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This is very misleading and surprising that a physician would make such a mistake. It seems that he only had Medicare Part A, which is not alone really health
by tempsy 7y ago
This is very misleading and surprising that a physician would make such a mistake.
It seems that he only had Medicare Part A, which is not alone really health insurance it is strictly for hospitalizations and has no premium. I think of it more like catastrophic insurance.
Medicare Part B is actually health insurance and requires a premium. He casually mentions that he didn’t have Part B but unclear why.
The 20% coinsurance he paid is what you’d pay under Part B, and unclear what other insurance he has, but for a high earner you should always buy Medigap which reduces the 20% since like in this example can still be thousands of dollars.
- zaroth 7y agoIn fact he admits that he has a Blue Cross plan (probably a sort of Medicare Advantage plan) that covered 80% of the bill. But it’s obscured by the headline and the long rant preceding the admission. > I wasn’t enrolled in Part B, but did have Blue Cross/Blue Shield supplemental insurance, which required me to pay 20% of the allowable hospital and surgical charges.
- deleted 7y ago[deleted]
- tempsy 7y agoNot sure what this means. Medigap is supplemental insurance that reduces the 20% coinsurance responsibility. If he didn’t have Part B then he couldn’t have bought this. Medicare Advantage is just A+B from a private insurance company.
- disabled 7y agoExactly. He made a big mistake. I suspect that he did not elect to have Medicare Part B, as he likely had private, employer-based insurance, which did not require him to. Usually the Medicare Part B premium is around $135/month. He was being penny-wise and dollar foolish, as Medicare Part B covers 80% of doctor's visits, outpatient care, medical supplies, etc. He probably would not need a Medigap plan, which covers the remaining 20% of Part B expenses, if he had employer-based insurance as creditable coverage. He really should have known that Medicare is relegating certain hospitalizations to Part B. This is very common and not new news. However, the rules involved with it, from the ER to the actual floor, are really strange and take a lot of time to understand. Yeah, you have to know and understand a ton of ridiculous rules prior to going on to Medicare. It is an unbelievable waste of time. Then, once you are on Medicare, you have to continue to keep a look-out of what is going on, including investigating certain rules, as things frequently change. He has my sympathies as this sort of situation should never exist in a developed, civilized country, like the United States. But, he made a series of mistakes, passively mostly, which got him in to this situation.
- rayiner 7y ago> He has my sympathies as this sort of situation should never exist in a developed, civilized country, like the United States. Some how nearly everyone in France manages to deal with buying top-up insurance for the 20-30% of medical costs the national health insurance doesn’t cover. This isn’t a uniquely American thing.
- refurb 7y agoAs someone who has experienced a single payer system, it entertains me to no end what Americans think it’s actually like.
- rayiner 7y agoIt should be noted that this sort of coverage is not some sort of weird American thing. In France, for example, the government insurance only pays 80% of hospital visits. Everyone signs up for private supplemental insurance to cover the gap.
- tempsy 7y agoIt sounds like he’s employed, which is why he probably didn’t buy B, but if his private insurance plan still makes him pay 20% coinsurance for this then it’s a really bad plan and he should’ve just bought Part B + Medigap.