Category: Medical

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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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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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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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Hearing Aids and Tinnitus

I have tinnitus it gets worse every day. My last hearing test showed that the nerve in my ear was deteriorating. In the past when I have had hearing tests my results were within normal limits.

Now with this new test, the ENT doctor finally said that yes you have tinnitus. I have asked doctors over the years why? What is it? But I have never received an answer.

I did know one thing whenever somebody said it was a ringing in my ears, I knew they were crazy. I never had a ringing in my ears I had a buzz saw going off in my brain.

Now with my test result, I got an MRI of my brain and ears and thankfully it was negative. I was sent to two other ENT doctors for different reasons and they all agreed I need hearing aids.

I went through the process of purchasing blue tooth hearing aids. I mainly wanted it for tinnitus.

I want you to know when I do not have the hearing aids in my ears, I have tinnitus. It seems that it gets louder.

I want you to be aware before you pay big bucks for hearing aids that tinnitus doesn’t go away sometimes.

I watched y-tube videos on tinnitus and it is a good education on what tinnitus is after twenty years of wondering the answer was there.

Hearing aids are great for the blue tooth part. Answering phone calls without your cell phone in your hand and listening to music.

I can hear.

Thank you for reading my article.

Copyright Linda Meckler 2022

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Drugs and Copays

When you go to the pharmacy you might have a copay to pay.

If you do and the druggist gives you an amount you know is wrong, question it.

This happened to me. I had taken this drug once before and my copay was $9.00. When I went to pick up my medication again the druggist asked for 99.00 dollars.

Do you think I paid 99.00 dollars?

Of course not. I said that is wrong.

The druggist said this is what the computer says.

I said, “check this my insurance company and call me when it is fixed.”

I received a call back from the pharmacy, and it was a computer error.

So, if it was a computer error is it my fault?

Stand up for yourself.

If you need your drugs speak out.

Get the pharmacist to call your insurance company.

Thank you for reading my article.

Copyright Linda Meckler 2021

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Medicare and Other Insurance Plans

Do you understand Medicare?

If you have Medicare, do you understand it?

Do you understand how Medicare works?

Do you know what parts A, B, C, and D mean?

If you do not understand this you do not understand Medicare.

Medicare is complicated. 

I don’t know why it is this way.

Do you?

Maybe it could be simplified.

Maybe it could be easier to understand.

What do you think?

What do you not understand?

Thank you for reading my article.

Copyright Linda Meckler 2021

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Red Hot Medical Bills

Believe it or not, you are not the only one who has medical bills. They seem endless and never-ending. You can get them from medical providers you have never heard of or thought of. Where did all these bills come from? If you have been in the hospital for a long-term stay expect a huge bill.

First, you have to break it down. What Date of Service (DOS) was billed and what was paid and what wasn’t paid and why – line by line.?

Let’s break it down. When you are admitted to the hospital for a scheduled surgery there is a facility fee. The doctors which are treating you have their fees. When tests are performed such as x-ray, MRI’s, lab, or any medication there are fees for these.

While in surgery there is an assistant surgeon and last but not least the Anthologist.  These are all the normal fees but of course, there could be other fees for your special needs.

Wow! these fees add up and your bill could be at least 30 pages long. When you have medical insurance your insurance company is billed. The insurance company whatever it is will usually pay 80% of the allowable. The allowable is determined from the contract your medical provider (the hospital) has with your insurance company. This is written off in a contractual agreement. It can be a different amount for different insurance plans. After the insurance has paid you are billed the balance of the bill if you do not have a 2nd insurance to apply it to.

If you have 10 bills from different Medical Providers this can get confusing and expensive.

Medical Bills are billed from the Date of Service (DOS) you were seen by a Medical Provider or in patient in a Hospital, etc.

There are all kinds of problems that can crop up which your medical insurance company will bring to your attention. This is where medical appeals come in.

Also, you must have some kind of understanding of how your insurance company works if you want to protect yourself and your family.

Now with people entering hospitals and are there for long or longer stays the medical bills are going to be astronomical.

Now you have to look at every Explanation of Benefits (EOB) line by line.

You have to make sure everything was billed from each individual medical provider. 

This is going to be complicated.

My book Medicare and Other Health Insurances will help you understand what the next step will be needed to get your bills paid.

Thank you for reading my article. Please feel free to read any of my numerous articles on various subjects.

Linda Meckler copyright 2009 updated 2021

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See See Rigney Nurse Retires at 96

Florence “SeeSee” Rigney from Tacoma, Washington retired after over 70 years as a nurse

By Vanessa Etienne

July 23, 2021 10:09 AM

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CREDIT: MULTICARE TACOMA GENERAL HOSPITAL

A 96-year-old woman, believed to be the oldest working nurse in the country, has retired from a Tacoma, Washington, hospital.

Last week, Florence “SeeSee” Rigney retired as a nurse at MultiCare Tacoma General Hospital after over 70 years, according to a press release from the hospital. Throughout her career — which began as a student nurse at the Tacoma General School of Nursing in Washington — Rigney worked consistently, only taking a “break” from nursing to raise her two children. 

According to the hospital, working as a nurse has kept Rigney very active. She’s traveled across the country as an operating nurse and even logs up to three miles on her Fitbit from walking during her shifts.

“I don’t like to sit around – I’ve always got to have something to do. That’s my nature,” Rigney said in a statement, adding that she always wanted to become a nurse. “I love to interact with patients and give them the help that I can.”

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Face Masks or Not?

What do you think about the removing of face masks in June?

You must have some kind of opinion.

I am vaccinated but for some reason some people do not want to be vaccinated.

I want to be able to remove my mask in public. I feel safe now that I have been vaccinated.

But I have my reservations about the people who are not vaccinated.

My question is why not?

Do you want to continue wearing face masks for the rest of your lives?

I for one, want to be with people who have been vaccinated.

What do you think?

I want to see children being back in school.

I want to see people going back to work.

I want to see people being social again.

I will continue wearing my mask. What can happen I will be safe.

What do you think?

Thank you for reading my article. My website is www.lindameckler-author-artist.com

Copyright Linda Meckler 2021