You're right Carolyn...Re Medicare....
Part A is hospital...No more charge for the payments as most of us have paid in advance for those premiums for all our working life.
--The Government picks up the tab for the hospital charges IF THE ADMIT is a Regular Admit.
--IF you are admitted on an OBSERVATION ADMIT, that's where it gets dicey. You are technically deemed to be an Outpatient, and can only stay on that kind of admit for about 2.5 days without further BIG charges. See my note below about the Supplement to Medicare.
One thing about this is, if it is a Regular Admit, the insurance picks up most of the drug charges or your Medicare supplement kicks in to help if need be. These are things like scheduled surgery, etc.
IF it is the Observation Admit, your Medicare WILL NOT cover drug charges....you are deemed as an Outpatient, and they don't pay for Outpatient drugs. The Hospitals won't let you bring your regularly scheduled meds into the hospital. SO they order them for you while you are there. When the nurse brings them to you, she gives them to you in your hand, you take them. What happens on your billing is that these drugs are then deemed to be "Self Medicated" so aren't covered by Medicare! And that goes for shots too....I had some, at a charge of $59++ for each one, and when I got the bill and questioned it, the billing office said that they were coded "Self Administered"........I raised Bloody Ned, and it turns out that our CONGRESS wrote those rules about 15-20 years ago!!!!!!!!!!!! So we had to pay for several hundred dollars of drugs that I could NOT have given to myself, but they said it was legal to have them coded that way.
I ran into this this last year when I was admitted that way in Dec 08 for a severe neck disc rupture....Long Long Story, and I did lots of research afterwards, and I was right. If you can avoid it, don't be admitted that way. I didn't know there was such a thing.
The insurance wants you out of the hospital the SECOND you are able to stand alone....so don't worry about extended care...as a rule you will be recovering at home.
The new Law Obama signed has a serious decrease to Medicare funding, and another serious decrease to Home Health Care, which is why for the last couple of decades the insurance co's and hospitals let (made) you go home immediately. But now that HHC is to be seriously decreased, I shudder to think what will happen. More of us will die unnecessarily, I think. If we don't have help at home....what then? And even if we do, the folks at home aren't medical professionals, and haven't been trained to use catathers, give shots, clean tubing, clean wounds, etc etc etc.....
And since most of us when and if we recover, don't have a large group around us to fend for us with the Congress or Insurance Companies, how does anyone really know what happened? We definitely need some patient advocates out here!!!
On Medicare Part B....that is the part the retired folks (and all the others that Congress added over the years that haven't paid into the program) pay premiums for....It is for the Doctors.... Those payments are pretty much the same for everyone who has that coverage. I think mine is about $106.50/per month now. I've never thought that my Doctor's bills were out of line for what they did....I've been quite fortunate in that regard. I'm still on this side of the grass because several of the Docs I've had provided such excellent care.
Then the Medicare Supplements are all over the map depending on your state and what you ordered. Mine is J, and it is either $206.50 or $210.50/per month ....When I got it, I thought it would cover EVERYTHING else if you were ill etc.
Wrong. It will ONLY cover what Medicare "Allows" as a charge. There are some things that Medicare won't "Allow" so your supplement won't cover them either.
THEN there is Medicare Part D...that's for Drug coverage. I carry it because of my track record... For me, it is a good thing. Most of my things are low co pays (a few dollars higher than if I had gone to WalMart and got the Rxs' filled there as generics for their $4/mo....
I carry the D part because we never know when or if we will have a really serious illness...I'm sure that there are drugs that this D part won't cover. Don't know if the "D part" will cover all cancer drugs, for instance. Maybe someone here does.
The Medicare Advantage plans are going to really be shafted, from what I can see. Those plans cost more, and the Government contributed to them as well. I thought about doing that, but because of a couple of pre-existing things, didn't, and chose the Medicare supplement instead. I think many of the people on the Advantage plans will have to go off them and onto the regular Medicare because of the serious raise in costs.
People that think this new Law is going to be better and less costly for them, I think will be in for a very rude awakening. Unfortunately.
Maybe this info will help others. It's only going to be worse from here on in....
UNFORTUNATELY!!!! Elections do have consequences!!!!
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