George, an 85 year old, was surprised when he received a $4000 bill for his pacemaker replacement procedure, after he was told that it would cost him $250. He’d called his Medicare Advantage plan before the procedure and was told that he would be responsible for a $250 inpatient hospital co-pay. Unfortunately, the hospital and the doctor’s office did not tell him that his procedure would be done as an outpatient with an overnight stay. He stayed overnight but since he was never an inpatient, the bill was applied to his $6500 deductible for outpatient services.
It’s a constant refrain! You’re a senior, on medicare, you do everything you’re told but somehow you still owe $4000. Again – these insurance companies DO NOT WATCH OUT FOR SENIORS and make the simplest of “medical procedures” complicated on the non-medical side. A simple medical procedure mixed with insurance is like a game with no rules. It doesn’t matter what plan you choose, there is still many a “slip between cup and lip”. No other industry in the U.S. is allowed to operate this way. It’s illegal!
This is especially true if you have a Medicare Advantage plan. These plans are less expensive than regular Medicare with a supplement for a reason. They may add extra benefits, but they are often more complicated to understand. So what do you need to do to avoid surprises or issues? Plan ahead, ask a lot of questions and advocate for yourself, your partner, your family members or call Parent Your parents. We can do it for you.
Parent Your Parents is pleased and proud to announce the advent of Ann McGuire, R.N. to our growing group of experts. Besides being a RN she is also a certified case manager and knows the pitfalls of senior insurance issues. Please go to our website, ParentYourParents.com to see her photo and biography. She and I will be collaborating on more articles to assist you with getting through the insurance maze . . . little things like what to do if you’re sent to the emergency room.
Bottom line: remember – insurance when going to a clinic or hospital for any procedure can be very tricky. It’s not because the doctor wants to charge you more, it’s because of the intricacies of how Medicare Advantage plans work.