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What happens if you don't have a Medicare Supplement???

Discussion in 'Topical Discussions (In Depth)' started by Rusty Shackelford, Jul 14, 2010.



  1. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Curious.

    We were talking at work about the Drs. that are dropping out of Medicare because of low reimbursement rates. But it did not make since to us since the Medicare supplement "supposedly picks up the difference (It is like a private secondary isurance right?). If that is the case, then Medicare+Supplement picks up the entire billed cost ????? So for a Dr to not be fully reimbursed then that must mean the patient did not have a Supplement. So if that person gets care why should anyone pay for a supplement?? Every elderly person I know has a supplement. What can happen to you if you don't have the supplement.

    I am only 36 and not well versed in Medicare BS yet the stories in the news don't make since about the Docs complaining about not getting enough money from medicare.
     
  2. NotTheOne

    NotTheOne Seeker Seeker

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    Mom's on Medicare & has a secondary.

    Here's how her bills go.

    Doctor bills for services
    Medicare says how much of this service is allowed.
    Doctor bills secondary for the rest.
    Secondary allows only a % age.
    Mom gets the rest of the bill.

    Invariably, almost to the point of "every time", the secondary company will have a reason why the cost is not allowed and passes the entire amount back to mom.

    (your results may vary)

    In your example, I must assume that the people are not paying the remainder of the bill.
     
  3. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    So it is not Medicare that is the problem. It is the deadbeats that skip out on their bills. What happens to those that don't pay the extra or skip out on the supplement all together.
     
  4. bulloncoins

    bulloncoins Silver Member Silver Miner

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    There are two reasons for a person to be on Medicare.

    1). You have reached retirement age.

    2). You are disabled....

    If you are on medicare, you have "insurance" so you are not un-insured. I do not believe the new laws require insurance companies to sell insurance to someone who is eligable for insurance under medicare...so pre-existing conditions still count. They will not issue a medicare Supplement to a disabled person....

    The only way to get the supplement, is to be in decent health when you hit retirement age.

    If you are on medicare without a supplemant (this means everyone who is disabled) then you doctor is paid a fraction of what private insurance pays, and you are responsible for 20% of the bill + something like $800.00 deductible per hospitial stay.

    If you were lucky enough to have a policy to cover you should you become disabled, before you actually do then you would be covered. Very few people pay for disability insurance, thinking they will never need it. Once you become disabled, you will not qualify for a private policy but you will qualify for medicare. Once on medicare, you are "insured" so no company is forced to accept an application for supplemental insurance.

    It is all a big circle jerk. Disabled people are not helped at all by Obama care. At the same time congress is cutting back on what Medicare pays doctors. More and More doctors are refusing to see new medicare patients. Before long they will have to force doctors by law to accept medicare. Otherwise, medicare will mean nothing because no one will take it.
     
  5. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Or maybe adjust the rates up to what private pays and accelerate the crash via the massive increase in taxes needed to fund this welfare program. Just love the idea of .gov forcing people and business to do things regardless of profit/loss.
     
  6. Merlin

    Merlin Gold Member Site Supporter Gold Chaser

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    I celebrated my 65th birthday on June 28 and thus became eligible for Medicare as of June 1. My insurance agent told me that there isn't an insurance company in the country that writes major medical insurance policies for people aged 65 and older. Don't know if that's true or not. But it seems reasonable to me. What insurance company could possibly compete with government sponsored Medicare insurance?

    In any case, Medicare supplement policies are available in different flavors, offering more or less depending on the plan you choose and the premium you pay. My AARP United Health Care policy costs me $128 a month and pays all the deductibles and copays that Medicare does not pay. Together with my $110 Medicare premium, my major medical coverage now costs me $238 a month, $127 a month less than the private major medical policy that I had with Assurant Health that carried an annual $5100 deductible.

    The supplement policy does not cover the difference between what Medicare pays and what the doctor billed. It covers only the difference between the amount Medicare allows and the amount Medicare pays. Increasingly, my doctor tells me, the private insurance carriers are paying the amounts that Medicare pays. The system is really putting the squeeze on doctors who, between their offices, staffs and insurance premiums, have a pretty big nut to crack.

    My family doctor tells me that he flat-out forbids his children to go to medical school. Even if you love the science of medicine and helping people, he says, it's a lousy life. In addition to his office hours, he has rounds at the hospital and gets paged and called at all hours of the night and early morning. When I saw him last, he hadn't seen his wife in two days (she's an obstetrician and had emergency c-sections and such that had kept her going way, way past any normal workday hours.
     
  7. Goldhedge

    Goldhedge Modal Operator/Moderator Site Mgr Site Supporter

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    My SIL is married to an Ophthalmologist. If someone comes in
    to get their eyes checked and they are on Medicaid/care they
    just do it gratis because the cost of recouping from the
    government is more than the bill....
     
  8. Meetzos

    Meetzos Gold Member Gold Chaser

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    I have to agree with you most heartly, I had cancer and there isn't an insurance company that will touch me. The VA is my only chance of any medical care. I don't know why all the horror stories out there about the VA.
     
  9. __hoot__

    __hoot__ Seeker

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    The system poisons you in the food water and air, shoots you up as a little tiny kid with vaccines full of green monkey cancer virus[SV40] and other fn ***** poisons etc.mercuryetc.etc...........and you run back to them to get "cured" and dump all your money back into their deeeeeeep pockets without any real fix........phew! what a slave system............hee hee hee and you work your asses off for the privlege of paying their insuracnce scams to boot
     

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