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Old 01-21-2017, 05:42 AM
 
Location: RVA
2,164 posts, read 1,264,175 times
Reputation: 4451

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I had to get a cortisone shot in my foot to shrink a Mortons neuroma. I have a high deductible health plan, and paid the $56 with a credit card. After me, in line was an Ed Asner look alike, so maybe late 70s? Age doesn't really matter except that he was not foreign and well over 65. He was one of the rudest, most belligerent seniors I have seen in action to date. He literally walked in to the office a few minutes before his 9:00 appt. and started complaining at 9:05 as to why he had to wait when he had an appointment!

Then, while the receptionist was going over the usual "Identification and Insurance card, please", she told the man that they don't accept his insurance at this office. He had some United Healthcare version. The man went insane. He did not drop to expletives but kept insisting, very very loudly, that he was told his insurance was good everywhere, and they HAD to take it. She replied, no, they didn't and that many doctors don't take many types of insurance, including Medicare. She told him that they had treated him in the past when he had Medicare, but could only now, if he wanted to pay out of pocket. I listened while she patiently explained the same things over and over and he kept insisting she "Get on the phone, and make this right!" She even called a similar orthopedic surgeon/dr thta DID take his insurance and they offered him a later same day appointment. He would have none of it! He only wanted a Dr that he knew, and actually said "for all I know, this guy is a veterinarian!" Then he told the receptionist he wanted all his medical records "RIGHT NOW". He wasn't leaving his records at a Drs office that was no good and worthless. I left before it was totally resolved, but wow.

Anyway, my question is, are there actually cheaper alternatives to Medicare, with less coverage that one can get instead? This was news to me. She specifically told him to call all his doctors and tell them he does not have Medicare, but has the United Healthcare plan he specified. I thought everyone after 65 and not under an employers plan had Medicare. I thought maybe it was possible he WAS retired, and on Medicare, then went back to work and this was his work plan? But Medicare would still be cheaper, so that is unlikely.
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Old 01-21-2017, 07:04 AM
 
Location: Ypsilanti, MI
2,431 posts, read 3,657,283 times
Reputation: 4758
To my knowledge, but I am 'only' 60, Medicare becomes your primary insurance coverage at age 65, even if you are working.

Did the Receptionist/Billings Clerk ask if he was still covered by Medicare? If they treated him in the past under Medicare they should still have his information. Seems odd that anyone over 65 would have the possibility of periodic insurance changes which require a new insurance verification with each visit. Still no reason to get rude. Pulling his records will not get him service by a Doctor he knows.

Maybe someone close to him just died or received horrible health news that has temporarily impacted his reasoning and civility abilities. My M-I-L is in her late 70's and has recently gotten very belligerent with everyone. We wonder if it might be a form or symptom of dementia.

Last edited by MI-Roger; 01-21-2017 at 07:42 AM..
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Old 01-21-2017, 07:26 AM
 
Location: Alexandria, VA
11,419 posts, read 20,245,949 times
Reputation: 16475
Not sure why you are talking about Medicaid.
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Old 01-21-2017, 07:41 AM
 
Location: Ypsilanti, MI
2,431 posts, read 3,657,283 times
Reputation: 4758
Quote:
Originally Posted by Flamingo13 View Post
Not sure why you are talking about Medicaid.
Oops. You are right. Medicaid covers Nursing Home Care, Medicare pays for what a Band-Aid won't fix.

Now you realize the source of my dyslexia with this. Previous post corrected.
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Old 01-21-2017, 07:41 AM
 
Location: 49th parallel
2,598 posts, read 1,355,863 times
Reputation: 5395
I think MI-Roger means "Medicare," not "Medicaid." Anyway, yes, everyone who is on Social Security pays into Medicare and is covered by Medicare. Not all doctors accept Medicare patients, however, and I guess doctors may possibly go on and off the Medicare lists as their particular situations change. This guy probably got caught in a situation where this doctor used to accept Medicare and now doesn't.

Also, it sounds like the guy may have changed from a regular Medicare plan to one of those cheaper Medicare plans (I will use current airline terminology now and call it "basic Medicare") in which you don't get as many benefits and have to use certain doctors, in exchange for cheaper premiums. I don't really know.

That guy probably was not like that at age 20. Unfortunately, getting old does bad things sometimes to people.
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Old 01-21-2017, 07:50 AM
 
Location: Idaho
1,451 posts, read 1,152,796 times
Reputation: 5472
Quote:
Originally Posted by Perryinva View Post
Anyway, my question is, are there actually cheaper alternatives to Medicare, with less coverage that one can get instead? This was news to me. She specifically told him to call all his doctors and tell them he does not have Medicare, but has the United Healthcare plan he specified. I thought everyone after 65 and not under an employers plan had Medicare. I thought maybe it was possible he WAS retired, and on Medicare, then went back to work and this was his work plan? But Medicare would still be cheaper, so that is unlikely.
Yes, everyone after 65 can enroll in Medicare. Part A (hospital insurance) has no premium but it is required for part B (Medical insurance) and D (Prescription insurance). There is also annual deductible cost.

To cover the insurance premiums and deductible cost, one can choose to either have Medigap or Medicare Advantage plan. The article below explains the difference between the two

Medigap vs Medicare Advantage - Consumer Reports News

It appears that the character you encountered at the doctor's office had a Medigap insurance plan in 2016 and switched to an HMO Medicare Advantage plan in 2017 (likely because it is cheaper). If he wanted to keep the same doctors, he should have checked to see if his doctors are in the network of his new insurance plan.

Medigap insurance is typically widely accepted by all health care providers. If the office is not in the network of your HMO Medicare Advantage plan, you either have to pay the full fee or an out-of-network fee (if your plan has that option).

One thing which was not mentioned in the CR's article is that typical Medicare Advantage plans do not cover international medical expenses. Medigap plans have high deductible for international travel medical cost but at least it is covered. Since we enjoy traveling, we will stay with Medigap plans.

Last edited by BellaDL; 01-21-2017 at 08:16 AM..
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Old 01-21-2017, 08:18 AM
 
3,455 posts, read 2,321,933 times
Reputation: 6998
Yes, it is most likely that he had switched to a Medicare Advantage plan; United Healthcare has a number of them. What many people don't realize when they switch to those cheaper plans is that although it is Medicare, you are in an HMO that has a network. You have to see those network doctors or else you will pay out of your pocket. There are some non-HMO Medicare Advantage plans, but they are more expensive and less common.

Even though the guy was belligerent, I do feel a teensy bit sorry for him. The Medicare Advantage plans are aggressively marketed as a cheaper alternative to "Original Medicare" (+ a Supplemental/MediGap plan). People happily sign up for the cheaper alternative and only when they try to see a doc who isn't in that insurance company's HMO network does it sink in that the cheaper "Advantage" translates into "less doctors to choose from". Fortunately, people can switch back to Original Medicare during the next open enrollment period that runs from mid-October through early December.
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Old 01-21-2017, 09:36 AM
 
Location: Los Angeles area
14,018 posts, read 17,723,738 times
Reputation: 32304
The technical reasons for the confusion about coverage are rather beside the point, it seems to me. The man's behavior was inexcusable. The poor receptionist was not to blame, in any case, but she had to undergo this extremely rude treatment. And everyone else in the office had to listen to it too. If I had been there I would have probably defended the receptionist and told the man he was out of line. Not my place to do so, you say? Well, that can be argued, but I will come to the aid of someone being abused unless my own physical safety would be compromised by doing so.
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Old 01-21-2017, 10:39 AM
 
Location: Lakewood OH
21,699 posts, read 23,648,620 times
Reputation: 35449
Quote:
Originally Posted by Perryinva View Post

Anyway, my question is, are there actually cheaper alternatives to Medicare, with less coverage that one can get instead? This was news to me. She specifically told him to call all his doctors and tell them he does not have Medicare, but has the United Healthcare plan he specified. I thought everyone after 65 and not under an employers plan had Medicare. I thought maybe it was possible he WAS retired, and on Medicare, then went back to work and this was his work plan? But Medicare would still be cheaper, so that is unlikely.
Maybe she told him to tell other doctors he has United Healthcare not so he could get a cheaper plan through them but so he could determine as to whether or not the new doctor would accept his Medigap or Advantage Plan.
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Old 01-21-2017, 11:32 AM
 
6,305 posts, read 5,042,575 times
Reputation: 12805
I hope the people that work there are trained to handle these situations. And after a while, it probably gets old - not the first angry patient they encountered.

We encountered one loud guy at a heart doctor's office. He was mad. Sheesh - the guy could have had a heart attack - he was so ticked off. And nowadays you don't know what they might do - come back and seek revenge while we are sitting there - scary.

Why can't insurance be simplified? I hear my older friends talking about medicare and supplements and HMOs etc- and my eyes start spinning in my head. That is why I am taking better care of myself. Getting hit by a car is one thing, but I think that being on all types of maintenance meds can be somewhat avoided.
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