Community Chat

[Jordan2]

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@LTT1 wrote:

@Jordan2

It IS so frustrating I agree with you!

i am so sorry this happened to you

It happened to me many, many years ago and I was with a major health insurer through my employer. 

The doctor I went to was an ENT who would be doing surgery.

Got to the office and "oh, by the way, we no longer accept your insurance so that will be $3000!  Hmmm sure WON'T lol !

I hope you will be able to get everything re-scheduled. (((Hugs)))

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@LTT1,thank you! About 3 years ago I picked a plan which I was assured was accepted by my gynecologist. I go to my appointment sitting there for 45 minutes or more, practically begging them to take my insurance information. I finally get called up to the desk, she tells me "oh this card has letters, we don't take this one"! I was so embarrassed because everyone heard, I was turned away. The thing is the doctor is oblivious to what goes on at the front desk, she probably never missed me!

[LTT1]

@Jordan2@Cakers3@Spurt@CalminHeart@151949

We are on Medicare, but not straight Medicare.

(AARP Secure Horizons)

If we had been on a PPO, my Opthalmologist would have accepted it for my annual checkup last week.

Her office manager gave me a piece of paper listing the ones they accept.

This list will undoubtedly change, so it will need to be updated by me before I count on coverage.

You might let the doctor know you were embarrassed by the way you were treated @Jordan2.

He has the most "pull" usually.

[Lali1]

Nothing free is ever great is right but some people just love free. Just wait until we have single payer and see how well they like it when they or someone they love gets sick and needs care. I need health insurance and I pay for every dime of mine on my own. I prefer to do that than to get free and not have my insulin pump covered and all the others stuff I want and need to care for my Type 1 Diabetes. People haven't a clue what they're pushing for. 

[Cakers3]

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@LTT1 wrote:

@Jordan2@Cakers3@Spurt@CalminHeart@151949

We are on Medicare, but not straight Medicare.

(AARP Secure Horizons)

If we had been on a PPO, my Opthalmologist would have accepted it for my annual checkup last week.

Her office manager gave me a piece of paper listing the ones they accept.

This list will undoubtedly change, so it will need to be updated by me before I count on coverage.

You might let the doctor know you were embarrassed by the way you were treated @Jordan2.

He has the most "pull" usually.

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@LTT1  Always call and verify with your insurance and with the doctor before your appt.  Many times we hear as long as the physician takes Medicare they will take your additional plan.  That simply isn't true.

It can be a hassle sometimes but it's true that things do change throughout the year.

When did health insurance get so complicated??????  jmo

[151949]

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@Cakers3 wrote:

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@151949 wrote:

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@Lindsays Grandma wrote:

I have Medicare A and B plus Aetna

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@Cakers3 wrote:

@momtochloe  Good luck.  I pay more for my Medicare than DH does because he is older than I am and had Medicare before I did.  We did get an increase in premiums but he is still paying less than I am and his SS is higher than mine.  Go figure.

We are concerned where our Advantage plan will go come the next open enrollment.

RIght now we are content but still have to go round and round to get definite answers on some things. 

I've heard people going just straight Medicare and picking up drug plans but crikey those are expensive when they stand alone.  I'm not sure if straight Medicare is the right way to go, either.

Thank goodness DS has military coverage. 

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Plan F as my supplement.  Every year Aetna increased my premium by no less than $25 and currently I am paying $196/mo.  My daughter can't believe it costs me so much and I'm not thrilled either.  In 2014 I had cataract surgery on both eyes and 2015 fell and broke my hip requiring surgery, one month in rehab and six months of home physical therapy.  If I did not have the supplement I don't know how I would have afforded the cost left over Medicare didn't pay.  As it stands I did not have to pay one penny.  Please think long and hard about having straight Medicare with no supplement.

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We have an advantage plan - pay zero premium per month - my DH just had surgery this spring for removal of a small cancerous polyp found when he had his colonscopy. He paid 2 nights co pay - $600 and that was all.He had previously paid some copays to the surgicenter where they did the colonscopy but that was refunded. We are - all in all - satisfied with our advantage plan. 

DH also had some skin cancers removed at the derm office - all paid 100%.

I had a fall last week and had to go to the ER. I called my ins co customer service # first to see what hospital would be in network - because I called first and wewent to the hospital they suggested they reduced the copay 15% from $75 down to $63.75.

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@151949  Correct me if I am wrong but isn't your advantage plan an HMO?  Our ins. also offers a $0 premium BUT it is an HMO and many doctors have been dropping out of HMO plans.  They will keep established patients but not accept new ones.

Our advantage plan is good with a very small premium but it is a PPO, which allows more flexibility in OUR area to choose physicians and specialists.

It all depends upon where you live.

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Actually, HMO , PPO or POS are all available no premium plans from our insurer.We have CHOSEN to have the HMO. WE have had no difficulty at all with the doctors we have seen within our network, or with finding a doctor within our network.

[151949]

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@Lali1 wrote:

Nothing free is ever great is right but some people just love free. Just wait until we have single payer and see how well they like it when they or someone they love gets sick and needs care. I need health insurance and I pay for every dime of mine on my own. I prefer to do that than to get free and not have my insulin pump covered and all the others stuff I want and need to care for my Type 1 Diabetes. People haven't a clue what they're pushing for. 

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You don't have any idea if anything said here is true. Just a whole lot of fear mongering.

[Drythe]

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@Lali1 wrote:

Nothing free is ever great is right but some people just love free. Just wait until we have single payer and see how well they like it when they or someone they love gets sick and needs care. I need health insurance and I pay for every dime of mine on my own. I prefer to do that than to get free and not have my insulin pump covered and all the others stuff I want and need to care for my Type 1 Diabetes. People haven't a clue what they're pushing for. 

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@Lali1

Who are 'they' you are speaking of?  Obviously not yourself.  Affordable and Free are not the same.  It's great for you that you can pay for every dime of your own, however many people work long hard jobs in this country and still can't afford health care.  Lucky You.

[Lali1]

• That's what Medicade is for. Changing the whole insurance system to single payer will not be a good thing. I'm not rich by any means but I need good care more than the average person who does not have a disease for the rest of their life. If the Aca is so fabulous why aren't all the politicians pushing it on it? Too many people want free health care, free college free everything they think they deserve while not looking at how well it works in other countries. 

[Drythe]

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@Lali1 wrote:

• That's what Medicade is for. Changing the whole insurance system to single payer will not be a good thing. I'm not rich by any means but I need good care more than the average person who does not have a disease for the rest of their life. If the Aca is so fabulous why aren't all the politicians pushing it on it? Too many people want free health care, free college free everything they think they deserve while not looking at how well it works in other countries. 

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@Lali1

It might be interesting to know your sources about single payer systems  - I have lived twice with one.  And you?

I can't imagine what makes you think you 'need good care more than the average person'. You are far from the only one here with a lifetime disease (or 2), some life threatening.  I'd say everyone deaerves good health care.

I don't think I'll gain much from further conversation.