Best supplemental ins - already have Medicare

[ezbtr]

Trying to see if it;s worth it as I have now had some bills come in, Thx guys

 

[alldodge]

Have not got there yet but getting close. Would suggest finding businesses in your area which deal with this. Mom was having same trouble years ago and I was trying to help. Sometime we did good, sometimes not. My buddy mentioned an office that deals with the concerns, so we went there and there has been no issue since for the largest part (donut hole)

The office is paid by how many they help so there is no cost to you

 

[Sprig]

Yes supplemental ins. is a good idea. Remember Medicare only pays 80% of medical bills based on the Medicare schedule of payment. What they pay can be thousands less that what the doctor/facility charges. The supplement plan will make up part or all of what medicare doesn’t pay. You also get drug coverage with supplemental plans. There are hundreds of entities that sell supplemental plans. Even AARP sells supplemental plans and they are pretty good plans. You should. also look into advantage plans they work like regular health insurance.

 

[WIMUSKY]

Medicare pays 80%, if they pay at all. In my dads case they didn't pay a dime when he went into the nursing home. Since they didnt pay neither would his primary ins. Aetna. Supposedly, most ins. co's. go off Medicare's lead. So supplemental ins is a must so u don't have to pay all out of pocket. Depending on your ailment, Medicare may not be an option. Even in some rehab situations Medicare(mediocrecare) will fight you tooth and nail....

I could go on and on.......

 

[hvymtl939]

I work at a VERY large brokerage agency that deals only with supplement insurance. Licensed agent myself, and run a team of 20. If you have any questions, pm me and I'll shoot you my cell number. Happy to answer any questions. That goes for anyone here wanting some info/advice on Medicare and your options.

 

[aspeck]

Medicare pays 80%, if they pay at all. In my dads case they didn't pay a dime when he went into the nursing home. Since they didnt pay neither would his primary ins. Aetna. Supposedly, most ins. co's. go off Medicare's lead. So supplemental ins is a must so u don't have to pay all out of pocket. Depending on your ailment, Medicare may not be an option. Even in some rehab situations Medicare(mediocrecare) will fight you tooth and nail....

I could go on and on.......

Generally Medicare will only pay for 100 days in a nursing home provided they went there after a 3 or more day stay in the hospital at the direction of the doctor. That is the way it was for my FIL. We all decided it was time for him to get the nursing care he needed (esophageal cancer). Doctor said, "let's get you in the hospital for 3 days and then send you to the nursing home." Pap refused. No way did he want to go to the Dr. It took several weeks to convince him to get checked in the hospital for 3 days. Then transferred to the nursing home. He lived at the nursing home for 101 days.

Supplemental usually will not pay for nursing home unless the hospital stay rule applies ... will pay for "therapy and/or rehab" but not for care... So, if you are thinking that at some point you might need long term care, check on long term care policies.

 

[hvymtl939]

Generally Medicare will only pay for 100 days in a nursing home provided they went there after a 3 or more day stay in the hospital at the direction of the doctor. That is the way it was for my FIL. We all decided it was time for him to get the nursing care he needed (esophageal cancer). Doctor said, "let's get you in the hospital for 3 days and then send you to the nursing home." Pap refused. No way did he want to go to the Dr. It took several weeks to convince him to get checked in the hospital for 3 days. Then transferred to the nursing home. He lived at the nursing home for 101 days.

Supplemental usually will not pay for nursing home unless the hospital stay rule applies ... will pay for "therapy and/or rehab" but not for care... So, if you are thinking that at some point you might need long term care, check on long term care policies.

The 100 day window is actually for a skilled nursing facility, not a nursing home.

 

[aspeck]

Thank-you for the correct terminology.

 

[WIMUSKY]

The 100 day window is actually for a skilled nursing facility, not a nursing home.

Which can be one in the same, if I recall. The nursing home was considered a skilled nursing facility, which is a joke. That's why Medicare fought tooth and nail when we admitted him to a hospital to get acute rehab. They finally paid.

When he was originally in the hospital for 3 days b4 going to the nursing home he wasnt "officially" admitted. He was there 4 observation, even though he went to the emergency room after falling at home. So his primary hospital screwed him over. The whole thing was a mess for months.

At least hes home and has a PCA coming over M-Th..

I guess I'm thinking about long term care not supplemental ins. I just get worked up discussing any of this...

 

[aspeck]

Understandable, Musky. It is tough enough dealing with the declining health of a parent, and then you have to add fighting with the insurance company on top ... ugggh!