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Old 08-14-2018, 07:58 AM
 
Location: Cochise county, AZ
5,101 posts, read 3,576,860 times
Reputation: 10942

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Quote:
Originally Posted by JRR View Post
[/b]

Oh, how I remember that year of turning 65 and having to beat the Medicare supplement/advantage plan people off with a stick. I actually had one call me stupid (in a roundabout way) because I said that I already knew what supplement I was going to get. He said that I might think that I knew what I was doing, but I really had no idea and should let him guide me.

Then the next year we had round 2 when my wife turned 65.
I'll be 65 the end of September. Really unsure as to what to do about the supplement. I looked at the Medicare part of the forum but am still confused. I suppose I will contact the Area Agency on Aging. They were so helpful when I had to switch prescription plans.

 
Old 08-14-2018, 01:52 PM
 
Location: University City, Philadelphia
22,607 posts, read 12,482,829 times
Reputation: 15595
Quote:
Originally Posted by meo92953 View Post
I'll be 65 the end of September. Really unsure as to what to do about the supplement. I looked at the Medicare part of the forum but am still confused. I suppose I will contact the Area Agency on Aging. They were so helpful when I had to switch prescription plans.
That sounds like a plan!
 
Old 08-15-2018, 05:15 PM
 
Location: ☀️ SWFL ⛱ 🌴
2,516 posts, read 1,741,218 times
Reputation: 9036
DH and I went to the Medicare 101 meeting at the library and I’m so glad we did.

It was put on by SHINE:
SHINE (Serving Health Insurance Needs of Elders) is a free program offered by the Florida Department of Elder Affairs and your local Area Agency on Aging. Specially trained volunteers can assist you with your Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential.

It was a great presentation with good information. The gentleman presenting is Medicare certified and was good. There were more people than I expected, around 20+. I signed up to be contacted for a one on one session with one of their volunteer counselors for my particular situation with DH still working and not taking SS for another year after Medicare.

Tossing all those postcards from “Medicare Specialists” into the recycle bin these past few months was the right thing to do. I went still half expecting to be sold something and pleased it was better than I expected and not affiliated with a money making entity.
 
Old 08-16-2018, 08:16 AM
 
Location: Cochise county, AZ
5,101 posts, read 3,576,860 times
Reputation: 10942
Thanks Jean. I m so thankful there are knowledgeable people out there who we willing to volunteer and help.
 
Old 08-16-2018, 08:32 AM
 
Location: Cochise county, AZ
5,101 posts, read 3,576,860 times
Reputation: 10942
Thanks jean. Nice to know there are people out there willing to help.
 
Old 08-16-2018, 11:28 AM
 
Location: Central NY
4,879 posts, read 3,380,409 times
Reputation: 12638
RANT: I just spent a lot of time on the phone trying to get information regarding insurance coverage for physical therapy. OMgosh. I'm in full sweat now.

The woman who answered the phone..... very pleasant. But I could not understand a lot of what she said. I played that game for a while..... please repeat that..... what did you say..... etc., etc. Then I asked to speak to someone I could understand (I wasn't snippy about it, I just told the woman that we were both wasting our time doing that). She put me on hold but she came back on the line. I think she forgot I asked to speak to someone else. I repeated my request, I could tell she was disappointed. She put me on hold again. More time passed, I hung up. Phone rang, it was someone who spoke very well and I got some of my questions answered. But this insurance stuff is very complicated.

Wait.... there's more!
If the PT is a provider, the copay is $15 and I need to have a letter of referral from my primary.

If the PT is not a provider, copay is 30% of total and no letter of referral is required.

It just sounds a little backwards to me.
 
Old 08-16-2018, 03:19 PM
 
Location: Prescott AZ
6,183 posts, read 9,242,986 times
Reputation: 11779
NYGal: Are you talking about in network vs. out of network? If your chosen PT is not in your network, then the cost of the service is on you, for 30% of the total, not just a $15 copay. Is this what you mean?
 
Old 08-16-2018, 03:38 PM
 
Location: Central NY
4,879 posts, read 3,380,409 times
Reputation: 12638
Quote:
Originally Posted by AZgarden View Post
NYGal: Are you talking about in network vs. out of network? If your chosen PT is not in your network, then the cost of the service is on you, for 30% of the total, not just a $15 copay. Is this what you mean?

No, that isn't what I was talking about. I do understand about in network and out of network. My insurance has been like that for years (different company).

My question was my current insurance calling provider vs non-provider. I think I thought that if a doctor was a provider and the copay was $15, why would I need a referral letter?

But no referral letter, higher copay, for non-provider.


I am also used to the terms in network and out of network. I think I thought provider would be in network and non-provider would be out of network.

Does that help?
 
Old 08-17-2018, 06:18 PM
 
1,645 posts, read 630,703 times
Reputation: 3538
NYgal

The out-of-network rates are always more expensive. I would not gamble, and would go to one that is a preferred provider so you can get the $15 co-pay. The PT costs ad up very quickly as they often want you to come 2-3 times a week and then it is $45/week x 4 weeks in a month, etc. It adds up fast. But they helps you a lot, too.

Doing PT with the non-preferred vendor is expensive.

The insurance companies get you coming or going!
 
Old 08-17-2018, 07:34 PM
 
Location: Central NY
4,879 posts, read 3,380,409 times
Reputation: 12638
Quote:
Originally Posted by HollyhockGarden View Post
NYgal

The out-of-network rates are always more expensive. I would not gamble, and would go to one that is a preferred provider so you can get the $15 co-pay. The PT costs ad up very quickly as they often want you to come 2-3 times a week and then it is $45/week x 4 weeks in a month, etc. It adds up fast. But they helps you a lot, too.

Doing PT with the non-preferred vendor is expensive.

The insurance companies get you coming or going!



I know that! Out of network is more expensive. Didn't I indicate that in the post?
My question is really about the referral letter.
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