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Old 11-20-2021, 09:51 AM
 
Location: Coastal Georgia
50,371 posts, read 63,964,084 times
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Quote:
Originally Posted by mathjak107 View Post
how 16k ? the govt sets caps on advantage plan out of pockets .

The Medicare out of pocket maximum for Medicare Advantage plans in 2021 is $7,550 for in-network expenses and $11,300 for combined in-network and out-of-network expenses

there has to be more to that story or something doesn't make sense
There might be, but I don’t have that info.
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Old 11-20-2021, 09:58 AM
 
Location: NMB, SC
43,091 posts, read 18,259,632 times
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Quote:
Originally Posted by gentlearts View Post
There might be, but I don’t have that info.
Well your original post made it seem as if that was the norm ..no cap and unlimited out of pocket.
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Old 11-20-2021, 09:58 AM
 
6,632 posts, read 4,300,748 times
Reputation: 7087
Quote:
Originally Posted by lenora View Post
The increase was not caused by the recent inflation. The CPI-U Oct 2020 - Oct 2021 was only 1.7% for Medical Care Services.
https://www.dol.gov/newsroom/economi...i_11102021.pdf

The significant increase was partially due to 2021 premium cost limitation imposed by Congress due to Covid and the possibility that the super expensive Alzheimer's Drug will be covered by Medicare Part B.
https://www.dol.gov/newsroom/economi...i_11102021.pdf
I think this increase is primarily due to soaring medical costs due to COVID hospitalizations of people who refused to get vaccinated. The premium increases should be passed on to those who refuse(d) to get vacciinated. Why should others have to pay?
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Old 11-20-2021, 10:05 AM
 
Location: NMB, SC
43,091 posts, read 18,259,632 times
Reputation: 34969
Quote:
Originally Posted by Lizap View Post
I think this increase is primarily due to soaring medical costs due to COVID hospitalizations of people who refused to get vaccinated. The premium increases should be passed on to those who refuse(d) to get vacciinated. Why should others have to pay?
It's due to a new drug just approved by the FDA. The cost of this drug alone could end up being more than all of medicare's cost for one year.

https://finance.yahoo.com/news/why-2...192955705.html
In June 2021 the Food and Drug Administration, using its “accelerated approval pathway,” greenlit the use of Aduhelm, a $56,000-per-year Alzeimer’s disease medication produced by Swiss pharmaceutical company Biogen.
..
The Kaiser Family Foundation in July said it conservatively estimates the cost to Medicare of Aduhelm at $29 billion in one year, based on 500,000 Medicare patients getting the new drug. For perspective, the total Medicare spending for all physician-administered drugs in 2019 was $37 billion.
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Old 11-20-2021, 12:26 PM
 
Location: Rural America
269 posts, read 329,524 times
Reputation: 1382
Quote:
Originally Posted by mathjak107 View Post
it isnt about how often do you see a doctor …..it is about mitigating the events that can happen that would be devastating financially .

despite being healthy both of us somehow got hospitalized with covid ….bills were 250k for both of us ..our share was under 1k for both
I've been on private insurance but will go on Medicare next year. But I'm confused about Medicare A and B.

Doesn't Medicare A (which is "free") cover hospitalizations? Yes, if I understand it correctly, it only covers 80%, and it's a good idea to get one "supplemental" or another.

And then does Medicare B strictly cover doctor office visits? (And is the $150-170 premium for Medicare B per month, not per quarter?) I typically have an office visit ("wellness checkup, blood draw) once per year. So it seems that just paying for the office visit myself rather than paying, what, $2,000/year for Medicare B would be the reasonable way to go? What am I missing?
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Old 11-20-2021, 12:47 PM
 
106,668 posts, read 108,810,853 times
Reputation: 80154
Quote:
Originally Posted by Heron31 View Post
I've been on private insurance but will go on Medicare next year. But I'm confused about Medicare A and B.

Doesn't Medicare A (which is "free") cover hospitalizations? Yes, if I understand it correctly, it only covers 80%, and it's a good idea to get one "supplemental" or another.

And then does Medicare B strictly cover doctor office visits? (And is the $150-170 premium for Medicare B per month, not per quarter?) I typically have an office visit ("wellness checkup, blood draw) once per year. So it seems that just paying for the office visit myself rather than paying, what, $2,000/year for Medicare B would be the reasonable way to go? What am I missing?
part b covers the outpatient stuff

we had tens of thousands in outpatient bills part b covered after we both were hospitalized with covid .

the hospitals put you on home care when you are released and most of that was part b

so once again , nothing is a problem until its a problem
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Old 11-20-2021, 12:57 PM
 
Location: NMB, SC
43,091 posts, read 18,259,632 times
Reputation: 34969
Quote:
Originally Posted by Heron31 View Post
I've been on private insurance but will go on Medicare next year. But I'm confused about Medicare A and B.

Doesn't Medicare A (which is "free") cover hospitalizations? Yes, if I understand it correctly, it only covers 80%, and it's a good idea to get one "supplemental" or another.

And then does Medicare B strictly cover doctor office visits? (And is the $150-170 premium for Medicare B per month, not per quarter?) I typically have an office visit ("wellness checkup, blood draw) once per year. So it seems that just paying for the office visit myself rather than paying, what, $2,000/year for Medicare B would be the reasonable way to go? What am I missing?
Part B covers more than just doctor visits. Here's an explanation:


https://www.medicare.gov/what-medica...-part-b-covers
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Old 11-20-2021, 01:01 PM
JRR
 
Location: Middle Tennessee
8,165 posts, read 5,659,209 times
Reputation: 15703
Quote:
Originally Posted by Heron31 View Post
I've been on private insurance but will go on Medicare next year. But I'm confused about Medicare A and B.

Doesn't Medicare A (which is "free") cover hospitalizations? Yes, if I understand it correctly, it only covers 80%, and it's a good idea to get one "supplemental" or another.

And then does Medicare B strictly cover doctor office visits? (And is the $150-170 premium for Medicare B per month, not per quarter?) I typically have an office visit ("wellness checkup, blood draw) once per year. So it seems that just paying for the office visit myself rather than paying, what, $2,000/year for Medicare B would be the reasonable way to go? What am I missing?
Just as an example; Medicare B pays $9200 every three weeks for my wife's cancer immunotherapy infusion. As well as the cost of the expensive PET scans she has needed (among other things).
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Old 11-20-2021, 01:04 PM
 
106,668 posts, read 108,810,853 times
Reputation: 80154
just the ambulance was 1000 bucks each , part b covered most of it .

we needed one for each of us going in and we needed one to take us both home since we had to transport oxygen units.

so just that was 3k

the pulmonologists you see after you are released was about 4k in work ups and the cardiologist was 3000
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Old 11-20-2021, 01:05 PM
 
Location: NMB, SC
43,091 posts, read 18,259,632 times
Reputation: 34969
So they are saying that part B is going up because of this new Alzheimer drug.

Why wouldn't that fall under part D for drugs and have that go up rather than part B ?
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