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Medicare vs. private insurance

 
 
Chai
 
Reply Wed 28 Feb, 2007 07:20 am
My husband (currently on disability) will be turning 62 in about a year and a half. At that time his disability payments turn into regular social security.

Right now he's covered by my insurance at work. He can either stay on my work insurance at 62 or switch to Medicare for both A & B. He already has the hospital part as that automatic.

Anyway, we were talking about this the other day, and we're toying with the idea of having him switch completely over at that time, and dropping my work insurance. The reason for this is that it would give me the freedom of seeking other employment, and not worrying about him remaining covered. I think in a year and a half I may be ready to move on from what I'm doing now.

My question is regarding the coverage, quality of care. I know every insurance plan where people work is different, and that one can't get too specific with the differences.

However, in general, for those of you who have switched, do you find youself better, the same, or worse off as far a benefits for doctors visits, tests, drugs, etc.?

Thanks
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Type: Discussion • Score: 1 • Views: 379 • Replies: 9
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roger
 
  1  
Reply Wed 28 Feb, 2007 08:21 am
Bookmarking, but I'll bet it's not better than either my or your insurance at work.
0 Replies
 
shewolfnm
 
  1  
Reply Wed 28 Feb, 2007 08:58 am
Im going to book mark with the offside comment that... UT.. is looking.. and hubby works for UT and thier insurance is awesome..


medicare is for the birds.
0 Replies
 
Cyracuz
 
  1  
Reply Wed 28 Feb, 2007 09:08 am
I am so glad I live in a coutry where medical treatment is free to all. If I get ill I'll get treatment. No cost to me. I love my country.
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shewolfnm
 
  1  
Reply Wed 28 Feb, 2007 09:10 am
I wish we had that here.


We, ( well I say we but I mean government) can find 600 million to fund a so called war, but cant find 1/2 of that to help with insurance costs


but that is another thread entirely.
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Setanta
 
  1  
Reply Wed 28 Feb, 2007 09:13 am
Perhaps you might find it useful to investigate Medicare coverage first. From Medicare-dot-gov, here is the official page on Medicare coverage. If you don't find all you need at that site, just search for "medicare coverage," which is what i did to find that site. I got 1,380,000 hits in under 2/tenths of a second.
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Cyracuz
 
  1  
Reply Wed 28 Feb, 2007 09:30 am
Well, to clarify. If I go to the doctor I have to pay a small fee for the consultation. If he says I have an infection and need medicine I must pay half the cost of that medicine myself. But if I am diagnosed with cancer to which the treatment is six months of chemo therapy (for example) with a cost of a year's income, that is all covered, and I don't have to pay anything. And if I'm sick with the flu I get money from the welfare system for the duration of my sickness, until I can support myself again.

Also, if I don't have the money for the small bills, like a box of penicillin, I can give the bill to the social welfare office along with documentation that I cannot afford it, and they will cover the charges.
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Chai
 
  1  
Reply Wed 28 Feb, 2007 09:30 am
thanks set. I've already looked at that site, and every year we get stuff in the mail about medicare, since he's on part A (or is it B)

I can compare point by point, but what I'm looking for rather is opinions on how seriously they take certain needs.

For instance, my husband has a defibrillator implanted and it must be checked every few months, just involves holding the phone up to your chest and they send a signal, but sometimes he needs to physically go in. Also, he sees his cardiologist twice a year, that's just when he tells him to come back. He's actually in pretty good shape, and sometimes he says he feels like he's just paying the cardiologist a social visit (he's a really nice guy), he'll always order some kind of test, but for all I know, it might just be to justify the visit, you know how that goes.

It's not so much I'm worried about it costing more, the money will come from somewhere, it always does. My main concern is that the doctor feels a procedure is necessary or wants to perform a test to rule out a problem, or pin point one, and medicare will say it's NOT necessary.

I've worked in the medical industry for a long time, and it's always been that if a doc ordered something, it's needed, no questions asked. Plus, authorizing things are cheaper in the long run, as they avoid bigger problems down the road.

shewolf, when you say medicare is for the birds, in what respect? The care they authorize?
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Chai
 
  1  
Reply Wed 28 Feb, 2007 09:38 am
Cyracuz wrote:
Well, to clarify. If I go to the doctor I have to pay a small fee for the consultation. If he says I have an infection and need medicine I must pay half the cost of that medicine myself. But if I am diagnosed with cancer to which the treatment is six months of chemo therapy (for example) with a cost of a year's income, that is all covered, and I don't have to pay anything. And if I'm sick with the flu I get money from the welfare system for the duration of my sickness, until I can support myself again.

Also, if I don't have the money for the small bills, like a box of penicillin, I can give the bill to the social welfare office along with documentation that I cannot afford it, and they will cover the charges.


Years back my husband accrued over half a million dollars of medical expenses in a very short time, and our out of pocket expense was a few hundred. Of course hospitals have agreements to accept a contract rate, but still.
We pay a co-pay of $40 or $60 dollars for a 3 month supply of pills that would cost about a tousand every couple of months if he had to pay himself. and he's on 3 or 4 other meds that don't run that high, but we still only pay that 40 or 60 co-pay.

I can't say I've been unhappy.

Anyway, has anyone on medicare ever found they told feel they were authorized to get the level of care a doctor deemed necessary?
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au1929
 
  1  
Reply Wed 28 Feb, 2007 10:39 am
I will not comment on which is better. Medicare or private insurance. However, I should remind you that medicare only pays 80% of you costs{Most in hospital costs are covered 100%] and that could be substantial considering your husbands medical needs. In order to be fully covered one needs a supplemental insurance policy to cover the rest.
Both my wife and I are on Medicare and as such I carry supplementary insurance to a tune of $336 a month. And that only pays 80% of the 20% uncovered by Medicare. Note, It is less than most because my old company subsidizes it.

I should also note that under the part D prescription drug coverage you would take a substantial beating compared to your present coverage. It would cost you several thousand $'s in out of pocket expense.
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