Posted on 02/25/2025 3:49:09 AM PST by davikkm
Third-party payments distort any market.
I recently had a mengeoma tumor removed with the exact same procedure as you described. The two day hospital bill was $90k. I told them I was self pay and without hesitation they took 60% off. The surgeon took 50% off his $22k bill. At the end of the day, patients need to be their own advocates. This is where the current system breaks down. Add government’s deep pockets with Medicare and Medicaid, legislating health care to anyone, the system is ripe for abuse.
I don’t know what the answer is, but government is not the answer.
Yes. You get a bill and if you’re on SSA they auto deduct it from any payments you get.
Medicare Advantage can work out ok *IF* you get a good plan and provider.
My advice to anyone who is close to 65 is to take care of any medical issues they know need addressing while they are on good insurance, and see if they can lay in a supply of meds (IF possible) because the Medicare RX benefits are awful.
There’s a big coverage gap that is referred to as the donut hole where you can get screwed in prescription costs if you’re on expensive prescriptions.
Taking care of any elective type surgery before going on Medicare is the way to go, stuff like cataract surgery if warranted.
I don’t know what the answer is, but government is not the answer.
offers some interesting possibilities. looking at it.
May want to check on your BCBS because they’ll reimburse up to $800 for medicare part b cost. So the wife and I do get a check for $1600 total. Just provide proof that you pay Medicare Part B premiums which will work with a SS letter showing what you pay.
I’ve had luck with BCBS so far.
Doctors and hospitals need to work like mechanics by providing estimates at certain points:
1) Here’s what it costs to diagnose you and estimate a cost of treatment options.
2) If not diagnosed by the consumption of estimate 1, here’s the estimate of continued research and diagnosis.
3) If diagnosed, here’s the estimate for treatment options, and follow up care, along with the cost of the most likely side effect or adverse reaction (e.g. you get a quote for a colonoscopy to include polyp removal, but you also get a quote for the event that a tear in the colon occurs during the procedure that needs to be sutured or what not.)
4) Estimates for follow up care should include estimates for the most likely adverse event to occur as well (eg you get an infection).
So basically, it’s providing the patient with the expected cost of care, along with some costs for crap that may come up along the way.
I didn’t know that but it’s too late for that.
We found a terrific Medicare Advantage plan so made the decision to switch over a couple years ago. There’s no going back.
Plus, it was retirement BCBS which means we paid a much higher percentage of the premium than we did when mr. mm was employed.
I’m retired after 40 years in healthcare. In my experience, there are three primary causes for the mess we have.
1. Government price fixing / interference in the market
2. Trial lawyers seeking jackpot ‘justice’
3. MBAs who turned healthcare into a cash cow by leveraging No 1&2.
Insurance companies are the catfish. Bottom dwellers sucking $ paid by the productive class to mitigate the threat cause by the 3 biggies.
The most ruthless “company” I ever worked for, in my career, and I spent a decade working for investment banks, was without question an integrated health care delivery and insurance company.
I haven't seen it here.
In fact they have been opening some speciality care facilities and urgent care facilities in the area.
It is, however an area with a growing population
In my area, I'm seeing medical groups being acquired by "private equity," which tells me right away that price-gouging, degradation of services and fraudulent billing are the goals.
Good grief... may I ask what kind of premiums I may be looking at? Is it monthly? Is it the same for everyone, or is it geared to how much your SSA payment is?
Man, I didn’t know about this. May I ask how much Medicaid is charging monthly?
I honestly don’t know or remember.
I believe it’s deducted monthly but I also recall paying the premiums quarterly for regular Medicare A & B before the Advantage Plan.
And I don’t know if its prorated based on SSA payments.
I think that maybe, HOPEFULLY, once Trump and DOGE are done with the audit and getting rid of the fraud and waste, things might like better for you than it has for us.
https://www.forbes.com/advisor/health-insurance/medicare/how-much-does-medicare-cost/
Thank you for answering... I hadn’t really thought about it. I retired at 55 in 2020 and have just been using the VA clinic for my (few) needs. I don’t have insurance at all, partly because I hate those companies so much, I’d just about rather die than use them. Finding out that Medicare is both mandatory and not free is... startling. It’s probably better than nothing, but I HATE not having the choice to simply decline.
Geez, this is appalling. I have no health problems, none. I’m on no medications. I don’t want to give them any money. Now I’m angry. (sigh) Well, it sounds like they’ll take a goodly chunk of my SS, so I’ll just be glad I have a separate pension and a part time job.
If you plan on taking SSA payments, you have to be careful about how much you earn until IIRC, 70. If you earn too much, they deduct from your SSA.
I’m glad to hear you have no health issues. That’s rare these days.
BTW, they also neg you about making sure all your shots are up to date, flu and Covid vaxxes, shingles, pneumonia, etc.
Which I ignore.
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