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Old 01-17-2012, 01:28 PM
 
Location: Wisconsin
14,255 posts, read 18,811,966 times
Reputation: 6808

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Quote:
Originally Posted by tickedinknoxville View Post
I'm 65 and still working with BCBS medical through work. I will work for at least the next 4 years, if not longer.
I just tried to get an appoint with a group of internist in the Tennova (previously Mercy) hospital system on Parkside Drive in Knoxville TN and was told flat out that because I have medicare they won't take me. And the woman was quite nasty about. People seem to forget that if they're fortunate to get to 65+ that they'll be in the same position. And believe me it gets here fast.
While UT and Parkside hospitals take medicare, I've had bad experiences with Drs at both places and don't particulary was to be forced to use those hospitals. But what choice do I have?
It really sucks that good medical care is being reserved for the young. These internists can take their place in history next to Hitler.
They're not taking Medicare because the reimbursement rates are atrociously low.

That said, if you are still working, you should not be on Medicare. Although I was automatically enrolled in Part A when I worked, I was not paying for Part B as my employer's insurance was primary. Medicare had NO part of any medical/insurance payment issues while I was employed. I worked full-time until age 67-1/2. Had cataract surgery on both eyes shortly before I was laid off, all paid by my employer's insurance - approximately $12,000. Medicare NEVER entered into it.

Check again. If you are working, BCBS should be primary. If you are paying Medicare Part B premium AND have BCBS through your employer, in all probability you are paying for Part B unnecessarily. You shouldn't even be enrolled in Medicare Part B if you are working and have employer health insurance. You can do that without penalty when you retire.
Quote:
Originally Posted by stockproipi View Post
I'm not sure if people know that when they sign up for Medicare part C (Medicare advantage) they are actually dealing with private insurance companies. The doctors will deal with private insurance companies and not directly with the Government. Many of these Medicare advantage plans are similar to and in some case are even better than the employer provided insurances.

So I don't know why people are making a big deal out of this? Also, the healthcare reform does not really change medicare and it does not even in effect yet (the real part of the reform) until 2014.
Doctors are more likely not to take an Advantage plan than they are Medicare. Ask Robyn. She's an expert on that.

Health care reform aside, more and more doctors haven't been taking Medicare patients - for years now - because of the low reimbursement rates. The well-to-do are employing concierge doctors and paying $5,000-$10,000 annual retainers. Last specialist I saw two years ago, before I was on an Advantage Plan, Medicare reimbursement rate $39. Employer supplement would not pay more than the Medicare approved rate. I felt like a charity case when I went on Medicare. At that point I began to look for coverage without a Medicare carve-out. It doesn't exist. I've been wondering ever since how long it will take before the elderly on Medicare are all in charity wards.

Last edited by Ariadne22; 01-17-2012 at 01:40 PM..
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Old 01-17-2012, 02:07 PM
 
Location: CHicago, United States
6,937 posts, read 3,492,554 times
Reputation: 3393
Quote:
Originally Posted by Ariadne22 View Post
They're not taking Medicare because the reimbursement rates are atrociously low.

That said, if you are still working, you should not be on Medicare. Although I was automatically enrolled in Part A when I worked, I was not paying for Part B as my employer's insurance was primary. Medicare had NO part of any medical/insurance payment issues while I was employed. I worked full-time until age 67-1/2. Had cataract surgery on both eyes shortly before I was laid off, all paid by my employer's insurance - approximately $12,000. Medicare NEVER entered into it.

Check again. If you are working, BCBS should be primary. If you are paying Medicare Part B premium AND have BCBS through your employer, in all probability you are paying for Part B unnecessarily. You shouldn't even be enrolled in Medicare Part B if you are working and have employer health insurance. You can do that without penalty when you retire.

Doctors are more likely not to take an Advantage plan than they are Medicare. Ask Robyn. She's an expert on that.

Health care reform aside, more and more doctors haven't been taking Medicare patients - for years now - because of the low reimbursement rates. The well-to-do are employing concierge doctors and paying $5,000-$10,000 annual retainers. Last specialist I saw two years ago, before I was on an Advantage Plan, Medicare reimbursement rate $39. Employer supplement would not pay more than the Medicare approved rate. I felt like a charity case when I went on Medicare. At that point I began to look for coverage without a Medicare carve-out. It doesn't exist. I've been wondering ever since how long it will take before the elderly on Medicare are all in charity wards.
I don't know with certainty, because I'm 62 and not 65, but my impression is that even though I may continue to work at and past 65 and have BCBS as part of my benefit package, Medicare will be my primary coverage and BCBS secondary. I know that some physicans are restricting new patients who have Medicare-only. I believe that's a result of the negative actions of Congress. I support President Obama's efforts to improve our care, and oppose the actions or promised actions of the extremists on the "other side."
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Old 01-17-2012, 02:32 PM
 
Location: Wisconsin
14,255 posts, read 18,811,966 times
Reputation: 6808
Quote:
Originally Posted by gomexico View Post
I don't know with certainty, because I'm 62 and not 65, but my impression is that even though I may continue to work at and past 65 and have BCBS as part of my benefit package, Medicare will be my primary coverage and BCBS secondary.
Check with your HR/benefits people for the correct answer. Ask twice. No sense paying the Medicare Part B premium until you have to. It's been stated over and over on this board by people working past retirement age and still covered by their employer that Medicare is not part of their equation. This could be an employer-specific/BCBS related parameter to keep costs down, but that borders on age-discrimination by your employer because people on Medicare are denied doctors available to people who are not.

Last edited by Ariadne22; 01-17-2012 at 02:47 PM..
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Old 01-17-2012, 04:35 PM
 
Location: Vermont
530 posts, read 643,856 times
Reputation: 508
Doctors refusing to accept Medicare-only patients? Wow, this never even crossed my mind! My mom is on Medicare only, and sees at least four specialists in addition to her primary care doctor, and no one has refused her. This is at Dartmouth-Hitchcock in NH. I sure hope it stays that way for awhile, as I will be on Medicare in less than 2 years. Luckily Vermont will kick in for a supplemental plan, maybe that will help...
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Old 01-18-2012, 07:34 AM
 
157 posts, read 255,633 times
Reputation: 78
It's a big problem in both North Georgia and Alaska.

One idea I've had is that perhaps they should require docs to take at least a few 2-5% Medicare or Medicaid patients as a condition for them to receive federal or state school loans or if they were military and government paid all their expenses for school. Government should also make the billing process easier-my understanding is that it's way too difficult to deal with.
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Old 01-18-2012, 01:44 PM
 
Location: New England
12,282 posts, read 8,469,575 times
Reputation: 8831
Quote:
Originally Posted by jenny1951 View Post
Doctors refusing to accept Medicare-only patients? Wow, this never even crossed my mind! My mom is on Medicare only, and sees at least four specialists in addition to her primary care doctor, and no one has refused her. This is at Dartmouth-Hitchcock in NH. I sure hope it stays that way for awhile, as I will be on Medicare in less than 2 years. Luckily Vermont will kick in for a supplemental plan, maybe that will help...
I am not eligible for Medicare yet but am trying to understand it.

Your mom has Medicare only, with no Advantage Plan and no "medigap" policy? (I still don't understand the difference between these two).

With Medicare only (part A and part B), does that cover all doctor visits, specialist visits, and tests like ultrasounds? How about dentistry?

Or do you need an additional policy to cover those?
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Old 01-18-2012, 01:57 PM
 
Location: 112 Ocean Avenue
5,706 posts, read 4,815,451 times
Reputation: 8664
Quote:
Originally Posted by newenglandgirl View Post
I am not eligible for Medicare yet but am trying to understand it.

Your mom has Medicare only, with no Advantage Plan and no "medigap" policy? (I still don't understand the difference between these two).

With Medicare only (part A and part B), does that cover all doctor visits, specialist visits, and tests like ultrasounds? How about dentistry?

Or do you need an additional policy to cover those?
Medigap Policies – Understanding Medigap Policies
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Old 01-18-2012, 02:40 PM
 
1,665 posts, read 3,362,842 times
Reputation: 945
Quote:
Originally Posted by stockproipi View Post
I'm not sure if people know that when they sign up for Medicare part C (Medicare advantage) they are actually dealing with private insurance companies. The doctors will deal with private insurance companies and not directly with the Government. Many of these Medicare advantage plans are similar to and in some case are even better than the employer provided insurances.

So I don't know why people are making a big deal out of this? Also, the healthcare reform does not really change medicare and it does not even in effect yet (the real part of the reform) until 2014.
In 2014 medicare will cost around $250,maybe more under Obamacare,an awful lot of money.
We were forced into Medicare PPO under United Healthcare with $250 deductable and cannot use Medicare card,you use doctors who are part of this setup.It will cost more for us than Medicare.
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Old 01-18-2012, 04:28 PM
 
Location: Vermont
530 posts, read 643,856 times
Reputation: 508
Quote:
Originally Posted by newenglandgirl View Post
Your mom has Medicare only, with no Advantage Plan and no "medigap" policy? (I still don't understand the difference between these two).

With Medicare only (part A and part B), does that cover all doctor visits, specialist visits, and tests like ultrasounds? How about dentistry?

Or do you need an additional policy to cover those?
No, my mom also has a supplemental plan, and so she rarely pays more than $10.00 for any visit. That plan costs her $139/month, in addition to the $99 for Medicare. No dentistry is covered. Maybe that is why the doctors see her? I don't understand Medicare yet either but I do know that Catamount Health in Vermont offers a subsidized Medicare supplemental plan for low-income seniors, like me. The allure of a warmer climate is forever being dashed by the generous benefits Vermont offers. Guess for now I will be staying put. In the interim, I am going to check into whether my doctor will give me the boot once I am on Medicare!
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Old 01-18-2012, 04:41 PM
 
Location: Hills & Hollers of the Aux Arcs
19,089 posts, read 16,338,016 times
Reputation: 17083
Quote:
Originally Posted by jenny1951 View Post
No, my mom also has a supplemental plan, and so she rarely pays more than $10.00 for any visit. That plan costs her $139/month, in addition to the $99 for Medicare. No dentistry is covered. Maybe that is why the doctors see her? I don't understand Medicare yet either but I do know that Catamount Health in Vermont offers a subsidized Medicare supplemental plan for low-income seniors, like me. The allure of a warmer climate is forever being dashed by the generous benefits Vermont offers. Guess for now I will be staying put. In the interim, I am going to check into whether my doctor will give me the boot once I am on Medicare!
If your doctor does accept Medicare patients or will keep you once you're on Medicare, as if he or she also accepts Medicare assignment. That means they will accept the Medicare approved amount in full. If not, you could end up paying 15% over that amount unless you have a supplement that will cover it. But you will need as supplement of some type because Medicare only pays 80% of their own approved amount. Supplements pick up the rest. Only some supplements pick up the extra 15%.
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