Page 2 of 2 FirstFirst 12
Results 11 to 15 of 15

Thread: Medicare Advantage vs Medigap

  1. #11
    Senior Member Oddity's Avatar
    Join Date
    Oct 2008
    Location
    Virginia Beach, VA
    Posts
    3,770
    Blog Entries
    1
    Quote Originally Posted by funklab View Post
    Doesn?t traditional part A cover 100% of hospital costs?
    Depends on length of stay and state insurance regulations. For short stays, yes. There is always a deductible (2019 ~$1,500 per "spell of illness"/admittance for a condition. Admissions for multiple issues means multiple $1,500 deductibles. Once for each diagnosis code being treated, per admission, essentially.) Long stays get up around $300-$400 per day co-pay. More in some states. It's not a flat 20% co-pay for Part A like it is for part B, but even some out patient part B services (chemo, radiation, outpatient surgeries, etc) still can be HUGE bills. My Dad racked up nearly $50k in Medicare copays over just a couple years recently.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  2. #12
    Senior Member
    Join Date
    May 2010
    Location
    Southern California
    Posts
    524
    Quote Originally Posted by Oddity View Post
    Depends on length of stay and state insurance regulations. For short stays, yes. There is always a deductible (2019 ~$1,500 per "spell of illness"/admittance for a condition. Admissions for multiple issues means multiple $1,500 deductibles. Once for each diagnosis code being treated, per admission, essentially.) Long stays get up around $300-$400 per day co-pay. More in some states. It's not a flat 20% co-pay for Part A like it is for part B, but even some out patient part B services (chemo, radiation, outpatient surgeries, etc) still can be HUGE bills. My Dad racked up nearly $50k in Medicare copays over just a couple years recently.
    Wow.

  3. #13
    Senior Member Oddity's Avatar
    Join Date
    Oct 2008
    Location
    Virginia Beach, VA
    Posts
    3,770
    Blog Entries
    1
    Quote Originally Posted by Tetracyclone View Post
    Wow.
    Yeah. That's why 'stop loss' risk management was so important to me. There is a lot of confusion as to what a "spell of illness" exactly means (that's the language used in the Medicare claims processing manual) and it's not perfectly consistent claim to claim, as far as I understand. E.g. I've heard from some folks who've had multiple admissions for what was adjudicated as a "single spell of illness" who've only paid the $1,500 once, and another who had a single admission for multiple illnesses get charge it twice. It's about as clear as mud to me.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  4. #14
    I enrolled in my Medigap policy during a special window of time that has closed, and over the years my premiums go up and up. So, I used to call around for something more reasonable (I was barely using my pricey Medigap policy), and the only alternatives offered me were Medicare Advantage. I was getting close to signing up, but called around to a couple more agents just in case. The last guy I reached, it was late Friday afternoon, closing time.

    He was talking to me about the Medicare Advantage plan I was considering, and at one point he dropped the sales speak. His voice changed. "Spitz, don't do this." Then he laid out the reasons why I, with a progressive condition, could get caught behind the eight ball. Losing my choice of providers and facilities. Being constrained by formularies if I needed newer treatments. Most likely losing coverage when away from my primary address, which is a concern in our lifestyle. He went on for a few minutes. It was a very sobering. I wish now I could recall more exact details.


    Meanwhile though my Medigap provider will keep trying to buck me off. Who knows what will happen? Go Bernie.

  5. #15
    Senior Member
    Join Date
    Jul 2010
    Location
    Leeds, AL USA
    Posts
    285
    I talked with Medicare today about a bill I received in the mail. The bill was about a claim from 2 1/2 years ago. My beef, 2 1/2 years and I was just now getting this surprise bill about a claim denied 2 yrs 5 months after it was originally submitted. .
    I was advised to talk to SHIP (don't know what that stands for). This is a medicare affiliated office with many local locations. After I receive protest form (in about 15 days), I will call and visit them.
    I need help writing the protest (hand function).
    Supposedly Medicare gurus work there and they also can advise which supplement policies are best for me or you.
    Ph # for SHIP 800-243-5463 Call for a location near you.
    Attack life, it's going to kill you anyway
    Steve Mcqueen (Mr Cool)

Similar Threads

  1. Medigap or Medicare Advantage
    By xsfxsf in forum Funding, Legislation, & Advocacy
    Replies: 0
    Last Post: 10-29-2012, 03:28 PM
  2. Medicare Advantage Plans
    By bubbagump in forum Work, School, & Money
    Replies: 5
    Last Post: 11-07-2011, 02:47 AM
  3. Medicare Advantage Plans
    By darkeyed_daisy in forum Life
    Replies: 4
    Last Post: 02-26-2008, 07:00 PM
  4. Medicare MediGap Plans
    By rdf in forum Care
    Replies: 0
    Last Post: 03-29-2006, 08:27 PM
  5. Medicare/Medigap
    By Quad62 in forum Care
    Replies: 16
    Last Post: 01-02-2005, 08:03 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •