Medicare - Part A Deductible

[LainieG 132]

How are some of your doctors or how are you handling the deductible for Part A Medicare

Thanks

LainieG

[LainieG 132]

I failed to say if you have not met your deductible do they require you to pay it before surgery. I am thinking not but no surprises. I do not start getting medicare until October 1. I have some test in October so I think they will be enough to cover.

[#9grammy 274]

I have Tricare as secondary but they don't cover the sleeve, so up to me to pay. I was told about 1800. but might be more. I don't have to pay anything for my other test and doctors seeing the Tricare will kick in for that.

Might be my doctor wanting 6 months nutrition , I will find out when I get back from vacation. Up in WI for few days seeing my others mother. Oh and yes I have to pay up front for hospital costs.

[Jersrose43 837]

Medicare part a deductible works a little differently than most commercial insurance

The part a deductible is not a yearly amount that you meet and are done. It is charged when you seek inpatient hospital care. And it is charged every hospitalization but if you have multiple withinf 90 days it is charged only once. You have per day copays as well that are high.

It is really important to have good supplemental insurance. A medigap plan. Or consider a medicare advantage plan which is medicare administered by a private commercial payer such as aarp/united bcbs etc

Your part b deductible is met once a year by your docs and renews every January.

Confirm with your doctor if you are going to be inpatient or outpatient classified. It's a huge financial difference for you. Please look into it before the surgery. Pm me if you need help.

[Jersrose43 837]

Lainieg I just noticed on a prior post you have Medicaid currently. You need to keep it. Make sure you meet guidelines for both the federal medicare program and your states Medicaid program and you should be covered in full.

You must meet both sets of requirements though

[LainieG 132]

I am going to a seminar tonight that I should have attended some time back. I am sure that I will find out more information there, or I hope so. Medicaid has proven not to be helpful for me at all. I have a spend down of 1097.00 per month,, which I have only met 3 times in the last year. I have had it for 3 years but with my medical issues and having leukemia I was able to meet. But the last year my visits to doctors and the hospital has greatly reduced, which is a great thing, but not if I have to rely on medicaid. I am still going to get a supplemental, hoping that I can drop the medicaid.

I have another seminar next week called Medicare Boot Camp. It should help me understand this better so I can proceed. I am afraid that I have not done a very good job at checking into everything. I have to have work done on my teeth and it took me a year to save 2600 to get them done. The chemo destroyed my teeth so bad that I had to get upper dentures and now lower.

I just have a bad feeling that my surgery is not going to happen as I had hoped. I have a feeling it is going to be put off due to financial reasons.

Kind of bummed right now, but maybe tonight will help and give me good news.

Thanks for all who replied, very helpful,

Lainie

[Jersrose43 837]

You have to call or go online with medicare.gov

You may qualify for financial assistance they can assist you. At least with prescription coverage through part d for sure.

The medicare supplemental plan will cover copays for those items medicare holds you liable for.

Additionally if you decide to go with a medicare advantage plan and qualify for federal subsidies based on your income, they can pick up any premium costs for those plans.

I hope that helps

[LainieG 132]

So I go to the seminar last night so I find out about insurance. The office tells me it last an hour or so. They had not gotten to the insurance after and hour and a half and I had to leave as I had a ride waiting for me. Needless to say I was ticked off. Guess I will find out hopefully next week at the medicare boot camp.

Tell me, if anyone knows.....I currently am on Medicaid (Mo Healthnet). Will begin Medicare on October 1st. Will I keep medicaid as my secondary (medi-gap) ? I have a spend down with medicaid of over 1000.00 per month. If I have the surgery, I am assuming that Medicare will pay and medicaid will pick up the rest since the spend down was met. But it still appears that somewhere I am going to have to dish out $1000.00 (to the hospital). I would ask Medicaid but they are as confused about their program than me. I talked to 2 different people when I went on Medicaid, no we don't cover WLS. Finally got hold of someone who knew, yes we do !! They have a lot to learn.

So confused

[Jersrose43 837]

I think you have to find out if you qualify to continue receiving the Medicaid. Again check out medicare.gov and see if you qualify for programs there to pick up costs as well due to limited income.