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Mondo Fuego
Do you get your monthly and quarterly Medicare statements?
Thu Jun 29, 2017 10:00am
68.114.135.59

They tell the whole story. They show what the health care provider billed Medicare and what Medicare paid. In most cases, Medicare pays from about 8% to 15% to the health care provider. You don't get billed for the difference that Medicare doesn't pay the hospital and other Part A services. You get billed for about 20% of what Medicare approves and pays for doctors and other Part B services, which can be covered with a supplemental plan from a private insurance company. You pay 100% of drug, dental and routine vision care unless you have private insurance paid by you.

We pay about $7,500 a year for health insurance, about half to Medicare for Part B, and the other for Plan B supplemental and Part D. We then pay dental and vision directly without insurance. Cornea replacement can cost $2,500 to $6,000 per eye. Dental can go thru the roof if you need anything other than cleaning and small fillings.

Medicare Part A covers most medically necessary hospital, skilled nursing facility, home health, and hospice care. It is free if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years); you will pay a monthly premium if you have worked and paid taxes for less time.

Part B (Medical Insurance) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. You pay a monthly premium for this coverage.

Medicare Part D (outpatient Prescription Drug Insurance) is the part of Medicare that provides outpatient prescription drug coverage. Part D is provided only through private insurance companies that have contracts with the government—it is never provided directly by the government (like Original Medicare is).

If you want Part D, you must choose Part D coverage that works with your Medicare health benefits. If you have Original Medicare, choose a stand-alone Part D plan (PDP).

Medicare Part C is not a separate benefit. Part C is the part of Medicare policy that allows private health insurance companies to provide Medicare benefits. These Medicare private health plans, such as HMOs and PPOs, are known as Medicare Advantage Plans. If you want, you can choose to get your Medicare coverage through a Medicare Advantage Plan instead of through Original Medicare.

Medicare Advantage Plans must offer at least the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs, and coverage restrictions. You also typically get Part D as part of your Medicare Advantage benefits package. Many different kinds of Medicare Advantage Plans are available. You may pay a monthly premium for this coverage, in addition to your Part B premium.

  • bills to the hospitals, etc. I have never received any complaint from the hospitals. I don't know where you got "ten cents on the dollar", but you are mistaken. DFM
    • My Medicare is a godsend!Phooey, Thu Jun 29 8:28pm
      And my supplemental is great! My use of it is negligible. And great to know it is there if and when I need it.
      • I agree with you 100%.DFM, Thu Jun 29 8:56pm
        All this country needs is to extend Medicare to EVERYBODY who is in the country legally. Then there will be a large free market in supplemental coverage. This will halt the avalanche of bankruptcies... more
        • It's not that easy ...Mondo Fuego™, Fri Jun 30 8:29am
          ... you are still dodging the issue that Medicare compensates health care providers about ten cents on the dollar. I have a friend who spent 2 days in the hospital and had heart surgery via catheter. ... more
    • Do you get your monthly and quarterly Medicare statements? — Mondo Fuego, Thu Jun 29 10:00am
      • You misinterpret what is happening.DFM, Thu Jun 29 6:38pm
        Hospitals jack up prices in anticipation that Medicare assignment will reduce them. Hospitals are famous for gross overcharges. $25 for an aspirin tablet, etc. $5000 per day for a room alone.... more
        • I know exactly what's happening ...Mondo Fuego™, Fri Jun 30 9:06am
          I know that hospitals jack up prices to cover losses from indigents and people who do not pay. But, hospitals have some real costs: They employ a huge number of people. Employee payroll taxes,... more
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