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We just had a neighbor shoot and kill his wife because of financial health issues at the age of 69 and 72 respectively. She needed a 3rd knee replacement.
My question is, under medicare how much financial crisis can there be for medical issues that are covered by medicare itself? This is a couple living in an active adult community -- homes all priced higher than $250,000 and they have lived in the community 12 years.
I understand that certain medical issues "might" not be covered by medicare that could cause financial distress and certain meds have high costs even with Part D coverage BUT from what I understand from the situation that more than likely this isn't the case.
Are there situations under medicare and/or supplements that might create a huge financial burden? Has anyone had any? Be interesting to know what situations cause huge out of pocket expenses on medicare.
You said he "shot and killed his wife." Did he kill himself, too? They're awfully young to be feeling such pain. Makes me wonder if they retired too soon and he suffered heavy losses in the recent stock market debacle. Or cumulative health issues led to depression. This COVID crisis is very unsettling for everyone.
Medicare has time parameters on how often it permits certain services. If this 3rd knee replacement isn't within that parameter or isn't deemed medically necessary, it is possible it wasn't covered.
Also, if she was seeing nonparticipating Medicare providers - i.e., not taking Medicare assignment - AND her Medigap did not pay excess fees (like Plan N) - the excess charges of essentially 15% of the cost can add up. For example, Mayo in AZ is a nonparticipating provider. If she's lucky enough to be a Mayo patient (they aren't taking Medicare patients at this time), she may have the excess coverage gap.
That said, this sounds more like an Advantage plan issue, not a supplement. For example if she's covered under an Advantage plan and seeing out-of-network providers - there could be much higher copays and coinsurance, although most Advantage plans cap these expenses somewhere between $5K-$10k/year. Advantage plans also cover drugs, but have copays there, as well.
No one here with a decent Medigap has complained about significant lack of coverage - even under some pretty extreme circumstances.
Last edited by Ariadne22; 04-12-2020 at 01:38 AM..
During the debate before ACA, one talking point of the Libs was that healthcare debt was "responsible" for a large portion of bankruptcy filings....
I always found that hard to believe. I should think that, given the very liberal (no pun intended) laws concerning medical debt repayment, that the truth is probably that medical debt might be named as a coincidental debt source in a court filing, but other things (like credit card debt & mortgages) are the real "cause." The med debt is just along for the ride.
We just had a neighbor shoot and kill his wife because of financial health issues at the age of 69 and 72 respectively. She needed a 3rd knee replacement.
My question is, under medicare how much financial crisis can there be for medical issues that are covered by medicare itself? This is a couple living in an active adult community -- homes all priced higher than $250,000 and they have lived in the community 12 years.
I understand that certain medical issues "might" not be covered by medicare that could cause financial distress and certain meds have high costs even with Part D coverage BUT from what I understand from the situation that more than likely this isn't the case.
Are there situations under medicare and/or supplements that might create a huge financial burden? Has anyone had any? Be interesting to know what situations cause huge out of pocket expenses on medicare.
If they didn’t have a supplemental than Medicare doesn’t cover 100%. With a supplemental they should have bills taken care of completely. As the other poster said Advatage plans have large co-pays though.
Had to be more going on there than finances IMO. Maybe it was simply their declining health, or hers. Maybe he didn’t want to be a caregiver. Maybe neither wanted to live until they are disabled. Maybe they had financial issues from other things. Maybe all their retirement was in the stock market. Maybe he had mental issues. Did he actually leave a note or something saying he was killing them both over possible co-pays for a knee replacement?? Not sure I buy that.
During the debate before ACA, one talking point of the Libs was that healthcare debt was "responsible" for a large portion of bankruptcy filings....
I always found that hard to believe. I should think that, given the very liberal (no pun intended) laws concerning medical debt repayment, that the truth is probably that medical debt might be named as a coincidental debt source in a court filing, but other things (like credit card debt & mortgages) are the real "cause." The med debt is just along for the ride.
Any one have data one way or the other?
Medical expenses and loss of income from being out of work before a back surgery (20+ mo yes) caused me to use 5 months of savings and take on tens of thousands in debt.
John Elwyn Smith, 72, called 911 shortly after 5 p.m. Thursday and told Buckeye police dispatch that he had shot and killed his wife while she slept in their home near Horsham Drive and Canyon Springs Boulevard, according to a Buckeye police news release.
Married for 49 years, Smith told dispatch his 69-year-old wife had numerous health issues and that sickness was weighing on them both.
While being questioned, Smith said that numerous things were weighing heavily on him and his wife's minds, including health issues and financial burdens.
Additionally, Smith was feeling stressed about not being able to leave his house due to COVID-19, according to the documents.
As tragic as it is, I wouldn't conclude that medical debts, existing or potential, were what drove him to this. "Financial burdens" could be credit card debt, sinking investment values or other financial stressors.
Medicare can have expensive pitfalls such as out-of-network charges or procedures not approved for Medicare Advantage, your 20% copay if you didn't get Medigap. or high co-pays on some prescriptions.
He may also have been worried about what would happen if one of them needed LTC.
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