Medicare question

[DonandBonnie]

We have our full timing domicile in South Dakota. When we signed up for our Medicare supplement through Humana we had to select a primary physician. We could not select our long time doctor in Ohio, but had to choose on from South Dakota, one that we have never seen.

We got worried recently when a friends father was hospitalized in Florida. Medicare would not pay for several areas of his treatment unless they were authorized by his primary care physician. Pop was a new resident of Florida and like us had never visited the primary care physician that he had chosen. Lucky his doctor was in the same town and arranged for a bedside exam to get the Medicare procedures authorized.

Our worry is that Bonnie is probably facing surgery on her knee. We are headed to Ohio in a couple weeks to see a long time friend who happens to be an orthopedic surgeon, the only guy we want working on her. What happens if Medicare won't authorize the costs unless authorized by the South Dakota doctor? Are we locked into having to travel to South Dakota for all but emergency medical issues?

[pineranch]

Doesn't medicare send you a book every year? If so, your answer may be found there. Good luck.
Mike

[kdeiss]

A lot of questions do you have a Medicare Supplement or a Advantage Plan if so is it a HMO or PPO does your insuranc have a Pass Port ?? The people that can answer this question is you Insurance plan!!
No one on here can answer that question with out knowing your insurance coverage MY advice again talk to you insurance plan, and tell them you plans

[bigskyjimmy]

Mine is Medicare advantage Humana PPO I did select a primary doctor but I do NOT have to go with him that is why I chose a PPO so I can go to any doctor or clinic (most accept Medicare Advantage) as opposed to a HMO where you HAVE to select and go your doctor and clinic (if he is in that HMO network) and get referals for a specialist Blah Blah Blah.. , I'm a Fulltimer as well and travel all over and have been to different clinics in different cities and all of them accepted my Humana PPO so a PPO was the only way to go for us even though it cost a Little more than a HMO AND... also I have a preexisting condition and nobody would want me before So YEAH I am happy with my PPO Humana:)

[DQDick]

That is the reason we went with AARP's supplement plan. We needed to be able to doctor where we are.

[JandC]

When we started full timing and sold the house, we gathered tons of information from this forum. We considered a mail service and out-of-state address. One of us is on medicare and one of us isn't there yet. Our health insurance, including medicare is changing constantly. We decided to change our address to our oldest son's address. He simply throws out any "junk" mail that comes to us and any other mail he boxes up and sends on every 2 weeks. With more changes coming to medicare in the near future other could start having serious issues like DonandBonnie are having when using an address in another state they are never in.

[Flymutt]

quote:Originally posted by kdeiss

A lot of questions do you have a Medicare Supplement or a Advantage Plan?? The people that can answer this question is you Insurance plan!!


I think you are on to something here. DW has a Supplement plan through BCBS (I'm not 65 yet:)) and doesn't need a primary care physician.

[kiltedpig]

My Medicare person said to stay away from Advantage and after I did my own research I agreed. The AARP sup costs more but when you need it who cares.

[jlb27537]

We both have original Medicare. The fee is deducted from our SS monthly. We both have Medicare Supplemental plan "F"

Plan "F" pays 100% of what Medicare does not pay. It also pays our yearly deductible. We have no drug coverage, if it is not on the Walmart or Walgreen 30day/$10 we ask the DR to prescribe something else. If not available, we pick it up in MX when we go south for 5 months.

We have a fixed amount we pay monthly, can go to any doctor who accepts Medicare, ANYWHERE. DO NOT get Medicare Advantage.

[bigskyjimmy]

Do not get medicare Advantage??? that is what we have and it works great , just make sure you get Advantage PPO NOT HMO we have been to a lot of clinics and different doctors in our travels as fulltimers and NEVER had a problem AND we have drug coverage And they have a nurse that is assigned to you and she calls every month to see if she can help with medications or any questions you might have(pretty cool) ,we have medicare advantage Humana PPO and it is taken out monthly out of our Social Security ,we were paying 100 bucks a month ea for just Plan A&B now we pay 180.00 a piece for Humana Advantage and well worth it

[kdeiss]

quote:Originally posted by pineranch

Doesn't medicare send you a book every year? If so, your answer may be found there. Good luck.
Mike

This is the Bible you need to consult this especially during the open enrollment period pick the coverage that fits your needs then call the insurance Companys to get clarity

[packnrat]

my head spins in trying to just figure out all this for my mom. i will be there very soon��

sad us free people must pay for medical, dental, glasses. but convicts get everything free. and some of the best possable no problem, including eleted procuders. ( non life threating).

[DQDick]

my head spins in trying to just figure out all this for my mom. i will be there very soon��

sad us free people must pay for medical, dental, glasses. but convicts get everything free. and some of the best possable no problem, including eleted procuders. ( non life threating).

It is a major problem when they escape and try to take their coverage with them:nonono::hide::lol:

[1retired06]

We have never had an issue. Medicare direct and Medicare supplement (Tricare for life) covers us with any Medicare provider anywhere at no cost. I had a total knee replacement last winter in Florida, wife had a colonoscopy 5 Jul in North Carolina (not much of a 4th of July celebration) and not a penny spent for either.

[richfaa]

I depends on your insurance coverage. We are retired Federal Employees and have FEHBP which is much like tricare. Our FEHBP is BC/BS and we are on Medicare. Medicare in most cases will be primary so our Medicare is primary and our FEHBP is secondary.Between the two of them they pay most everything.It is rare that we have a "you owe the provider" amount on bill. BTW...our FEHBP is NOT free. FEHBP= Federal Employees Health benefits Plan.

[Rondo]

I know the pain Rich, I know the pain of the payments for FEHBP!

[footz1941]

Have GEHA (government employees health insurance) Have not paid a penny in Dr & Hospital expenses since we went on Medicare Have had no problems getting Drs & Hospitals to accept it. Most prescriptions $15.00 for three months. Get meds thru Walgreens`

[FISCALMAN]

I sell med supplements the only one I sell is Blue Cross Plan F it cost more but when you need medical attention your not searching for a doctor just make sure you have your address correct if you move things can change so make sure you know what your doing
or hope you have an agent with some knowledge to give you good advice.

[mlh]

I sell med supplements the only one I sell is Blue Cross Plan F it cost more but when you need medical attention your not searching for a doctor just make sure you have your address correct if you move things can change so make sure you know what your doing
or hope you have an agent with some knowledge to give you good advice.

I have Bluecross. I’m wondering what is the difference in some of these plans?
Before my wife and I turned 65 we were paying over $20,000 a year for health insurance with a $2500 deductible. After I turned 65 her premium was over $1100 per month.
Lynwood

[FISCALMAN]

I am not trying to give advice I am just stating what I prefer depending on were you live things can be different your agent should be able to help you.

[mazboy]

Bottomline...talk to Medicare not us to find your best option.

[richfaa]

Bottomline...talk to Medicare not us to find your best option.

Agree we do not know for sure. Talk to medicare. We have no problems but we are long timers not full timers .We have a S&B that we are at a few months of every year and a primary care physician.

[awheeler]

Mine is Medicare advantage Humana PPO I did select a primary doctor but I do NOT have to go with him that is why I chose a PPO so I can go to any doctor or clinic (most accept Medicare Advantage) as opposed to a HMO where you HAVE to select and go your doctor and clinic (if he is in that HMO network) and get referals for a specialist Blah Blah Blah.. , I'm a Fulltimer as well and travel all over and have been to different clinics in different cities and all of them accepted my Humana PPO so a PPO was the only way to go for us even though it cost a Little more than a HMO AND... also I have a preexisting condition and nobody would want me before So YEAH I am happy with my PPO Humana:)


I totally agree! While I am not currently on medicare, I do know that one should never choose an HMO unless there is not other option.



Ann

[kdeiss]

[QUOTE=awheeler;1107960]I totally agree! While I am not currently on medicare, I do know that one should never choose an HMO unless there is not other option.



We have AARP Medicare Complete United Health Care HMO.
For us the coverage is fantastic most Doctors in our area of Florida accept with no problem we all so have Pass Port so we can travel! No Monthly Cost!