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Honored Contributor
Posts: 13,593
Registered: ‎10-25-2010

Re: Medicare Open Enrollmentt

First, those annoying calls from insurance brokers are illegal.  They are allowed to send info by mail and only call you if you send a card back asking for more info or call them first.

 

Second, physicals are not covered by Medicare ( though some Advantage Plans could cover them). 

 

Wellness exams do not cover much..mostly the doctor asks questions, but if you have a preexisting condition like diabetes, high blood pressure or a history or headaches, the doctor can order tests and use the preX diagnosis on the claim to get it to process for payment and often they will code the claim as a follow-up visit to check Meds, etc.

Honored Contributor
Posts: 34,520
Registered: ‎06-11-2011

Re: Medicare Open Enrollmentt

[ Edited ]

@CARMIE wrote:

First, those annoying calls from insurance brokers are illegal.  They are allowed to send info by mail and only call you if you send a card back asking for more info or call them first.

 

Second, physicals are not covered by Medicare ( though some Advantage Plans could cover them). 

 

Wellness exams do not cover much..mostly the doctor asks questions, but if you have a preexisting condition like diabetes, high blood pressure or a history or headaches, the doctor can order tests and use the preX diagnosis on the claim to get it to process for payment and often they will code the claim as a follow-up visit to check Meds, etc.


@CARMIE  Yes in my OP I wrote Medicare does not cover a physical exam. And I wrote I have Medigap (not an Advantage plan) yet Ove had a physical every year that has been covered. Hence the 3explanation for it is the one I've given above.

 

ETA Some Medigap programs offer "extras" in coverage but mine from Anthem whom I called this a.m does not so my Medigap wasn't what covered it).

Respected Contributor
Posts: 4,592
Registered: ‎03-10-2010

Re: Medicare Open Enrollmentt

As a Federal retiree, obviously I kept my BCBS as supplemental.  Its extraordinary; DH has had many health challenges (cardiac and spinal) and we've never paid anything (other than low prescription co pay ).  Couldn't be happier!

Trusted Contributor
Posts: 1,937
Registered: ‎10-07-2013

Re: Medicare Open Enrollment

@Pearley The last "physical exam" I had was a pre-op exam for Cataract Surgery.  Prior to that, I can't remember the last one I had.  Medicare does cover a "Wellness Exam"; haven't had one of those either in ages.  My doctors treat me for symptoms as needed.

Honored Contributor
Posts: 13,593
Registered: ‎10-25-2010

Re: Medicare Open Enrollment

@Pearley   You might think you are having a physical exam every year, but your doctor is not billing for a physical exam.

 

My bet would be a follow up exam for a condition you have and a med check.  Some people do this once a year, for others it is every 3,4 or 6 months depending on their health history.

 

Honored Contributor
Posts: 34,520
Registered: ‎06-11-2011

Re: Medicare Open Enrollment


@CARMIE wrote:

@Pearley   You might think you are having a physical exam every year, but your doctor is not billing for a physical exam.

 

My bet would be a follow up exam for a condition you have and a med check.  Some people do this once a year, for others it is every 3,4 or 6 months depending on their health history.

 


@CARMIE  Exactly. you are saying in a different way what I stated earlier about the coding.

Honored Contributor
Posts: 20,559
Registered: ‎03-10-2010

Re: Medicare Open Enrollment

My husband  and I have a secondary insurance with Premera Blue Cross. We pay $850 a month for the two of us for that coverage With that we have yearly physicals....blood tests.. etc..... no silly wellness physical BS...

 

Medicare is our primary....but Blue cross kicks in and covers everything Medicare does not.

 

 I would not depend on Medicare.

Contributor
Posts: 21
Registered: ‎03-01-2013

Re: Medicare Open Enrollmentt

[ Edited ]

I have had United health care supplement (medigap plan C) for over 10 years.  For 180.00 a month in addition to Medicare cost, I wouldn't think of changing plans either.  No bothering with networks, CO pays Co insurance, deductibles. Out of pocket anything.  Even though I'm disabled, I only go for Dr visits once or twice a month, the 180.00 more than pays for itself within one visit, for the year.  I've had this discussion with my parents so often, since they are older and go to drs multiple times a week between them.  They spend a fortune with all these co-pays etc, I get nervous if one of them had to go in the hospital, what would cost me nothing, would cost them so much. I know they think they're saving money not paying a monthly bill, but in reality they would pay much more with an advantage plan, in the end.  I have never paid a cent in 10+ years, have had multiple surgeries, been hospitalized many many times, except my monthly payment, which I build into my budget.  I don't like surprises that could put me in debt for years.  I'm with you, I'm very happy with my plan! 

Honored Contributor
Posts: 34,520
Registered: ‎06-11-2011

Re: Medicare Open Enrollmentt

[ Edited ]

@curled up in bed. I agree with you. I have the most coverage possible(and most expensive) with Anthem's Medigap Plan F which isn't even offered any more to those going on Medicare after  Jan 1 of 2020. It even pays my Part B deductible for me every year. I'm healthy so I knew I wouldn't be breaking even on it for a while (which I haven't on medical costs each year) but don't care. I want the best possible insurance that allows me to go to any doctor or hospital anywhere that takes medicare and I don't pay anything.

Esteemed Contributor
Posts: 6,472
Registered: ‎03-10-2010

Re: Medicare Open Enrollment

I started checking different companies very early this year, way before we really had to.  And then it hit me, I stopped looking, stopped checking because it got to be too much.  I have my Aetna supplement which I am keeping and yes, it has gone up to $305 a month.  I am also keeping my BCBS Prescription plan and that's it.   I hate that they do this to us every year.                                                                                                                                                                                                                                                                                                           

The moving finger writes; And having writ, Moves on: nor all your Piety nor Wit Shall lure it back to cancel half a Line Nor all your Tears Wash out a Word of it. Omar Khayam