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Posted by Avrum Lapin on December 22, 2009, 12:16 pm
In article
> My mom turned 64 last year and was eligible for Medicare. She
> continues to work for a really small employer.
>
> In prior years she paid around $350/mo for insurance just for herself
> every month through her employer. I don't know the details of her plan
> but in prior years had used medical benefits and even Hosiptial and
> only paid a small co-pay.
>
> Recently, and possibly ill advised, she opted to use her employer's
> United medical plan as Part-B. She did not know this, but the plan
> changed and she has a really high deductable .. like $4000 now.
>
> She had a colonoscopy and is now getting a bill for around $3500.
> United is saying it falls under her deductable, and Medicare is saying
> her employer coverage must come first... Say what??? Does this make
> any sense, what's the point of Part-B if coverage would be better
> without it?
>
> Another stupid thing is that the company owner who is also covered has
> no deductible.
>
> Medicare says if her employer has less than 20 covered they will cover
> the deductible or first.. and while it appears her employer has only 9
> covered, many of the employers ownership and family might be covered
> as well.
>
> Does this make any sense?
I see problems here.
If your mother is under 65 why would medicare be involved?
How can she have a part B if she is not in Medicare.
Was your mother offered a no deductible plan.
The $3500 for a colonoscopy is way too much. The medicare approved
payment for my combined colonoscopy and endoscope was $1100. The
hospital took the biggest haircut bulling $3045 and getting only $642
for use of the day surgery facilities. Room for negotiation.
I suggest that if Medicare is really involved that your mom (perhaps
with you accompaning her) seek no cost help from a SHIP counsellor (call
1-800-MEDICARE) for the toll free number in her state.
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