When I turned 65 earlier this year I became eligible for Medicare. And so far I’m thrilled. In fact, it’s great. It’s been everything I wanted and hoped for. With my supplemental insurance plan I’m now fully covered and it costs me only about $1500 a year (a bit more if my income goes up). I get to choose pretty much any doctor I want to see, although I’ve continued seeing the same ones I used to see. The only difference is that I no longer have to pay my $20 or $40 copay. Instead, I walk out of the doctor’s office with a zero balance. I haven’t had to go to the hospital, but I know that the bill will be the same, basically zero.
Don’t you think everyone should have this kind of coverage? Sure, I paid into Medicare for the 40+ years I worked and contributed through FICA. But even if I hadn’t, I’d still be covered. Isn’t that great? What if I had been a stay-at-home Mom or Dad and never earned any money so didn’t contribute? Know what, I’d still be covered. Isn’t that great! Sure, one could say my spouse had contributed. But that’s kind of stretching it, isn’t it? I’m a freelancer and there were years when I didn’t make much. So I didn’t contribute much, if anything to the Medicare fund. Doesn’t matter. I’m still covered now.
As I understand it, the “single payer” system that everyone was so worried about is just like Medicare. So I don’t understand why anyone was worried. This is, shall I say it again, GREAT!
Ok, there are a few little glitches. One is that not every doctor accepts Medicare patients. And in my area, the DC suburbs, it can be almost impossible to find a doctor who will accept a new Medicare patient. I know because I tried. At one point my wife’s current primary physician decided he would not accept Medicare patients at all, not just new ones. We could still see him but if we did we’d pay him whatever his costs were, submit his bill to Medicare and get reimbursed whatever amount Medicare had worked out with comparable doctors. That amount would definitely not be anywhere near what my doctor in this high cost area charged. After a year of doing this, my wife decided to look for another primary physician. I called at least 30 different practices and the only one that would accept a new Medicare patient was a Doctor of Osteopathic Medicine (D.O). I have nothing against D.O.’s, and, in fact, my wife went to him and everything was fine. But it was telling that there were no MD’s within 20 miles of my home that would accept her as a new Medicare patient. I even tried Gerontologists! And none of them would accept her either. Hello! A doctor dealing with the medicine of aging won’t accept an aging patient?
But our primary doc decided to once again accept Medicare. He still doesn’t accept new Medicare patients. But he accepts the low payment he gets and doesn’t charge us any more. I don’t know why he changed his policy. But it works for us. I imagine if he had too many Medicare patients he wouldn’t be able to sustain his practice. I know that the payments are way below his costs. But I think a lot of that is because we’re in this high cost area. I hope that in other areas of the country doctors accept Medicare, even though the payments are so low. And I certainly hope gerontologists accept Medicare. Otherwise I wonder who they’ll be treating?
One of my doctors, a noted back surgeon who is a partner in one of the most prestigious orthopedic groups in the DC area, does not accept any insurance. That is, he’s “out of network” for every insurance plan. But ironically, he does accept Medicare. So when I went to him, Medicare paid its share of the office visit and my supplemental plan (Medigap) paid its share. Since he’s out of network, my supplemental plan didn’t pay the total remaining bill so I did have some small balance.
I don’t know if I’ll need it, but if I do have to have surgery with this doc, I’m so relieved to know that Medicare will pay his bill. If it didn’t I couldn’t afford to go to him because no matter what other insurance plan covered me, I’d be out of network. That would cost me thousands of dollars. If I have the surgery and he still accepts Medicare, I think my bill will be a few hundred dollars at most.
Have I told you that I love Medicare!
Don’t you think everyone should have this kind of coverage? Sure, I paid into Medicare for the 40+ years I worked and contributed through FICA. But even if I hadn’t, I’d still be covered. Isn’t that great? What if I had been a stay-at-home Mom or Dad and never earned any money so didn’t contribute? Know what, I’d still be covered. Isn’t that great! Sure, one could say my spouse had contributed. But that’s kind of stretching it, isn’t it? I’m a freelancer and there were years when I didn’t make much. So I didn’t contribute much, if anything to the Medicare fund. Doesn’t matter. I’m still covered now.
As I understand it, the “single payer” system that everyone was so worried about is just like Medicare. So I don’t understand why anyone was worried. This is, shall I say it again, GREAT!
Ok, there are a few little glitches. One is that not every doctor accepts Medicare patients. And in my area, the DC suburbs, it can be almost impossible to find a doctor who will accept a new Medicare patient. I know because I tried. At one point my wife’s current primary physician decided he would not accept Medicare patients at all, not just new ones. We could still see him but if we did we’d pay him whatever his costs were, submit his bill to Medicare and get reimbursed whatever amount Medicare had worked out with comparable doctors. That amount would definitely not be anywhere near what my doctor in this high cost area charged. After a year of doing this, my wife decided to look for another primary physician. I called at least 30 different practices and the only one that would accept a new Medicare patient was a Doctor of Osteopathic Medicine (D.O). I have nothing against D.O.’s, and, in fact, my wife went to him and everything was fine. But it was telling that there were no MD’s within 20 miles of my home that would accept her as a new Medicare patient. I even tried Gerontologists! And none of them would accept her either. Hello! A doctor dealing with the medicine of aging won’t accept an aging patient?
But our primary doc decided to once again accept Medicare. He still doesn’t accept new Medicare patients. But he accepts the low payment he gets and doesn’t charge us any more. I don’t know why he changed his policy. But it works for us. I imagine if he had too many Medicare patients he wouldn’t be able to sustain his practice. I know that the payments are way below his costs. But I think a lot of that is because we’re in this high cost area. I hope that in other areas of the country doctors accept Medicare, even though the payments are so low. And I certainly hope gerontologists accept Medicare. Otherwise I wonder who they’ll be treating?
One of my doctors, a noted back surgeon who is a partner in one of the most prestigious orthopedic groups in the DC area, does not accept any insurance. That is, he’s “out of network” for every insurance plan. But ironically, he does accept Medicare. So when I went to him, Medicare paid its share of the office visit and my supplemental plan (Medigap) paid its share. Since he’s out of network, my supplemental plan didn’t pay the total remaining bill so I did have some small balance.
I don’t know if I’ll need it, but if I do have to have surgery with this doc, I’m so relieved to know that Medicare will pay his bill. If it didn’t I couldn’t afford to go to him because no matter what other insurance plan covered me, I’d be out of network. That would cost me thousands of dollars. If I have the surgery and he still accepts Medicare, I think my bill will be a few hundred dollars at most.
Have I told you that I love Medicare!
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