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It does take a phone call--call them, ask for a case manager...
As for your shots--they aren't medically necessary-you don't HAVE to go to Singapore, nor are the vaccines required for travel--but they are a good idea...
A few minutes on the website could have told you the information you needed.
just like why I had to pay for my flu shot this year....thought it was odd, until I looked and the pharmacy I went to for the shot wasn't in-network for the flu shot only--didn't know that, learned to look more closely in the future. They ARE in network as a pharmacy though. That has nothing to do with the ACA and has everything to do with the certification to offer the shots and the pharmacy applying to be in the network....
I don't care why or why not Medicare won't cover my shots. Just whether it does. And I wouldn't be upset if Medicare said the shots I needed for vacations weren't covered at all. OTOH - perhaps it's cheaper for Medicare to pay at least in part for the shots than the disease(s) I might get if I didn't get the shots. After all - we're talking about preventive medicine. And - if you try looking on a website (which website if I might ask???) - you're not going to find an answer (I did explore both the Medicare and our Medicare Part D websites before our visit today).
FWIW - Costco is usually the cheapest - at least in terms of people on Medicare - for any shots a pharmacist can administer. Our flu shots at Costco this year cost us zero out of pocket. OTOH - since the Hep A shot can't be administered by a pharmacist (don't know why) - Costco wasn't an option.
I think of medical payment/reimbursement stuff these days as one big "Magical Mystery Tour" . For example - if I were to go to Walgreens to get wax cleaned out of my ears by a NP or similar using the lots of warm water in the ear method (what you might do at home) - it costs $59. My board certified ENT - who uses some fancy electronic tool to do the procedure - accepts Medicare for this - and gets reimbursed $32.
I don't get it. I don't get any of it. Because very little of it makes any sense at all. So I'll just keep trying to get the best care possible - at the most reasonable cost possible (although my definition of reasonable cost may vary a lot from yours). Robyn
It's off topic , but , I like my Medacare. Best insurance I have ever had period. Part G ( includes drug coverage) cost me 161.00 a month.
That's not Medicare. That is a Supplement...it would be the same as someone in Canada using their NHS and a private plan...it's not a single payer plan like people make it out to be...
That's not Medicare. That is a Supplement...it would be the same as someone in Canada using their NHS and a private plan...it's not a single payer plan like people make it out to be...
We all got to choose somewhat , and it was apart of turning 65, could not have one without the other......so how is the combo not Medacare?
Because it is the position of the American College of Physicians — developed over many decades of analysis, and consensus — that every American should have guaranteed access to health insurance coverage, no matter where they work or live or how much they earn.
Because universal coverage is a moral and medical imperative.
Because the ACA comes close to providing universal coverage.
Because the ACA’s key policies, including tax credits to buy qualified health plans and Medicaid expansion, are identical to the College’s own proposals.
Because if the ACA fails, we will have turned our backs on the tens of millions of our fellow Americans who are at greater risk of living sicker and dying younger, simply because they lack health insurance.
Oh, and one more thing:, this is personal. I have spent my entire professional life fighting to expand coverage for the uninsured, only to see it fail, time and time again, because of unrelenting political and ideological opposition. I first started working as an advocate for internal medicine at the American Society of Internal Medicine in January, 1979. Since then, I have seen the cause of universal coverage fail under successive administrations and congresses. I have seen it fail despite all of the well-meaning reports and commissions that challenged us to do better. I have seen it fail as the number of uninsured has grown, year after year, decade after decade. I lived through the debacle of President Clinton’s failure to achieve universal coverage, and then I saw it put aside for another 16 years, until President Obama vowed to try again. I lived through the contentious debate preceding the ACA’s enactment in March, 2010. I am living through the ongoing political wars to block, defund, or repeal it. I am living through the challenges created by the law’s troubled implementation.
But if I have any influence whatsoever, I am not going to watch it fail this time, not when we are so close to providing affordable coverage to nearly all Americans, the moral and medical imperative described by the American College of Physician almost a quarter century ago.
Bob Doherty is senior vice-president, governmental affairs and public policy, American College of Physicians and blogs at The ACP Advocate Blog.
One panelist, a neurologoist specializing in MS, is now on the CMS "doesn't meet standards" list because he treats sick people w/chronic MS requiring expensive, continuing medication, monitoring, and tests. He is also now out-of-network on many ACA plans.
As is another panelist, the sole-practitioner NY opthamalogist, who also discussed, among other things, the inability to refer to appropriate specialist because of restricted provider networks in the ACA plans.
In short, those needing special and exotic care had better have money as many others on this board have stated.
Further, apparently there is a hole in the ACA which requires providers to extend care after the first of year with no recourse on payment if insured doesn't pay his premiums and insurance company then won't cover the treatment.
Most of the Congress people- came off as fools and buffoons, especially the guy from MA who was downright obnoxious to the opthamologist from NY who did not deserve his rude, hostile attitude. She isn't the enemy. But, he treated her like one. Representative Maloney from NY was completely clueless. Congressman Elijah Cummings, I think, gets it, but he is very careful in what he says.
The first video was amusing near the end - the fighting between the parties almost got out of hand for a while, there. Thanks, again, to the MA guy.
Idjits.
I watched the First Panel on C-Span. I have to say that I found the Political Theater of it all nauseating.
Though I do not not doubt the issues raised by the doctors themselves have merit, the manner of this inquest was not at all legitimate, but merely another "kill Obamacare" stage play attempt by the Republicans. I thought the few Democrats on the panel were week and ineffective too.
I was surprised not one of the doctors didn't make at least some issue with it when they saw the real agenda. It should have been clear at least to the Ophthalmologist that the Republicans there had no intent to do anything that might help fix it. It is was only their intent to help kill it and that they were being used to further their cause. You heard the one congressman. This was put together by the Republicans, and they refused to let any doctors on the panel who supported the ACA. He even named one particular doctor who was taken off and not allowed to testify.
It is such a shame that we could not have a "real committe" of non partisan participants sit down and actually work together towards bettering the system, and fixing what needs to be fixed to make it better.
You know and I know, that 1000,s of doctors could sit at a table and give testimony to what needs to be fixed, and not one Republican would put their signature to a bill to make any corrections or improvement to the ACA to help patients and doctors. That is a fact. We will never be able to improve on it, because the current HOUSE will block any attempts to try and fix it. The only thing they would pass would be any measures to weaken it. Working together for the common good is dead for now in Washington.
Last edited by modhatter; 12-17-2013 at 12:35 PM..
I watched the First Panel on C-Span. I have to say that I found the Political Theater of it all nauseating.
It is such a shame that we could not have a "real committe" of non partisan participants sit down and actually work together towards bettering the system, and fixing what needs to be fixed to make it better.
You know and I know, that 1000,s of doctors could sit at a table and give testimony to what needs to be fixed, and not one Republican would put their signature to a bill to make any corrections or improvement to the ACA to help patients and doctors.
That is a fact. We will never be able to improve on it, because the current HOUSE will block any attempts to try and fix it. The only thing they would pass would be any measures to weaken it. Working together for the common good is dead for now in Washington.
Oh, it was indeed, nauseating, political theater, and grandstanding at its finest from both sides. Yes,, given the completely dysfunctional nature of our government, no one on the right will make any effort to fix anything.
Quote:
Originally Posted by modhatter
This was put together by the Republicans, and they refused to let any doctors on the panel who supported the ACA. He even named one particular doctor who was taken off and not allowed to testify.
You are referring to Janet Feder, Ph.D. - NOT a physician, but a think-tank, public policy person from the Clinton Admin. First panel was comprised of practicing physicians. Since she isn't a physician, she was included with the think tank people on the following panel.
Oh, it was indeed, nauseating, political theater, and grandstanding at its finest from both sides. Yes,, given the completely dysfunctional nature of our government, no one on the right will make any effort to fix anything.
You are referring to Janet Feder, Ph.D. - NOT a physician, but a think-tank, public policy person from the Clinton Admin. First panel was comprised of practicing physicians. Since she isn't a physician, she was included with the think tank people on the following panel.
Thank you, I missed that. Thought they were referring to physician. Will watch the 2nd one soon as I get more time. Thanks for posting.
It is such a shame that we could not have a "real committe" of non partisan participants sit down and actually work together towards bettering the system, and fixing what needs to be fixed to make it better.
Fixing the system is probably impossible. Fewer than 50% of all people in the US pay income taxes. And many/most of the un/underinsured (and I include people on Medicaid in this category) have little or no income to speak of (or negative income - EITC stuff).
How can we afford to spend tens of thousands of dollars on health care for millions of people who don't even gross that much? I mean - who's going to pay for it? You don't expect health care providers to work for lawn guy wages - do you? (Although some do now.)
I have a simple proposal. How about all of us on Medicare - including you and me and Wardendresden - we're all on Medicare - we should give up our Medicare subsidies until our health care costs are more than say 30% of our gross income. Redistribute our Medicare subsidies to poor people. Like Pope Francis is becoming famous for - "walk the walk". I wouldn't especially like it - but wouldn't consider it unfair (since I don't know why middle class taxpayers should subsidize me).
Can I count you and Wardendresden in on this - giving up your Medicare subsidies and paying more out of pocket to help the poor? Robyn
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. For example - if I were to go to Walgreens to get wax cleaned out of my ears by a NP or similar using the lots of warm water in the ear method (what you might do at home) - it costs $59. My board certified ENT - who uses some fancy electronic tool to do the procedure - accepts Medicare for this - and gets reimbursed $32.
