One Of My Few Rants: Medicare Advantage Plan



For the most part, I’ve been very satisfied – actually, happy – with my plan.  It doesn’t cost a monthly premium and I still get most of my Social Security check without having the full Medicare cost deducted.  And, I have been fortunate with the doctors I have found from the list of providers.  A good situation…  Until I found out about the following:

Last week, I received a bill from a company that provides cardiologists and hospitals with a recording device that is attached to a patient’s chest and measures whatever.  It was for a visit that occurred A YEAR AGO, when I spent most of the day at my cardiologist’s office while several different tests were accomplished.

Imagine my surprise.  I don’t recall any mention of a separate bill for this device usage.  Of course, it was a year ago.  Who would remember anything?  Well, maybe somebody would, but I think that is asking too much.

I won’t advertise the $ amount this company charged.  That is their prerogative to charge whatever they believe the service is worth while covering some of their expenses.  That amount is not the reason for my rant.

The reason is:  My insurance company paid only $2.00!!  And I am asked to pay many times that amount.  The device company allowed the insurance company to deduct almost $1,000 from their invoice, after failing to convince the insurance company to pay a larger portion.  Except for the $2.00 and my co-pay, the device company had to write off the bulk of the price.

More and more, as we are experiencing, the cost of health care is being borne by the people who can least afford it, while the insurance companies are laughing all the way to the bank.

There’s no doubt about who is ruling the roost.


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[Medicare Advantage Plan image from bingdotcom]


2 responses to “One Of My Few Rants: Medicare Advantage Plan

  1. Sunshine.I could not tell by your post if you are responsible for a big bill?
    If so, I have a couple suggestions.
    1. Contact your insurance provider and ask to talk to a supervisor. They are the only ones who can make decisions. Everyone else will just say “It’s policy”. Ask for an explanation and get the name of the supervisor. If you don’t agree with the explanation most insurers have methods for challenging a claim.
    2. Contact the hospital and ask them to explain this as well.
    3. I don’t know what state you are in. I am in NY. I had a problem with my BC insurance a few years ago . They refused to cover a drug that should have been covered, because they claimed the DOCTOR had not done the proper PAPERWORK. After 2 months of phone tag I finally called the NY State Insurance Commission. I sent them all the letters, details, etc. Lo and behold. Within 2 weeks I got a letter from my insurance company saying it had all been a “mistake”. They covered the drug and paid me back for my out of pocket payments I had to make. So, they said I had no need to follow up with NY state on the issue!
    NY is very consumer-friendly and companies know it. I guess it depends on your state.

    Liked by 2 people

    • Joseph, the amount I was billed was equal to my usual co-pay – it wasn’t an enormous amount. My rant was the fact that the Insurance company got away with really not paying anything at all (what’s $2.00?). I know that NY is consumer friendly. That’s good. The insurance co. I have has a Medicare Advantage contract. It’s different from your example (if you are not of the age for Medicare).

      Right! They said you shouldn’t have followed up with the state. Huh! What else would they say? They got caught, and didn’t want to admit it.

      Thanks for your great comment!

      Liked by 1 person

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