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Thinking about this and going back to 2003 when I enrolled in for medicare and didn't buy a supplement due to finances and due to the fact that I don't go to doctors very often. And when I have I can handle copays. I even got thru hip replacement in 2010 and handled my copays...made payments etc.
And it's not until this knee "disaster" that I wish I had a supplement, but I don't. So I've worked other angles.
Now isn't it pretty much the case that people who frequent doctors a lot and have a lot of medical issues, really need that supplement.
Yes, I know stuff can happen and it did for me starting last Dec 2 ...but I'm working thru it.
I will be calling a local medicare contact here and talk to him again.
PS: I have a neighbor who just turned 90 and has Many issues and lives on a lower income than me, her one son sends her monthly money to help her. She often asks the provider to accept what medicare will pay them and Often they do for her. California is a very expensive housing state...very.
Last edited by jaminhealth; 05-24-2017 at 08:03 PM..
Now isn't it pretty much the case that people who frequent doctors a lot and have a lot of medical issues, really need that supplement.
No, I totally disagree. This isn't the political forum which is why I didn't address this. I was concerned about getting into a debate about health insurance and, if I'm not mistaken, this forum is only to discuss options and give advice. Let's just say that I have NEVER used my high deductible supplement or prescription drug plan. I just thought it was the responsible thing to do. I also didn't want to be stuck with enormous bills if I needed surgery or got a serious illness.
Like you, I also live on a very low income so believe me, I completely understand what it's like to be on a budget. Again, had you not brought up the subject, I wouldn't have even mentioned it, but what you wrote just isn't true. Nobody knows when they'll get cancer, have a stroke or a heart attack.
Good luck. I hope you contact the right people and get the information you require.
Last edited by justNancy; 05-24-2017 at 09:13 PM..
Reason: fix post
PS: I have a neighbor who just turned 90 and has Many issues and lives on a lower income than me, her one son sends her monthly money to help her. She often asks the provider to accept what medicare will pay them and Often they do for her. California is a very expensive housing state...very.
Good for her, but that's not common. However, it never hurts to ask. On the Medicare website there is a list of doctors who accept Medicare assignment. Assignment means they'll accept the Medicare fee plus the patient's co-payment (after meeting the Part B deductible) without any excess charges.
Automatic Denial - within past 90 days - have you been hospitalized, are you in a nursing home, do you have ESR.
This right here would eliminate me right off since I just got home from 3 rehabs/hospitals from Dec 2 to April 13...
If denial is in the picture then so be it. I'll have to go on as I do, pay as I can and count on the supplements I take to keep me as healthy as I've been. They can't get blood from a turnip either and I own nothing for them to take. They can take my 20 yr old auto.
I just spoke to a medicare rep that has spoken to many seniors here and he said No one will touch me since out of hospital and rehabs...BUT there is a Medicare Plan F high deductible that he briefly went over...said I'd have to get off medical in order to apply for this medicare plan F....I'm to call him back later and he will have more facts and figures for me.
Why are you confused? hd-F was explained upthread in my posts and embedded links. Once again, for an hd-F, you pay a premium and the first $2,200 of Medicare copays. Thereafter, plan pays 100%. Only difference between and hd-F and regular F is the $2,200 deductible and the much lower premium. Otherwise, the plans are the same.
Know that underwriting - whether an hd-F or regular F - is the same. You will still need to pass health underwriting.
Quote:
Originally Posted by jaminhealth
I'm a person who does NOT run to doctors, I work to avoid them, so confusion reigns for me. I'm talking about this now since the knee mess for the last almost 5 months and my running out of medicare and having to file for high deductible medical.
What do you mean "my running out of Medicare"? What happened that you exceeded Medicare allowances?
If you have exceeded Medicare limits for certain procedures/services, a Medigap will NOT help you - unless you are hospitalized excessively or want help with SNF copays, or need additional home health services. Otherwise, Medigaps only pay their share for Medicare-approved services.
As I said on upthread, your option this fall and for the next two years until you can pass Medigap underwriting is an Advantage plan. Look at Kaiser - there may be less oversight and fewer cost issues with them - v. the Medicare/Medi-Cal you now have.
Chances are your expenses, because of the spend-down you have on Medi-Cal, is higher than if you were enrolled w/Kaiser - unless Medi-Cal is paying your Part B premium. In that case, you're probably better off w/Medi-Cal.
By running out of medicare I mean that when I went to UCLA with 3 falls at my house and we all thought it was bone on bone arthritis and UCLA did not do an MRI which showed infection until 2.5 months in first rehab. None thought infection.. I sure didn't...but now I believe UCLA should have down MRI very early on.
Being in 3 rehabs ate up medicare...that is why I applied for medical along the way but had no clue about the $1005 spend down deductible with medical....since I was a couple hundred over the big poverty level. They didn't mention it at the time I applied. All so new.
Many seniors in my circle of friends are in HMOs including Kaiser. I just can't seem to go there YET.
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