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sarahsweets
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Default Mar 07, 2019 at 02:51 AM
  #1
So I have been on disability for a long while and have one of those red white and blue cards for medicare. I have never participated in the part D coverage because my husband's insurance covers more of the medications I take and ends up to be cheaper. I was looking at it yesterday and saw 'hospital benefits'. Do I have them?
In the past I have had medical persons ask me about my medicare co-insurance and I have always told them I do not have co-insurance and have been buried under out of pocket medical bills for a long time. I am having surgery march 15th and I was wondering if sharing this information might help lower what my part would be. My husband's insurance covers most but until I have met my deductible its my responsibility and also they only cover 85% after that. I cant believe after all these years I have only just now noticed this, please do not make fun of me over it.

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amandalouise
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Default Mar 07, 2019 at 12:41 PM
  #2
Quote:
Originally Posted by sarahsweets View Post
So I have been on disability for a long while and have one of those red white and blue cards for medicare. I have never participated in the part D coverage because my husband's insurance covers more of the medications I take and ends up to be cheaper. I was looking at it yesterday and saw 'hospital benefits'. Do I have them?
In the past I have had medical persons ask me about my medicare co-insurance and I have always told them I do not have co-insurance and have been buried under out of pocket medical bills for a long time. I am having surgery march 15th and I was wondering if sharing this information might help lower what my part would be. My husband's insurance covers most but until I have met my deductible its my responsibility and also they only cover 85% after that. I cant believe after all these years I have only just now noticed this, please do not make fun of me over it.
what you are covered for depends upon your own individual case and what medicare package you chose when you signed up for it.

suggestion contact your insurance they will look up your file and tell you whether you are covered for your up coming surgery or not.

co insurance.... do you mean co pay? a co pay is when you have to pay so much before the insurance will pay the rest.

example some people have to pay 3.00 to the pharmacy when they get their refills and then the pharmacy bills the rest on the insurance. (just using this for an example of what a co pay is.)

if you mean co insurance as in having more than one insurance plan... this applies to those that have both medicare and medicaid or medicare plus a second insurance plan like work place insurnace or other private insurance.

how this works when someone has more than one insurance plan is they bill one insurance (example medicaid) first then after that first insurance plan paid their part, they bill medicare and medicare pays for the rest of the bill as long as the services are things on your insurance plan package.

you can tell your treatment providers what your insurance plans are for things and then they can make sure that they only prescribe treatments and meds that your insurance will cover so that you dont keep getting bogged down with having to pay for things your insurance didnt cover.

Last edited by Merlin; Mar 07, 2019 at 11:33 PM.. Reason: Typo correction
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Thanks for this!
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Default Mar 07, 2019 at 10:00 PM
  #3
This is from Medicare. See if it helps.

Inpatient Hospital Care Coverage

You definitely should be using your Med A as it may at minimum knock your costs down some. With surgery you do have to be admitted, not just kept for observation (up to 24 hours). They often get you out about 23 hours post-op it seems.

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sarahsweets
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Default Mar 08, 2019 at 01:35 AM
  #4
Thank you so much. It looks like unless I am admitted then my husband's insurance will be taking care of 80% of the surgery.
Mods.. you can close this thread now if you want.

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jaynedough
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Default Mar 08, 2019 at 11:39 AM
  #5
I may be totally misunderstanding what you said, but... When I had Medicare and another insurance, one paid the majority of the bill and the other covered the copays.
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Default Mar 10, 2019 at 07:33 AM
  #6
Quote:
Originally Posted by sarahsweets View Post
So I have been on disability for a long while and have one of those red white and blue cards for medicare. I have never participated in the part D coverage because my husband's insurance covers more of the medications I take and ends up to be cheaper. I was looking at it yesterday and saw 'hospital benefits'. Do I have them?
In the past I have had medical persons ask me about my medicare co-insurance and I have always told them I do not have co-insurance and have been buried under out of pocket medical bills for a long time. I am having surgery march 15th and I was wondering if sharing this information might help lower what my part would be. My husband's insurance covers most but until I have met my deductible its my responsibility and also they only cover 85% after that. I cant believe after all these years I have only just now noticed this, please do not make fun of me over it.
I assume you have original medicare and did not enroll in a private insurance plan. Because of the Part A deductible of $1,364 for each calendar year, if you are only staying one day in the hospital--it may not cover anything/much. This is the info on what it covers: Inpatient Hospital Care Coverage Even if Medicare pays nothing, if you present your medicare card, medicare only allows doctors to charge very little for procedures and what you pay toward the surgery will become part of your deductible paid this year. That could be good if you are admitted unexpectantly to the hospital later this year....
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Rose76
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Default Mar 11, 2019 at 12:29 AM
  #7
It sounds like you don't have Medicare Part B. Part B pays the doctors.

If you can't rely on your husband's insurance for ever, then I would advise you to start paying for Part B.
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Default Mar 11, 2019 at 12:32 AM
  #8
If a person has both Medicare and Medicaid, then Medicare is always billed first. Medicaid kicks in after Medicare.
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