FrankTalk.org

I just got a quote from Dr Eids office of a co-pay of $250ish. Is this right? Why is the hospital copay $4000+? I find the billing office at Dr Eids office confusing.

What insurance do you have? If you have straight medicare it will only cover 80%. You have to have a supplement if you want 100% coverage. If you have a medicare advantage it should cover 100% if you are admitted into the hospital overnight, IF you are an out patient like I have been both times, first one was 60 dollar co pay, second one fifteen years later was I believe one hundred dollars.

Now if you are still working and probably have a PPO type insurance, most will cover 80%. The Afordable Care Act was pretty good insurance according to people I talked to that had it, but now this administration has just about destroyed it instead of improving it. Not sure what you have, it does not say on your posts. Need more information so that people posting can help you.

RayChez-i have straight up Medicare. No supplemental. But why would hospital be more than surgeon co-pay??

Well, there are costs incurred from use of the facilities, space occupancy, medical technology to monitor your life functions, anesthesia regulation, etc. I have repeatedly found that surgeon’s fees only make up about 40% of an itemized bill.

And there is the whole insurance billing concept of “usual & customary” that may or may not apply to Medicare billing.

rok

Hospital bill also includes price of implant plus everything what was mentioned before.
MK

If your on Medicare and your not doing this till next year then get a BCBS supplemental plan for around $200.00/ month they will pick up the whole cost its a no brainer.

Thanks guys! Makes much more sense now.

There may be the issue of some parts of the procedure are not covered if the testing and such are not done more than 23 hours before surgery. When I consulted with Dr. Eid there were a number of things that insurance would cover if I arrived 2 days early and had testing but if I had the EKG, lab work, office visit and whatever the day of arrival and surgery the following day, they paid for none of it. Do get yourself a supplemental Medicare policy though. Many can be bought between $160 to $200 a month. 1 year for $2400 beats $4 grand unless you are used to using the fuzzy math politicians use. Cheers.

My medicare and BCBS sup paid all. Had pre op at family doctor in NC and have never seen a bill. University of Maryland made it all work. Good luck

dirtman1993 wrote:My medicare and BCBS sup paid all. Had pre op at family doctor in NC and have never seen a bill. University of Maryland made it all work. Good luck

Dr. Kramer did the same for me. I had all my pre-op done in St. Louis (2 hour drive each way) after the local assholes at both hospitals told me at each appointment that they would not do pre op if I was not going to use their own local quacks. Most out of town surgeons have let me do local ekg and labs or use some recent ones I had. Must say UMMC made it the smoothest ever! Thanks