich benefit plan but not such a great variety of participating doctors. I suppose that it's their long term strategy. All of the other plans incl the dominant Secure Horizons have upped their spec copays, hosp, outpt surgery and deleted their Silver Sneakers membership.
All of the other plans incl the dominant Secure Horizons have upped their spec copays, hosp, outpt surgery and deleted their Silver Sneakers membership.
My UHC Advantage still has Silver Sneakers for 2014. After reading ER's thread in retirement, I may just take advantage of that this year.
See if there's a local Y in your area. Ours gives income based discounts to people who can't afford to pay "full freight". Robyn
The difference is, for those of us that can't seem to get self-motivated, the SS gyms offer exercise classes.
If I didn't need the impetus of joining a group, I would be all set since the husband has a great Body Solid home gym and treadmill.
Developing Achilles Tendinosis gave me a legitimate excuse to avoid the treadmill, walking, jogging, etc.
I did have my hands on the gym this summer,though...I polished the surface rust starting on the chrome parts.
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