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I found a link that gives two CPT codes for the VAP test: 83701 and 84478. 83701 is listed with a price of $34.05 next to it. 84478 is also listed but with a notation of QW and also $7.88 in the price column.
Does it matter that your linked PDF says "Kentucky Only" and "Kentucky and Ohio Part B" ? I am not in either of those states.
Not much. The variances by area are only a dollar or two. What you want to know is if the procedure is paid for by Medicare. It apparently is - provided it fits the timeframe/medically necessary guideline for that procedure.
You have to plan in advance to keep your income low enough for the subsidy. I know people that filed early for social security, which disqualified them from getting a subsidy. You can’t withdraw from your IRA or show a gain on a house sale. People don’t think about those things and then they find out they don’t qualify for the subsidy.
I retired at 59 without insurance and had to make do with a small pension. I was supposed to have retiree medical but American Airlines filed for bankruptcy and took away our insurance.
This year I took out a HELC because I couldn’t withdraw from my IRA. I put off selling my house too until after January due to the subsidy.
All of my investments are in IRA’s, so my income is very low.
So like anything else, it takes planning.
Where did you got the info that taking withdraws from an IRA disqualifies you from an Obamacare subsidy? I've been doing it and have had no problems. I need to take the withdraw to boost my income so it is high enough to qualify for a subsidy. Otherwise, I would need to go on Medicaid or pay the full Obamacare premium. Obamacare uses "modified adjusted gross income" to determine if one can get a subsidy.
I did plan ahead and created an income stream from annuities purchased from after-tax savings (not in IRA or 401K). Most of my monthly annuity payments is return of capital, which is not reported to the IRS as income since it is merely giving me back my savings. The interest portion of the payments is reported as income, but it is too low to get my income above the Medicaid threshold, so I have to make a withdraw from my IRA to get me above that threshold.
I'm carrying a large capital loss from a stock that went bust, so any capital gains I earn from after-tax investments are negated against a portion of my capital loss carryover. I sold a condo I had held as a rental investment for over 25 years and negated all the depreciation recapture and capital gain realized from the sale. The sale therefore had no effect on my Obamacare subsidy.
Last edited by mitchmiller9; 01-19-2020 at 09:14 PM..
Medicare will pay for Blood tests for cardiovascular disease screening only once every 5 years. However; if you have a history of abnormal cholesterol/lipid levels, you may be considered are "at risk" which would fall under the diagnostic lab test benefit. Diagnostic tests can be performed more frequently than “screening” but are subject to the Medicare Part B 20% coinsurance.
I got an end of year notice from Medicare for my October well exam, that the visit to dr. was covered, but a comprehensive blood test was not covered. Apparently the blood test also included Hep C, and that is not covered, either.
If a service isn't covered, that means my Medigap plan won't pay for it, either, doesn't it?
I've never heard of a standard blood profile not being covered as part of a well exam. Is this normal?
(I also think it's odd to have a Hep C test. I don't think I've had one of those before, because there's no reason for it. I'm in excellent health w/no reason to think I have any med condition.)
I've heard, that they'll cover certain routine bloodwork if the right codes are used. It seems, that the trick is in picking the right code for each item. I've heard patients say, that Medicare won't cover Vit. D levels on lab orders, but I've heard doctors say, they always pay for the vit. D testing they order. So, go figure. It sounds like a horrible system, though. I DO NOT WANT this system "for all"! I won't vote for anyone planning to stick the nation with this horribly inadequate system, as if it were a good deal!
It sounds like a horrible system, though. I DO NOT WANT this system "for all"! I won't vote for anyone planning to stick the nation with this horribly inadequate system, as if it were a good deal!
You'll be hard pressed to find anyone on this forum who dislikes Medicare. As they say, a little knowledge - in this case zero knowledge - is a dangerous thing. People may question 'coding' and how to get Medicare to pay in full outside their deductible (Welcome v. Wellness v. Regular Office Visit) - but that's about it. If you believe a $198 deductible is onerous, well, that's your prerogative. If you think $144 for Part B plus let's say $250 for a Medigap and Part D is expensive and a ripoff, talk to the person under Medicare age who is paying $1,000/mo. premium with a $5k+++ deductible, copays, restricted networks, etc., etc., etc..
There is nothing inadequate about Medicare. For those on Original Medicare + Medigap, coverage is pretty much 100% for all Medicare-approved services - which is just about everything except experimental.
Lots of stories here from Medicare people facing serious illnesses and expensive treatments whose out-of-pockets are virtually nil.
You'll be hard pressed to find anyone on this forum who dislikes Medicare. As they say, a little knowledge - in this case zero knowledge - is a dangerous thing. People may question 'coding' and how to get Medicare to pay in full outside their deductible (Welcome v. Wellness v. Regular Office Visit) - but that's about it. If you believe a $198 deductible is onerous, well, that's your prerogative. If you think $144 for Part B plus let's say $250 for a Medigap and Part D is expensive and a ripoff, talk to the person under Medicare age who is paying $1,000/mo. premium with a $5k+++ deductible, copays, restricted networks, etc., etc., etc..
There is nothing inadequate about Medicare. For those on Original Medicare + Medigap, coverage is pretty much 100% for all Medicare-approved services - which is just about everything except experimental.
Lots of stories here from Medicare people facing serious illnesses and expensive treatments whose out-of-pockets are virtually nil.
Sorry Ariadne, there are some who have had terrible experiences with medicare. Its a crappy system and its only close to 100% if you have an “approved” disease. Come down with a somewhat rare disease and medicare is crap. Also, if you are a type 1 diabetic, and your drs believe in tight control, you cant get medicare to approve testing more than 3x a day no matter how many drs order it. Medicare would rather pay for all the terrible side effects of diabetes than pay for testing more than 3x a day to prevent them. Its a crappy ins co.
Q: How much would you be paying in premiums and deductibles for coverage other than Medicare?
A: At least close to $20K a year - which is what most over 60 y/os are paying - $12k premiums, another $5k deductible before policy pays a dime, plus copays. Minimum. Or, at least three to four times what Medicare is costing you.
Medicare is substantially subsidized by the govt. - at least 25% for Part B and substantially more for Part A which is free to those who've worked sufficient quarters. Whatever you paid in, doesn't come anywhere near to covering what you'll be getting out of it if, heaven forbid, serious illness strikes. Costs ramp up to in the 100's of thousands, some exceeding a million. Sister's hospitalization last year was $300k. Did you pay that much in? Did she? NO.
Medicare is a bargain.
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