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Medicare Part B Sucks

Posted: Tue Dec 18, 2018 10:45 am
by Dogface
Getting ready to pull the trigger and schedule implant surgery. Since turning 65 Medicare A and B has become primary and they are a pain in the ass. Don't want to cover ongoing prostate cancer blood work and question about every medical procedure which is not very much. Dr. Kramer's office requires some expensive pre-surgical test (EKG, and comprehensive blood work etc.). Has anybody had issues with Medicare A and B covering implant (pre and post surgical) expenses? Does medicare require advance authorization prior to implant surgery? I can see myself getting stuck with a $20,000 bill. Medicare has already denied $800 in blood work which I recently appealed.

On a positive note seniors are allowed to cancel Part B anytime. Can't receive a refund ($130 a month for me) however my Cigna insurance would become primary with a $300 deductible and 100% coverage on blood work.

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 3:20 pm
by UTVOLS
Dogface, I don't think you will fine a better insurance than medicare for the price. I suggest you do a lot of research before you cancel. JUST MY 2 CENTS

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 4:28 pm
by Dave52
My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 4:29 pm
by LMCatman
Did you have a prostatectomy? My first implant and revisions (pre-Medicare) were through Humana and had something to do with "making me whole" after RP, a concept similar to breast reconstruction for women. My second revision was through Medicare with no "issues".

Not approving the bloodwork seems strange. I've done blood (PSA) tests every 3 or 4 months for the past 8 years. Again no issues HOWEVER...with my most recent physical, my Primary did NOT order a PSA test. When I asked, he said 'you've reached the age (67) where you are very unlikely to get an aggressive cancer'. I was surprised (and pleased).

It's also possible that the surgeon's office might know "tricks" about getting these through Medicare.

Yes, UTVOLS, more research!

Good luck, man!

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 4:47 pm
by Xomanow
Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave


Same here......Medicare & supplemental covered the entire thing.......that's almost enough to give me an erection right there......

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 7:53 pm
by DougAnd
Medicare B did not cover certain types of things. For example my doc did an injection before my venous leakage test they did not pay for and a few other things, They would not pay for an MRI or CAT scan to see if you have scarring but will pay for ultrasound. They only accept the bare min testing.

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 9:51 pm
by David_R
Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny

Same for me.

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 9:52 pm
by David_R
Xomanow wrote:that's almost enough to give me an erection right there......

:lol:

Re: Medicare Part B Sucks

Posted: Tue Dec 18, 2018 10:02 pm
by CTR5000
Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave


Same for me... $0.00 with Medicare primary and Aetna secondary. I was 61 when I got my implant... 2015.

Re: Medicare Part B Sucks

Posted: Wed Dec 19, 2018 6:36 am
by Larry10625
Dogface wrote:Getting ready to pull the trigger and schedule implant surgery. Since turning 65 Medicare A and B has become primary and they are a pain in the ass. Don't want to cover ongoing prostate cancer blood work and question about every medical procedure which is not very much. Dr. Kramer's office requires some expensive pre-surgical test (EKG, and comprehensive blood work etc.). Has anybody had issues with Medicare A and B covering implant (pre and post surgical) expenses? Does medicare require advance authorization prior to implant surgery? I can see myself getting stuck with a $20,000 bill. Medicare has already denied $800 in blood work which I recently appealed.

On a positive note seniors are allowed to cancel Part B anytime. Can't receive a refund ($130 a month for me) however my Cigna insurance would become primary with a $300 deductible and 100% coverage on blood work.



I would like to suggest to you that you look at the "other stuff" that might come up i.e.. blood test meter, needles lancets and test strips if you become diabetes, physiotherapy etc. :)

Larry