No.1 is No. Misleading information again

本帖於 2023-01-14 16:36:57 時間, 由普通用戶 goingplaces 編輯
回答: 謝謝非常詳細的介紹,補充幾點littlerabbit2023-01-14 14:41:32

很多說很多醫生不收Medicare的,大概用的是Medicare Advantage吧

Cannot be far from truth.  I would say Obamacare is prone to have this issue.  NOT Medicare Advantage.

Medigap的口服藥是Part D支付。目前沒有支付上限,對某些極貴的藥,自付可達上萬甚至更多。Medicare Advantage因為有支付上限,可能會便宜點。

Medicare Plan D 2023  自付上限 is $7400

As has been the case in previous years, the thresholds where a person enters and exits the “donut hole” increased in 2023. We’ll explain this in more detail below, but the short story is that the initial coverage limit increased to $4,660, and the threshold for exiting the donut hole and entering the catastrophic coverage level increased to $7,400.

https://www.medicareresources.org/faqs/are-there-changes-in-the-medicare-part-d-prescription-drug-coverage-this-year/

較健康時選Advantage可能便宜些,但是得了大病可能就換不了MediGap了,除了少數州可以隨時換外

Dont understand this logic.  What diseases covered are determined by Medicare - does not matter what plan you choose.  The tricky part is on the Treatments.  Medicare does not cover some treatments when lower cost treatments are just as effective.

For example, cataract operation - Laser is not covered.  However a good othomologist would tell you there is NO DIFFERENCE or obvious advantage from the Laser option.  That was her words almost Verbatim - Laser is used to break up the cataract,  it is still ME who manually, surgically, remove those pieces.  Medicare covers 100% the traditional procedure.  Additional advanced evaluation by euipment before surgery is not covered.  This doctor charges $400 for the pre-op examination using specialized equipment.  That $400 is not covered.  But the $250 Flexi spend $ can be used to pay for that.  Facility used to perform the surgery has $40 copay each usage.  The whole operation costed 2x $40.

加州的Kaiser計劃每個county不同,我們所在地區是每月20元,不知道別的地方會200元這麽高還是你的信息有誤。

Correct.  My long post already said that the premium is determined by the county you live in.  You can only get the plans offered within your county.  The premium of $200 was told by our friend who we kept thinking his additional  premium was too high that he should ask his daughter to go over it.  But he insisted his was Advantage Plan he had.  He said it was directly switched from the work coverage to Medicare Advantage (years ago and he never looked back or looked into details).

May be his is a ppo that I am not sure.  To me, ppo does not offer advantage over hmo - key is to carefully choose your PCP and then your specialists.  

Another friend in Chicago also pays $200+ prem a month.  They (both husband and wife) do not want to change their plan. 

選擇Medicare不需要agent,但是用agent沒有另外收費,能幫助辦手續和幫助解釋政策,還是方便很多。

Totally agree!  握手

But hhtt first reply was to question me whether I was an agent - as if anybody gives information "for free" must have some hidden agenda - typical Chinese thought process. 

所有跟帖: 

你知道多,確實不錯!但是你也太自以為是了,別人都錯,就你正確?你看來是雌墨索裏尼? -hhtt- 給 hhtt 發送悄悄話 hhtt 的博客首頁 (0 bytes) () 01/14/2023 postreply 15:09:20

我對你知道這麽多信息很佩服,就問了一聲是不是經紀?竟然被你說是老中思維,知道你走了很多碼頭,低調些,沒人說你不懂? -hhtt- 給 hhtt 發送悄悄話 hhtt 的博客首頁 (0 bytes) () 01/14/2023 postreply 15:12:22

Because Chinese hardly share info when that happens, -goingplaces- 給 goingplaces 發送悄悄話 (209 bytes) () 01/14/2023 postreply 17:01:40

哈哈,就看到左一個No右一個No別人說的全是中國人思維。 -haomahaoma99- 給 haomahaoma99 發送悄悄話 (0 bytes) () 01/14/2023 postreply 15:24:59

他的No裏有些是不對的,我也懶得解釋了,畢竟他是道聽途說的,我是給家人辦過的 -littlerabbit- 給 littlerabbit 發送悄悄話 littlerabbit 的博客首頁 (0 bytes) () 01/14/2023 postreply 15:29:44

同意。她說的有幾樣不準確。因為我就在加州,我用過Kaiser, 也用過 advantage. 現在是suppleme -原上草2017- 給 原上草2017 發送悄悄話 原上草2017 的博客首頁 (0 bytes) () 01/14/2023 postreply 19:55:26

U think if it is wrong I should still say Yes? -goingplaces- 給 goingplaces 發送悄悄話 (32 bytes) () 01/14/2023 postreply 16:16:44

Plan D達到$7400 以後還要付5%的藥費,我家人的一個藥今年一年自付就是一萬三,如果再多幾個藥就更多了 -littlerabbit- 給 littlerabbit 發送悄悄話 littlerabbit 的博客首頁 (119 bytes) () 01/14/2023 postreply 15:15:12

老了真是藥費都貴過夥食費了啊。 -haomahaoma99- 給 haomahaoma99 發送悄悄話 (0 bytes) () 01/14/2023 postreply 15:19:12

普通的藥不貴,copay隻要幾塊錢,大病就貴了 -littlerabbit- 給 littlerabbit 發送悄悄話 littlerabbit 的博客首頁 (70 bytes) () 01/14/2023 postreply 15:22:55

OMG -大西洋裏來的人- 給 大西洋裏來的人 發送悄悄話 (0 bytes) () 01/14/2023 postreply 16:04:00

long term maintenance drugs such those for immune system -goingplaces- 給 goingplaces 發送悄悄話 (319 bytes) () 01/14/2023 postreply 16:46:34

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