Category: Medicare Insurance

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Medicare    ????????????

The time of year for us senior citizens to make decisions on what kind of Medicare do we need.

I would say it would be determined by your income.

I would say it would be determined upon your health.

I would say it would be determined upon your doctor.

Now that you have determined this what is next.

But how do you determine if your doctor is on your Medicare plan.

Call Medicare. The customer service representative can tell you if your doctor is on your plan.

Medicare Plans

Regular Medicare

You pay 80% of your bill and you pay the 20%.

You can have a secondary insurance to cover the 20%.

HMO

This is the cheapest way to go but also the most aggravating.

You must pick a (PCP) a Primary Care Physician.

You must go by referral to a specialist or medical test.

You must have an authorization to have surgery or some specific test.

You must stay inside the contracted arena of medical care for your HMO.

PPO

You have more control over your medical care. But it does cost more.

Medicare/Medical or Medicaid

You need to qualify for this insurance.

It is for low income.

Whatever insurance you decide to go with always check with Medicare to make sure you are up-to-date in their computer system. 1-800-633-4227

www.lindameckler-author-author.com

My books Medicare and Other Health Insurances and Appeal and Collections Letters are available on Amazon.com.

Thank you for reading my article. Linda Meckler 2023 copyrighted

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Transferring When Can’t Walk

I went to work one morning and didn’t have any idea of what the day had in store for me. I was a caregiver. I went into people’s houses and helped them. On this particular morning, I was transporting a woman to the doctor. She was sleeping and leaped out of bed and said,” “let’s go.”

She started walking fast down the hallway with me running behind. I had never been in this house before. The next thing I remember was sitting on a step almost on the floor of a garage.

My ankles were turned backward but there wasn’t any blood. The woman put a blanket over me and we waited for the ambulance. It wasn’t long but it felt like forever. The ambulance people had me stand up and take a couple of steps to the gurney. Then I was transported to the hospital. My life had changed.

My ankles were x-rayed and to my horror, I had broken three bones in each ankle. The next day I was in surgery and my ankles were loaded with hardware. 15 screws and a plate in my left ankle and 2 screws and one plate in my right.

Not being able to walk I had to learn how to transfer myself from the bed to a chair and a portable toilet. I transferred myself from the bed to a wheelchair using my arms. I stayed in the hospital for a week and went to a rehabilitation hospital. My life was now in a wheelchair.

I worked with the physical therapist daily to straighten my arms as well as my core stomach muscles. I will never forget when the therapist and I went outside. When I graduated to a walker she said, “stand up and walk up the steps.” I stood up and put my foot on the first step. I couldn’t believe it. I was hanging on to the handrail for dear life. I couldn’t bring my weight to pull myself up one step. It takes a lot of strength to walk up and down stairs. You use your hips to walk upstairs and your knees to walk down. I flunked that test. After that, we worked for a week on strengthening my hips and knees to walk up and down stairs. I was in rehab for three months and finally went home.

Copyright Linda Meckler 2023

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Medicare Attack

This is now the time of year when Medicare starts mailing out information on every HMO and PPO that Medicare covers. Everyday handfuls of information will be in your mailbox. Does it make Medicare more confusing?

If you do not understand Medicare Parts A, B, C, D, and G you will not understand Medicare.

Part A is free if you qualify and it is inpatient in the hospital.

Everybody pays for part B which is all out-patient services doctor, ambulance, lab, x-ray, etc.

Medicare Part A and B is fine but it only pays for 80% of your medical bill. You are responsible for 20%.1556.00

This is good for 60 days

After 60 days the charge is $1556.00

The truth is the best Medicare coverage you can have is Medicare Part G a supplement. This, of course, is the most expensive. But if money is no object you can sign up for Medicare Part A and B and G when you sign up for the first time.

You pay monthly for the supplemental plan plus part D drug coverage.

If you have been on other Medicare plans and want to change to a supplemental plan you will have to answer health questions and might not be approved.

Advantage Plan -C- You can change your insurance plan once a year. Each plan is different. You pick your  primary care physician, you get a referral to go to a specialist and authorizations for surgery, etc.

If you do not have extra money to spend on your Medicare plan and HMO plan is the cheapest way to go. The only thing is if you are hospitalized then it becomes expensive.

PPO is another option it costs more than an HMO but it does have some advantages.

No matter what you decide it is complicated. Medicare makes it that way to confuse the public. My book Medicare and Other Health Plans explains Medicare and it is something everybody needs to know.

Thank you for reading my article. Linda Meckler    www.lindameckler-author-artist.com

Posted on by

Medicare Attack

This is now the time of year when Medicare starts mailing out information on every HMO and PPO that Medicare covers. Everyday handfuls of information will be in your mailbox. Does it make Medicare more confusing?

Part A is free if you qualify and it is inpatient in the hospital.

Everybody pays for part B which is all out patient services doctor, ambulance, lab, x-ray, etc.

Medicare Part A and B is fine but it only pays for 80% of your medical bill. You are responsible for 20%. When in the hospital you pay $1556.00 for 60 days. After 60 days you pay that amount again. 

The truth is the best Medicare coverage you can have is Medicare Part G a supplement. This, of course, is the most expensive. But if money is no object you can sign up for Medicare Part A and B and G when you sign up for the first time.

You pay monthly for the supplemental plan plus part D drug coverage.

If you have been on other Medicare plans and want to change to a supplemental plan you will have to answer health questions and might not be approved.

Advantage Plan -C- You can change your insurance plan once a year. Each plan is different. You pick your primary care physician, you get a referral to go to a specialist and authorizations for surgery, etc.

If you do not have extra money to spend on your Medicare plan and HMO plan is the cheapest way to go. The only thing is if you are hospitalized then it becomes expensive.

PPO is another option it costs more than an HMO but it does have some advantages.

No matter what you decide it is complicated. Medicare makes it that way to confuse the public. My book Medicare and Other Health Plans explains Medicare and it is something everybody needs to know.

Thank you for reading my article. Linda Meckler  www.lindameckler-author-artist.com

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Dental Insurance Screwups

In this article, I will give you an example of what can go wrong when you make a dental appointment and when you have HMO medical insurance.

I was in a dental office recently and watched this drama play out in front of my eyes. That is when I knew I had to write this article and add it to my Medicare and Other Health Insurances book.

This man had an appointment in this dental office. He was in pain. He checked in his list of Dentist’s that were contracted with his medical insurance. He called the Dentist and made an appointment.

What is wrong with this. Can you tell me?

Everything in medical or dental insurance works by contract. Yes, his medical insurance was contracted with this Dentist. But the man never called his insurance company and said, “I want his Dentist and I need an appointment immediately I am in pain.”

So, what happened? He didn’t make a contract with his medical insurance to plug him into this Dentist. He showed up and said, “I have an appointment and I’m in pain.”

The receptionist said, “I am sorry sir the Dentist can’t see you because you are not contracted with this office.”

“But you are on the list of dentists I was given that is on my plan”

“Sir, you did not call your insurance company and tell them you chose this Dentist and since you did it today the insurance company should have called us and we would have seen you.”

Whose fault was this mix-up?

It was both the Dental receptionist’s fault and the man’s. The receptionist should have called the insurance company when she didn’t see his name on the computer as being this Dentist’s patient.

The man should have realized how his insurance works.

In most cases, this is how we learn by doing.

Thank you for reading my article. Copyright Linda Meckler 2022

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Medicare HMO Horrors

www.lindameckler-author-artist.com

I have worked in medical insurance billing for almost thirty years. I have said repeatedly that the insurance companies practice medicine.

In an article in the AARP June Bulletin 2022, there is an article that does indeed prove what I have said.

This article states that when Medical Providers see their patients and require pre-authorization for testing, or surgery Medicare denies it.

Federal Investigators reviewed a week of these inquiries in 2019 and found that those denied 13% should have been authorized under the original Medicare rules. 85,000 requests that year were wrongfully denied.

What about the years before and after 2019?

Do not take for granted when something is denied that is denied permanently.

A medical appeal can always be sent to Medicare. If a medical provider requests pre-authorization for a test, surgery, etc. that means the patient needs it. If the patient does not receive the care needed, you can use your imagination as to the result.

Thank you for reading my article. My books Medicare and Other Health Insurance and Appeal and Collection Letters for Medical Providers are on www.amazon.com

Copyright Linda Meckler 2022

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Prescription Drugs Goodrx.com and Singlecare.com

If you have medical insurance or do not have insurance it can become a horror story when the medicine you need costs out in space.

You need the medicine, otherwise, the doctor would not have prescribed it in the first place.

Sometimes, the medication can be replaced with another medication the same thing but costs less.

One medication can have many names and with each name a different charge.

But I have found out recently that there is hope. Two websites can help people like me and you that are on a small social security income.

The two websites are www.rx.com and www.singleacare.com

Now, these two websites need a little work. They can be downloaded to your cell phone.

On their website, you can find your medication and then you can scroll through the different pharmacies that take this website. You can print a coupon or use the one on your cell phone app.

This is a great option for you to know where to go and how much it is going to last.

I truly recommend these two websites when you get hit in the wallet for a ridiculous charge for your medication.

Thank you for reading my article. Let me hear from you.

Copyright Linda Meckler 2022

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Vote No to kill new born babies

Vote No to murder new born babies.

After assaulting basic human rights for over two years, California Governor Gavin Newsom is working on a new INFANTICIDE bill that would legalize the murder of children up to nine months gestation and in the week(s) after birth. The bill has been proposed by Newsom’s “Future of Abortion Council” which makes recommendations to “strengthen and expand” abortions in the state of California.

Under California AB 2223, a mother will be shielded from civil and criminal charges for any “actions or omissions” related to her pregnancy. These actions include not only abortion in any stage of pregnancy, but also “perinatal death.” Perinatal death is defined as the death of a newborn up to seven days or more.

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Can You Live On Social Security

Can You Live on Social Security?

 

 

 

 

 

 

 

Here is the deal. You work the best years of your life and now that you are older your retired. The salary you had been earning for the past years is gone.

Yes, you have earned money from Social Security. But can you live on it?

There are thousands of people living on the streets. Did you ever ask yourself why is that?

The simple reason is Social Security does not pay you enough to live in the inflated world we are living in.

After my rent is paid, I have $100.00 left from my Social Security check.

How much do you have left?

Yeah! Social Security went up this year a few dollars and guess what they took most of the increase out in Medicare Part B payments.

If you are lucky to have a spouse who still brings in an income, is independently wealthy, or receives a retirement check from your employment  – hurrah!

But for most of us out in the world, seniors, who need more help now than ever before there are only the streets.

What do you think?

Thank you for reading my article copyright Linda Meckler 2022

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The Miracle of Hearing Aids and Tinnitus

I was one of these hard-headed people who didn’t think I needed hearing aids. Every year I had a hearing test and it came out within-in normal hearing.

This last hearing test came out differently. It said my hearing was declining. Is that why I turned the television up? Is that why I always used my phone on speaker so I could hear the person speaking?

I checked out a few hearing aid places and from the prices being sky high and their presentation, I wasn’t impressed.

My tinnitus or white snow sounds were harboring on I want brain surgery to remove whatever was shrieking in my ears 24-7. After years of asking why I have tinnitus and what causes it, I was answered. My usual answer was there is not a known reason for tinnitus. But this time I was given the reason. The brain receptors were broken. Instead of the brain commuting with other receptors of the brain it was broken and the brain filled in the space with white noise, or electricidal screaming, or whatever you hear. Also, the nerve was shutting down. It was nice to know what was making my life so miserable.

I made an appointment for Costco where I know people that have gotten their hearing aids there. I was very impressed with the presentation and I had a free hearing test different from the usual hearing tests. This test was geared to the blue tooth hearing I needed.

After the hearing test, I was shown the hearing aids I needed and told the price and was happy to hear that the hearing test was free and it was under warranty for two years.

Three weeks later I received my hearing aids. The hearing aids sit on top of the ear not behind. There is a small piece that goes in the ear.

Because of the blue tooth capabilities, I can hear clearly on the phone. I can answer the phone even if it is in another room. My tinnitus while wearing my hearing aids is down. I haven’t had them long and I hope it will get better than this. But when I remove them, my tinnitus comes back full blast.

Hearing aids have come a long way from the old battery-powered ones.

Thank you for reading my article.

Copyright Linda Meckler 2021