No.1 is No. Misleading information again

来源: goingplaces 2023-01-14 15:01:53 [] [旧帖] [给我悄悄话] 本文已被阅读: 次 (3761 bytes)
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回答: 谢谢非常详细的介绍,补充几点littlerabbit2023-01-14 14:41:32

很多说很多医生不收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的口服药是Part D支付。目前没有支付上限,对某些极贵的药,自付可达上万甚至更多。Medicare Advantage因为有支付上限,可能会便宜点。

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/

较健康时选Advantage可能便宜些,但是得了大病可能就换不了MediGap了,除了少数州可以随时换外

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计划每个county不同,我们所在地区是每月20元,不知道别的地方会200元这么高还是你的信息有误。

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. 

选择Medicare不需要agent,但是用agent没有另外收费,能帮助办手续和帮助解释政策,还是方便很多。

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,确实不错!但是你也太自以为是了,别人都错,就你正确?你看来是雌墨索里尼? -hhtt- 给 hhtt 发送悄悄话 hhtt 的博客首页 (0 bytes) () 01/14/2023 postreply 15:09:20

我对你知道这么多信息很佩服,就问了一声是不是经纪?竟然被你说是老中思维,知道你走了很多码头,低调些,没人说你不懂? -hhtt- 给 hhtt 发送悄悄话 hhtt 的博客首页 (0 bytes) () 01/14/2023 postreply 15:12:22

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

哈哈,就看到左一个No右一个No别人说的全是中国人思维。 -haomahaoma99- 给 haomahaoma99 发送悄悄话 (0 bytes) () 01/14/2023 postreply 15:24:59

他的No里有些是不对的,我也懒得解释了,毕竟他是道听途说的,我是给家人办过的 -littlerabbit- 给 littlerabbit 发送悄悄话 littlerabbit 的博客首页 (0 bytes) () 01/14/2023 postreply 15:29:44

同意。她说的有几样不准确。因为我就在加州,我用过Kaiser, 也用过 advantage. 现在是suppleme -原上草2017- 给 原上草2017 发送悄悄话 原上草2017 的博客首页 (0 bytes) () 01/14/2023 postreply 19:55:26

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

Plan D达到$7400 以后还要付5%的药费,我家人的一个药今年一年自付就是一万三,如果再多几个药就更多了 -littlerabbit- 给 littlerabbit 发送悄悄话 littlerabbit 的博客首页 (119 bytes) () 01/14/2023 postreply 15:15:12

老了真是药费都贵过伙食费了啊。 -haomahaoma99- 给 haomahaoma99 发送悄悄话 (0 bytes) () 01/14/2023 postreply 15:19:12

普通的药不贵,copay只要几块钱,大病就贵了 -littlerabbit- 给 littlerabbit 发送悄悄话 littlerabbit 的博客首页 (70 bytes) () 01/14/2023 postreply 15:22:55

OMG -大西洋里来的人- 给 大西洋里来的人 发送悄悄话 (0 bytes) () 01/14/2023 postreply 16:04:00

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

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