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lillypaddle

(9,581 posts)
Thu Aug 16, 2012, 12:46 PM Aug 2012

Guess what I got in the mail today?

My Medicare card, effective 12/01/12! Instead of making me feel old, I feel nothing but grateful. I'll no longer have to pay $640 a month for insurance through BC/BS, I'll be paying $99 a month.

I only hope Medicare will be there for my son and his wife when they reach my age, and for all other Americans, too. We can't let Medicare and Social Security be gutted!

74 replies = new reply since forum marked as read
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Guess what I got in the mail today? (Original Post) lillypaddle Aug 2012 OP
Phew! Glad that you have it now. That must be a stress reliever, for sure! *hugs* I also GreenPartyVoter Aug 2012 #1
I finally got mine recently, too Warpy Aug 2012 #18
I agree. It should cover everything. GreenPartyVoter Aug 2012 #19
I start next year and am already getting junk phone calls Kingofalldems Aug 2012 #2
They enrolled me automatically lillypaddle Aug 2012 #12
They will send you a form. dixiegrrrrl Aug 2012 #26
What happens with my private insurance? Kingofalldems Aug 2012 #28
You'll have to keep buying insurance for her...but it will be much cheaper! Auntie Bush Aug 2012 #34
Thanks for the info Kingofalldems Aug 2012 #36
Re: 10% penalty beveeheart Aug 2012 #38
Thank you for the easy ChazII Aug 2012 #67
Welcome... dixiegrrrrl Aug 2012 #70
Contact AARP. Brigid Aug 2012 #52
Breathe deeply, xxqqqzme Aug 2012 #3
Good advice lillypaddle Aug 2012 #13
Well you have it for now Pakid Aug 2012 #4
I (at 50 years of age) am bothered by that $99/month you still have to pay. ieoeja Aug 2012 #5
Well, I've been on Medicare for awhile, and I believe that's the premium for Medicare B. classof56 Aug 2012 #6
What's the supplemental and cost? ErikJ Aug 2012 #8
This message was self-deleted by its author druidqueen Aug 2012 #9
Medicare supplementtal druidqueen Aug 2012 #10
Sorry about your husband's condition. ErikJ Aug 2012 #29
I don't know if it was always there or not ($99) lillypaddle Aug 2012 #15
The part B premium has always been there. dixiegrrrrl Aug 2012 #30
You'd better get on the ball and call BCBS back! Tracer Aug 2012 #7
My Medicare goes into effect 09/01/2012! I'm looking into supplementals snappyturtle Aug 2012 #11
Try the SHIP program for your state. Brigid Aug 2012 #53
Thank you! I haven't tried the SHIP site.....will do that! nt snappyturtle Aug 2012 #65
No, for now I'll think I'll pass lillypaddle Aug 2012 #16
Congrats for living long enough to collect. alfredo Aug 2012 #14
Why do you think I took early retirement? lillypaddle Aug 2012 #17
Ha! alfredo Aug 2012 #57
I am so jealous - I have 2 years to go and hope I can last that long rurallib Aug 2012 #20
I'm not on Medicare, but I recieved something regarding medical loss ratio information. muntrv Aug 2012 #21
On Tuesday I got a mailing from my health insurance SheilaT Aug 2012 #22
As you get closer to 65, the multiple "offers" of supplemental insurance will start to hit your sad sally Aug 2012 #39
I have avoided AARP so far, so I won't be getting too much from them. SheilaT Aug 2012 #68
How old do you have to be to apply for Medicare?? Major Hogwash Aug 2012 #23
Some answers to your questions. flpoljunkie Aug 2012 #31
Age of applciation depends dixiegrrrrl Aug 2012 #32
Both great answers, thanks. Major Hogwash Aug 2012 #45
FWIW... dixiegrrrrl Aug 2012 #46
So, even if I work until 67-68 yrs old and have health insurance thru employer, I should apply for txwhitedove Aug 2012 #47
Hmmmm...good question. dixiegrrrrl Aug 2012 #48
First answer direct from AARP: "Most people enroll in Medicare Part A (hospital insurance) and txwhitedove Aug 2012 #62
I have had my Medicare card since I was 25. Panasonic Aug 2012 #24
I've had it a year now. marew Aug 2012 #25
. Liberal_in_LA Aug 2012 #27
I got mine a couple of years ago. MineralMan Aug 2012 #33
Thank you for reminding us the system works :0) DonRedwood Aug 2012 #35
let's hope it KEEPS working lillypaddle Aug 2012 #42
This message was self-deleted by its author BOG PERSON Aug 2012 #37
Really? You think that's a good idea? Cleita Aug 2012 #41
This message was self-deleted by its author BOG PERSON Aug 2012 #44
You will have to pay a little more because you are going to need Cleita Aug 2012 #40
If you have no insurance now & only want the free part of Medicare indefinitely can that be done@65? lunasun Aug 2012 #49
Really poor people can get Medicaid to supplement Cleita Aug 2012 #50
So much good lillypaddle Aug 2012 #43
So explain to me..please. What's the $99 for? Is that for Part B coverage? hlthe2b Aug 2012 #51
My Wellpoint supplemental offers vision & dental for additional $25. month NT julian09 Aug 2012 #54
The $99 is a premium for Medicare Part B. Brigid Aug 2012 #55
I just hope that if you're covered by Medicare you're actually covered aint_no_life_nowhere Aug 2012 #56
Doesn't sound right to me. Does your mother have a Medicare advantage plan? Cleita Aug 2012 #59
No, she has only regular Medicare and Tricare for Life and should be fully covered aint_no_life_nowhere Aug 2012 #60
Still doesn't sound right to me. Cleita Aug 2012 #63
During my father in law's first year on Medicare, he contracted... reACTIONary Aug 2012 #58
I was relieved when I got mine.... WCGreen Aug 2012 #61
I was going to say Mitt Romney's tax returns LynneSin Aug 2012 #64
Congratulations! PatSeg Aug 2012 #66
congratulations brightertomorrow Aug 2012 #69
3 1/2 more years and hopefully I B Calm Aug 2012 #71
Yea for you! Gman Aug 2012 #72
Good for you, but your son and his wife will never know such a feeling. RagAss Aug 2012 #73
you made it!, congrats...it's like making it to the finish line for health Demonaut Aug 2012 #74

GreenPartyVoter

(72,381 posts)
1. Phew! Glad that you have it now. That must be a stress reliever, for sure! *hugs* I also
Thu Aug 16, 2012, 12:52 PM
Aug 2012

worry that it won't be there for my husband and myself in another 25 years. My parents didn't live long enough to use it. I fear that for many people, even with the ACA, this will be the case. Affordable healthcare is only useful if you have a job, and if Medicaid gets slashed (as many Repub governors want to do) then a lot more people will be doing without healthcare.

We shouldn't just worry about Ryan now. He's young and can show up again unless he's completely discredited and tossed aside, like Sarah Palin was.

Warpy

(111,339 posts)
18. I finally got mine recently, too
Thu Aug 16, 2012, 02:31 PM
Aug 2012

but dragged my feet on Part B because I resent even $99/month going to the insurance companies who left me completely out in the cold with no insurance for 26 years.

At least I now know hospitalization won't wipe me out and that I don't have to keep living in bare survival mode so I can save for the next disaster.

Kingofalldems

(38,476 posts)
2. I start next year and am already getting junk phone calls
Thu Aug 16, 2012, 12:56 PM
Aug 2012

about Medicare from God knows who. I actually don't know where to start re Medicare.

Also cannot believe I am this old!

lillypaddle

(9,581 posts)
12. They enrolled me automatically
Thu Aug 16, 2012, 02:25 PM
Aug 2012

in Part A & B. Don't know if it was automatic because I started drawing SS early, last December at 63. So really, all I really need to deal with is whether or not I want to get prescription drug benefits, and with whom. Don't know what it will cost. I'm still working part-time. I threw away all those mailers from insurance companies trying to sell me "Medi-gap" and other stuff.

dixiegrrrrl

(60,010 posts)
26. They will send you a form.
Thu Aug 16, 2012, 03:15 PM
Aug 2012

The form gives you a chance to check off which Medicare you want, Part A ( no premiums) and Part B
( premiums, around 100.00 monthly now, but goes up every year).
You will be covered 6 months after checking off the form, and any Part B premium is due then.
There are 2 enrollment periods, I think, one is "annual" and one is "special".
If you do NOT choose Part B at age 65, there is a 10% added monthly premium increase for EACH year you delayed enrolling.
I enrolled a year "late" and have to pay 109.00 a month instead of 99.00 a month.
Next year ( in Jan) if the premium increases ( it will) I will still pay the extra 10% "fine".
Part A has an annual deduct of 1500.00
and part B has annual deduct of 140.00 plus any co-pays.
Still a HUGE savings over private insurance.

Auntie Bush

(17,528 posts)
34. You'll have to keep buying insurance for her...but it will be much cheaper!
Thu Aug 16, 2012, 04:18 PM
Aug 2012

I don't know if it will be half price but it will defiantly be much cheaper and cover your cost for her. That's what my husband had to do for me too. That was the only BD I ever looked forward to. That was also the first time I confessed how old I was...and also the last time...he kept forgetting.

beveeheart

(1,370 posts)
38. Re: 10% penalty
Thu Aug 16, 2012, 04:45 PM
Aug 2012

I have to pay the penalty because I did not sign up within that "special period" after my COBRA insurance stopped. I was notified 3 DAYS after I would have still been eligible to sign up. I think the time frame for the special is either 3 or 6 months.

xxqqqzme

(14,887 posts)
3. Breathe deeply,
Thu Aug 16, 2012, 01:24 PM
Aug 2012

sit down and put your feet up for a few minutes. I know it feels good to get that card. I kept appealing my SS disability denials because I needed the Medicare card. Getting that card put money in my pocket.

Pakid

(478 posts)
4. Well you have it for now
Thu Aug 16, 2012, 01:44 PM
Aug 2012

If the two idiot on the Republican side win you may not have it for long. I don't believe them when they say anyone over 55 is safe it just a lie to help them steal the election. Once in power they will do the bidding of the rich They don't really care if they get reelected just as long as they get to screw over the American people for there rich pals!

 

ieoeja

(9,748 posts)
5. I (at 50 years of age) am bothered by that $99/month you still have to pay.
Thu Aug 16, 2012, 01:48 PM
Aug 2012

Was there always that hole in Medicare? Or was that created via cuts at some point during the 32yrs-and-counting Reagan Era?


classof56

(5,376 posts)
6. Well, I've been on Medicare for awhile, and I believe that's the premium for Medicare B.
Thu Aug 16, 2012, 01:58 PM
Aug 2012

Not sure if it's still optional, but must say it's more than worth it. My father (rest his soul) decided to opt out of Part B and when he passed away following a stroke and a long hospital stay, the charges that would have been covered had he had B were not fun to deal with. Pretty much wiped out his meager savings not to mention funeral expenses, since he only had a small life insurance policy. I've often wondered if he turned over in his grave, knowing how much it cost to get him there. Me, I pay the premium and have a supplemental as well. Grateful for the safety net, and honestly don't know what I'll do if they take it away and medical care is no longer an affordable option.

Obama/Biden 2012

Response to ErikJ (Reply #8)

druidqueen

(62 posts)
10. Medicare supplementtal
Thu Aug 16, 2012, 02:16 PM
Aug 2012

A supplemental policy pays what Medicare doesn't pay.....they pay the 20% that Medicare doesn't pay.. Also, you will need a medicare D policy from a private insurer to help pay for your prescriptions. My husband (who has lung cancer - both lungs, a serious heart condition and is in the late stages of emphysema) pays $208/month for the supplemental policy and $94/month is deducted from his monthly SS benefit for Medicare D. You can get cheaper policies (i.e. some Medicare D policies are as little as $30 or so, but you must check what drugs are covered. Medicare D policies vary to which drugs they will pay for, so if you are fairly healthy, you can probably get by with a less expensive Medicare D policy.

 

ErikJ

(6,335 posts)
29. Sorry about your husband's condition.
Thu Aug 16, 2012, 03:29 PM
Aug 2012

It all so sounds so complicated. Thanks to decades of Republican efforts to enrich their cronies and doom Medicare. That's one reason I'm working on emigrating.

lillypaddle

(9,581 posts)
15. I don't know if it was always there or not ($99)
Thu Aug 16, 2012, 02:28 PM
Aug 2012

but for hospital & medical coverage, I think it's a bargain. And when you combine it with some of the benefits, especially for seniors, included in ACA, it's even a bigger bargain.

On edit: Classof56 is correct. The hospital coverage (part A) is free. The $99 is for the medical (part B)

dixiegrrrrl

(60,010 posts)
30. The part B premium has always been there.
Thu Aug 16, 2012, 03:36 PM
Aug 2012

This year, at 99.00 a month, it is lower than last year.

The REAL hole in Medicare is Part D, the prescripton plan. That program was written by the drug companies.
Fortunately, there are a lot of generics available, whcih help.

Tracer

(2,769 posts)
7. You'd better get on the ball and call BCBS back!
Thu Aug 16, 2012, 02:01 PM
Aug 2012

Don't forget that you ought to get supplemental insurance.

snappyturtle

(14,656 posts)
11. My Medicare goes into effect 09/01/2012! I'm looking into supplementals
Thu Aug 16, 2012, 02:17 PM
Aug 2012

and it's not so confusing as voluminous! I think I understand that we have six months after Medicare goes into effect to pick up a supplemental without suffering any penalty. I'm looking for a supplemental (Medigap) policy that has drug coverage too as the Part D is ridulously expensive for me. I can get my drugs much cheaper without beig tied to part D. Does anyone know of a good supplemental with drug coverage plan "F"?

Brigid

(17,621 posts)
53. Try the SHIP program for your state.
Thu Aug 16, 2012, 08:49 PM
Aug 2012

That's the Senior Health Insurance Program. Each state has one. They help Medicare beneficiaries sort through supplemental policies, Medicare HMOs and replacement policies, and the like, to help you decide what's right for you. Find yours here:

http://www.workworld.org/wwwebhelp/state_health_insurance_assistance_program_ship_.htm

Oh, and www.medicare.gov too.

lillypaddle

(9,581 posts)
17. Why do you think I took early retirement?
Thu Aug 16, 2012, 02:30 PM
Aug 2012

Damn, I wanted to get at least something I paid in all these years!

rurallib

(62,448 posts)
20. I am so jealous - I have 2 years to go and hope I can last that long
Thu Aug 16, 2012, 02:49 PM
Aug 2012

my heartiest congrats!
My wife has medicare due to disability and she LOVES it.

muntrv

(14,505 posts)
21. I'm not on Medicare, but I recieved something regarding medical loss ratio information.
Thu Aug 16, 2012, 02:54 PM
Aug 2012

It says "You are receiving this notice because your health insurer had a Medical Loss Ratio for 2011 that met or exceeded the required Medical Loss Ratio." My insurer is Blue Cross Blue Shield.

 

SheilaT

(23,156 posts)
22. On Tuesday I got a mailing from my health insurance
Thu Aug 16, 2012, 02:58 PM
Aug 2012

(United Health Care) explaining that I need to start planning for Medicare and all the options connected to it. I'm turning 64 this month, still working, and I'm glad I have a year to figure it all out.

I take absolutely no prescription meds, so I probably should simply sign up for the absolutely cheapest policy so I have it, and then switch, if need be, to one that's better for me if I ever start needing to take anything.

I am also going to look carefully at getting into a Medicare Advantage Plan. I used to to registration at the hospital where I work, and I loved the older patients with the Advantage Plans, because they made life much simpler for us.

sad sally

(2,627 posts)
39. As you get closer to 65, the multiple "offers" of supplemental insurance will start to hit your
Thu Aug 16, 2012, 04:46 PM
Aug 2012

mail box, and if you're an AARP member the amount of stuff they send (sometimes the same brochures over and over) will mean at least a half-dozen trees will have been used to produce all that paper.

You might want to check out the changes to Medicare Advantage that the Affordable Care Act has phased in with a freeze in payments to MA plans that started in 2011. Before the ACA passed, MA plans were paid about 13% more than traditional Medicare programs, which meant the government (taxpayers) spent about $14 billion more than it would have if we (enrollees) had stayed in traditional Medicare programs rather than MA.

Medicare Advantage is still a good deal, and the ACA will slow the growth in future Medicare spending by reducing overpayments to private Medicare Advantage plans. Starting in 2014, 85% of MA plan revenues must go towards benefits, not profits, or plans may be subject to sanctions.

So much to "learn" at 65...

 

SheilaT

(23,156 posts)
68. I have avoided AARP so far, so I won't be getting too much from them.
Thu Aug 16, 2012, 10:57 PM
Aug 2012

However, all the hearing aid companies in the state know that I'm old enough that I might make a desirable customer!

Because I've always been amazingly healthy, and because I've always had pretty good insurance through various workplaces or from husband, I have absolutely no skills in negotiating this stuff.

I am under that vague impression that the Medicare Advantage programs are going to be phased out because they do cost more money. But I will be researching them. Since I work at a hospital, I might see if I can get the billing department to tell me which plans actually cover the most.

I am very appreciative that I'm getting a year to figure this out.

flpoljunkie

(26,184 posts)
31. Some answers to your questions.
Thu Aug 16, 2012, 03:44 PM
Aug 2012
Enrolling in Medicare - How Do I Sign up for Medicare Part A & B if I am close to age 65 and get or can get Social Security benefits?

You Already Get Social Security Benefits

You will not need to do anything. You will be automatically enrolled in Medicare Part A and Part B effective the month you are 65. For example, if your 65th birthday is February 20, 2001, your Medicare effective date would be February 1, 2001. (Note: if your birthday is on the 1st day of any month, Medicare Part A and Part B will be effective the 1st day of the prior month. For example, if your 65th birthday is February 1, 2001, your Medicare effective date would be January 1, 2001.) Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you do not want Medicare Part B, follow the instructions that come with the card. For complete information on enrollment see the Initial Enrollment Package section.

You Want To Apply for Both Social Security Retirement Benefits and Medicare

If you are close to age 65 and not yet getting Social Security benefits or Medicare, you can apply for both at the same time. To make sure that your Medicare Part B coverage start date is not delayed, you should apply three months before the month you turn 65. This is the beginning of your 7 month Initial Enrollment Period. If you wait until you are 65, or in the last 3 months of your Initial Enrollment Period, your Medicare Part B coverage start date will be delayed.

To apply, you can call or visit your local Social Security office or call Social Security at 1-800-772-1213. You can apply online (using the Internet) if you meet certain rules. To apply online, visit www.socialsecurity.gov. You must answer a series of questions that will tell if you can apply online. For example, you must be at least 61 years and 9 months old; plan to start receiving Social Security retirement benefits within the next 4 months; live in the United States or one of its territories/commonwealths; agree to get your Social Security benefits by direct deposit to your bank or other financial institution. You must answer some other questions as well.

You Do Not Yet Get Social Security Benefits and You Only Want To Apply for Medicare

If you are close to age 65 and not getting Social Security benefits, you must apply for Medicare. You can apply by calling or visiting your local Social Security office, or by calling Social Security at 1-800-772-1213. You should apply three months before the month you turn 65. This is the beginning of your 7 month Initial Enrollment Period. If you wait until you are 65, or in the last 3 months of your Initial Enrollment Period, your Medicare Part B coverage start date will be delayed. You currently cannot apply for Medicare only online (using the Internet).

http://www.medicare.gov/basics/socialsecurity.asp

dixiegrrrrl

(60,010 posts)
32. Age of applciation depends
Thu Aug 16, 2012, 03:47 PM
Aug 2012

If you retire, Medicare kicks in at age 65.
If you are on Soc. Sec. disability, it kicks in ..I think 2 years?...after going on disability, no matter how young you are.
When you turn 65, your disabilitypayments convert over to Soc Sec progarm payments, your Medicare is unchanged.

If you are getting Soc. Sec. the form will show up close to the time you are eligible.

You have to fill out a form...basicaily check one box...and return the form, they send it to you on the beginning of the annual enrollment date..mine came in Dec. There is only a 3 month enrollment period every year.

dixiegrrrrl

(60,010 posts)
46. FWIW...
Thu Aug 16, 2012, 07:33 PM
Aug 2012

I was surprised at how much "plain English" info. was on the web.
Faced with the daunting chore of "time to figure out Medicare" last year, Google really did come thru.
In fact, I found the Medicare code/billing book online and was able to convince the hospital we had been incorrectly billed.

txwhitedove

(3,929 posts)
47. So, even if I work until 67-68 yrs old and have health insurance thru employer, I should apply for
Thu Aug 16, 2012, 07:40 PM
Aug 2012

Medicare at age 65???

txwhitedove

(3,929 posts)
62. First answer direct from AARP: "Most people enroll in Medicare Part A (hospital insurance) and
Thu Aug 16, 2012, 09:36 PM
Aug 2012

Part B (doctor visits and other outpatient services) during their seven-month initial enrollment period (IEP) around the time they turn 65.

But you can delay enrolling in Part B beyond age 65 without penalty if you have group health insurance from an employer for whom you (or your spouse) are still working. When you retire and this coverage ends, you'll be entitled to an eight-month special enrollment period (SEP) to sign up for Part B without penalty.

This delay is permitted only for people working for companies or organizations that employ 20 or more workers. If you work for a smaller employer, you must enroll in Part A and Part B when you turn 65, and then Medicare pays claims first and your employer plan becomes your secondary insurance.

Medicare has strict enrollment rules that affect people differently according to their circumstances. (See "When Does the Part B Late Penalty Clock Start Ticking?&quot If you don't sign up within your initial enrollment period or a special enrollment period (whichever is appropriate to you), your monthly premium will permanently increase 10 percent for each 12-month period you were eligible but did not enroll."

Good to know I can keep my insurance through work and sign up upon actual retirement without penalty.

 

Panasonic

(2,921 posts)
24. I have had my Medicare card since I was 25.
Thu Aug 16, 2012, 03:10 PM
Aug 2012

Applied for disability due to deafness, and got it after I could not find work past 9/11.

I'm 36 and have been grateful for Medicare taking care of my recent broken foot.

(Still paying off - hospitalization due to unexpected complications)

marew

(1,588 posts)
25. I've had it a year now.
Thu Aug 16, 2012, 03:12 PM
Aug 2012

And, like you, I'd been paying over $600 a month for health care and I'm, fortunately, very healthy. I am outraged that the GOTP wants to take this away from those aged age 54 and younger after the decades so many of them have paid into it!
You are right! We cannot let this happen! In fact, I'll be at my local Obama campaign office shortly to do my best to make sure this DOES NOT happen!

MineralMan

(146,331 posts)
33. I got mine a couple of years ago.
Thu Aug 16, 2012, 03:48 PM
Aug 2012

Wouldn't you know it, though? I haven't been sick, so I haven't used it. I guess that's a good thing, though...

Response to lillypaddle (Original post)

Response to Cleita (Reply #41)

Cleita

(75,480 posts)
40. You will have to pay a little more because you are going to need
Thu Aug 16, 2012, 05:46 PM
Aug 2012

a supplemental insurance. It won't be that costly though and definitely not what you are paying now. But welcome to the club. I love my Medicare with a supplemental because I can go to any doctor I want and I have never been refused because of it, not like used to happen with my pre-Medicare PPD. I also don't have deductibles and co-pays with the supplemental.

lunasun

(21,646 posts)
49. If you have no insurance now & only want the free part of Medicare indefinitely can that be done@65?
Thu Aug 16, 2012, 08:11 PM
Aug 2012

I have friend whose turning 65 this yr but sez it will cost too much to get Medicare and is not applying at all.....couldnt tell him much since I did not know
maybe some one here does know if Medicare is avlbl to uninsured poor but working folk
in other words is part B forced on you at any future point?

Cleita

(75,480 posts)
50. Really poor people can get Medicaid to supplement
Thu Aug 16, 2012, 08:19 PM
Aug 2012

and pay for Medicare. It's not very good coverage though cuz it pays so poorly, many doctors won't accept it although county hospitals will.

lillypaddle

(9,581 posts)
43. So much good
Thu Aug 16, 2012, 06:01 PM
Aug 2012

and helpful information. Thanks to all for sharing their experiences!

Maybe we should have our own 65+ forum????

hlthe2b

(102,360 posts)
51. So explain to me..please. What's the $99 for? Is that for Part B coverage?
Thu Aug 16, 2012, 08:23 PM
Aug 2012

What will you do for dental coverage? I'm probably in that "screwed" age range--too young to be exempted from these extremist plans and too old to be able to do a damned thing about it if they do. But, I'd like to know what I might have a chance of reaping if we turn away these RW thugs.

Brigid

(17,621 posts)
55. The $99 is a premium for Medicare Part B.
Thu Aug 16, 2012, 08:56 PM
Aug 2012

Part B is for labs, doctor's visits, and the like. Part A is for hospitalization. See www.medicare.gov for more information.

aint_no_life_nowhere

(21,925 posts)
56. I just hope that if you're covered by Medicare you're actually covered
Thu Aug 16, 2012, 09:04 PM
Aug 2012

My mother of 92 years of age spent a month in the hospital and Medicare refused to cover some of the expenses. For example her doctor ordered her to spend two weeks rehabilitating at a nursing home after a life-threatening bout with pneumonia. An ambulance came to transfer her from the hospital to the nursing home. Medicare has refused to cover the ambulance despite the fact it was ordered by her doctor who provided a thorough statement to Medicare as to the medical necessity of the supervised transport. Now my mother is getting weekly bills of $800 from the ambulance company demanding payment. This is the second time this has happened regarding ambulance transport. In addition she's getting direct bills from radiology whose bills were denied by Medicare as duplicative services. This is killing me because she has both Medicare and Tricare and my dad suffered as a POW of the Germans during WWII and was a bronze star recipient in Vietnam and he earned the right to have his spouse fully covered. It makes me feel that even if you're told you have medical coverage you aren't really covered. Hell, if a crazy doctor ordered my mother to have a giraffe transported from Africa to her bedside as a therapy at a cost of $1 million she'd be liable it seems. She had no say in the nature of the treatment she received including the ambulance transport but there's nothing she can do if Medicare denies the claim except wait to be sued by the doctors, hire an attorney, and fight the bills in court. It makes me want to move to a country that keeps its promise to you that when you're covered, you're covered.

Cleita

(75,480 posts)
59. Doesn't sound right to me. Does your mother have a Medicare advantage plan?
Thu Aug 16, 2012, 09:16 PM
Aug 2012

Because they can refuse to pay on account of the fact your mother signed away her Medicare rights when she went with a private insurance Medicare advantage plan. Towards the end of his life, my husband had to go to the hospital in an ambulance several times a month. They never refused to pay, nor for an MRIs needed or other treatments and diagnostic tools or hospitalization. I'm on Medicare and have never been denied payment of a medical bill.

If she has Blue Cross or Secure Horizons or Humana, etc. she's screwed. Get her back on traditional Medicare the next time the annual re-enrollment period comes around, which is I believe in December.

aint_no_life_nowhere

(21,925 posts)
60. No, she has only regular Medicare and Tricare for Life and should be fully covered
Thu Aug 16, 2012, 09:23 PM
Aug 2012

She signed away no rights that I'm aware of. In fact she can't sign her name because she has Alzheimer's. A Medicare employee told me that lately they're especially cracking down on ambulance services and denying them much of the time.

reACTIONary

(5,771 posts)
58. During my father in law's first year on Medicare, he contracted...
Thu Aug 16, 2012, 09:14 PM
Aug 2012

... colon cancer. This was a real blow to him and the family, but Medicare was a big help. Without it the suffering for him and the family would have been much, much worse.

We had signed him up for the "supplemental" during that first year; during the first year it can be done without a physical and regardless of prior conditions. He would not have been able to sign up for this after the first year, given his condition.

Think about doing that, it can be a big help also.

(On second reading, I see that you did sign up for Part B. Good move, in my opinion!)

PatSeg

(47,589 posts)
66. Congratulations!
Thu Aug 16, 2012, 10:46 PM
Aug 2012

Until I got my Medicare card, I had no idea what an amazing program it is. Medicare was far better than any private insurance I've had in the past 15 years. They are helpful and efficient, surprisingly well organized. I was treated better in the hospital under Medicare than when I had United Healthcare.

brightertomorrow

(122 posts)
69. congratulations
Thu Aug 16, 2012, 11:30 PM
Aug 2012

So many people I know can't wait to get on medicare. It says a lot about private insurance in this country when people can hardly wait to get on medicare. Hope it will still be there when hubby & I get old enough. Happy for you. :-}

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