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To: skinowski who wrote (340967)	1/2/2010 2:55:45 AM
From: KLP	Read Replies (2) \| Respond to of 793917

No, the Doctor didn't charge us....The "statement/bill" noted what the charge was, and what Medicare paid, and we could see from the Supplement paid, how comparatively little that was. The amount that the Doctor received was about 1/4 to 1/5 of the entire charge. What continually surprises me are a couple of things: --that regular folks 65 y/o and who don't have government insurance, have to take Medicare, because there generally aren't any other alternatives. This appears to be the way things are UNLESS a person is one of the very few who have never had a thing wrong in their entire lives so wouldn't be disqualified from another insurance. and --when we bought a Medicare Supplement, we both thought it would help to cover things that Medicare didn't. Through a play on words, what actually happens is that IF Medicare doesn't ALLOW the charge, Medicare won't pay for it, and the Supplement won't either, BECAUSE Medicare won't allow the charge. Alice in Wonderland stuff. And evidently, this is happening to people who aren't on Medicare yet as well. The Hospitals are using Medicare rules to bill everyone, as near as I can figure. One more thing: IF EVERYONE in the US, including ALL the union workers, and the Government workers, including Adm and Congress, and Senate as well as all State and City, etc workers were made to follow whatever rules the US eventually decides is the way for the US citizens to go, I don't believe we would have a problem. There would be a large risk pool, and the costs for everyone should come down.

To: skinowski who wrote (340967)	1/2/2010 8:16:00 AM
From: steve harris	Respond to of 793917

Correct as far as I have experienced. If the doc/facility is listed on your insurance, that means he has agreed to their "fee schedule" and will accept as payment in full what the insurance company pays. He cannot bill you for the rest. Of course you are responsible for your deductible. With that said, he will send the insurance company a statement with some prices that look horrible when you open your insurance benefits statement. At first, I assumed I was responsible for the rest that the insurance didn't pay, but I was wrong. I asked the doc on my next visit and he explained to me about the fee schedule thingy.