topic Re: Medicare Question in Community Chat

Medicare Question

rms1954 — Tue, 26 Jul 2022 00:22:10 GMT

I've been on Medicare for some time and was never charged a co-pay. Today I had to had blood work done. I do this every week. Went today and they said I owed a co-pay of $25. I asked her why because I never paid a copay before, not any of the previous times and there have been MANY. All she kept saying was "things change." I get so confused with all this health insurance stuff.

Re: Medicare Question

gidgetgh — Tue, 26 Jul 2022 00:28:11 GMT

@rms1954 - what Medicare coverage do you have?

Traditional Medicare plus a supplement like F, G or N?

Or do you have a Medicare Advantage Plan instead of traditional Medicare and a supplement?

Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 01:01:30 GMT

@gidgetgh wrote:
@rms1954 - what Medicare coverage do you have?

Traditional Medicare plus a supplement like F, G or N?

Or do you have a Medicare Advantage Plan instead of traditional Medicare and a supplement?

Traditional Medicare.

Re: Medicare Question

KailaS — Tue, 26 Jul 2022 01:15:41 GMT

@rms1954

Do you have a supplemental plan along with traditional Medicare?

Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 01:37:43 GMT

@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?

No supplement. Just traditional.

Re: Medicare Question

gidgetgh — Tue, 26 Jul 2022 01:43:33 GMT

@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?

Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 01:46:38 GMT

@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?

I don't need to show my card cuz my info is in the computer. This has never come up before.

Re: Medicare Question

gidgetgh — Tue, 26 Jul 2022 01:48:15 GMT

@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?
I don't need to show my card cuz my info is in the computer. This has never come up before.

@rms1954 - ok, I'm really trying to help you here. If you were to go to a new doctor, for the first time, what card would you give that doctor?

Re: Medicare Question

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Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 02:01:47 GMT

@gidgetgh wrote:
@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?
I don't need to show my card cuz my info is in the computer. This has never come up before.

@rms1954 - ok, I'm really trying to help you here. If you were to go to a new doctor, for the first time, what card would you give that doctor?

My Medicare card.

Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 02:10:13 GMT

@gidgetgh wrote:
@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?
I don't need to show my card cuz my info is in the computer. This has never come up before.

@rms1954 - ok, I'm really trying to help you here. If you were to go to a new doctor, for the first time, what card would you give that doctor?

Sorry not trying to be difficult. I appreciate your help. I'm trying to understand all this. I am not feeling well either.

Re: Medicare Question

shoesnbags — Tue, 26 Jul 2022 02:36:22 GMT

@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?
I don't need to show my card cuz my info is in the computer. This has never come up before.

@rms1954 - ok, I'm really trying to help you here. If you were to go to a new doctor, for the first time, what card would you give that doctor?
Sorry not trying to be difficult. I appreciate your help. I'm trying to understand all this. I am not feeling well either.

@rms1954

She's asking if you hand over one card or two cards when you see a new medical person. For example, I have Medicare with a supplement, so I have to show my original Medicare Card and my supplement card in any new medical office.

Re: Medicare Question

rms1954 — Tue, 26 Jul 2022 02:52:58 GMT

@shoesnbags wrote:
@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@gidgetgh wrote:
@rms1954 wrote:
@KailaS wrote:
@rms1954
Do you have a supplemental plan along with traditional Medicare?
No supplement. Just traditional.

@rms1954 - if you have only Medicare A and B, with no supplemental coverage at all, Medicare pays 80% and you are responsible for the rest, the remaining 20%. Are you sure that is what you have? That doesn't sound right to me. Are you sure you don't have an Advantage Plan?

When you go to the doctor, which card do you give them?
I don't need to show my card cuz my info is in the computer. This has never come up before.

@rms1954 - ok, I'm really trying to help you here. If you were to go to a new doctor, for the first time, what card would you give that doctor?
Sorry not trying to be difficult. I appreciate your help. I'm trying to understand all this. I am not feeling well either.
@rms1954
She's asking if you hand over one card or two cards when you see a new medical person. For example, I have Medicare with a supplement, so I have to show my original Medicare Card and my supplement card in any new medical office.

No supplement card. Just my medicare card. I keep answering the same thing. I have Part A and Part B.

Re: Medicare Question

elated — Tue, 26 Jul 2022 03:40:47 GMT

I am with United Healthcare and just show them this card. Do you belong to a plan, i.e. Blue Cross, Aetna etc. When I first went on Medicare I had Aetna. Which group do you have? That plan determines what your copays are or not. I hope I am making this clear. Do you need referrals before you go to a specialist? It could be an HMO Advantage Plan. If not, you could have a PPO plan that requires no referrals.

Do you have a card that shows what plan you are on? If so, you can call the customer service and they will help you. Medicare offers A and B. If you want more coverage, than you choose an insurance in your area that works with Medicare. That plan offers more benefits with or without co-pays. Hope this helps.

If you need more information go to medicare.gov.

Re: Medicare Question

shoesnbags — Tue, 26 Jul 2022 04:30:12 GMT

@rms1954

The reason we're confused is that if you've had just Medicare, not an Advantage plan and no supplement, you would have been paying a 20% co pay all along. Because Medicare by itself just pays 80% of the bill. So something is missing in your understanding of what's going on, and people here are trying to help you figure out what it is.

Re: Medicare Question

paixmcdao — Tue, 26 Jul 2022 09:38:46 GMT

Weren't you recently hospitalized after falling and hitting your head? How much of your stay was covered by Medicare?

1-800-633-4227 1-800-MEDICARE

Re: Medicare Question

millieshops — Tue, 26 Jul 2022 09:52:31 GMT

@rms1954 When I had just traditional Medicare A & B, the number on my card was my social security plus a letter. My insurance was changed to an advantage plan and now the number on my card is not my social security number.

Look at the number on the card you would give to a new doctor or look at the number of one of your recent monthly reports. If the number is not your SS, I believe you have an advantage plan of some type. If so, you most likely can call the company.

Re: Medicare Question

gidgetgh — Tue, 26 Jul 2022 09:53:58 GMT

@millieshops wrote:
@rms1954 When I had just traditional Medicare A & B, the number on my card was my social security plus a letter. My insurance was changed to an advantage plan and now the number on my card is not my social security number.

Look at the number on the card you would give to a new doctor or look at the number of one of your recent monthly reports. If the number is not your SS, I believe you have an advantage plan of some type. If so, you most likely can call the company.

@millieshops - I believe ALL Medicare numbers were changed to non social security numbers.

Re: Medicare Question

millieshops — Tue, 26 Jul 2022 10:09:04 GMT

@gidgetgh I believe you're right. Thanks for the correction.

@rms1954 But I still believe you need to find your card and see if there are phpne numbers on it because if this is truly the first time you've been asked for a co-pay, I'd want to know why, too.

Re: Medicare Question

aroc3435 — Tue, 26 Jul 2022 15:41:23 GMT

@rms1954 "Things change" would not be an acceptable answer for me. Is the woman who said this the receptionist or the one who handles the accounting end of things in the office.

You will get a statement in the mail since you had to make a co-payment which will have codes on it for the procedure. Compare it to earlier statements for the same work to see if there is a change.

Then I would go back to the doctor's office, papers in hand, and ask what PRECISELY has changed. Is it no longer a procedure REQUIRED by your physician?

If this is a legitimate change for a procedure you get weekly you need to adjust your budget to cover this outlay from you pocket and you need to know why. Did the office make a mistake by NOT charging the co-pay for prior weeks? Did Medicare change a policy with respect to this procedure?

Medical charges and statements and billing are usually confusing. And there are mistakes made in the codes used in billing Medicare or other insurance carriers.

It gets even MORE complicated when hospitalization is involved--in OR outpatient.

There is a great, concise, clearly written book--Never Pay the First Bill--by Marshall Allen that is a real eye opener concerning medical procedures and billing and all the medical system's quirks. I highly recommend it.

Hope you feel better and that you get better information from someone more competent and professional in that office.

aroc3435

Washington, DC