More insurance brokers would choose traditional Medicare over Medicare Advantage: Report

[sman]

So if the patient pays $2163 and the Part B responsibility is 20% what would be the total cost?

The $2,163 IS the 20%. Also note that these are national averages. Some areas could be more and some could be less. But no way the Medicare approved amount is $50,000. That may be what the facility and physician charge, but as you know, that amount gets greatly reduced.

The interesting part on the above referenced amount is that the hospital side shows an amount that is less than 20% of the total approved amount. This is due to Medicare capping the 20% to $1,600 for outpatient hospital services which is the inpatient deductible. So in this scenario, the patient actually saves Medicare money by having the surgery in the hospital instead of at an ambulatory surgical center.

 

[straightnochaser]

The $2,163 IS the 20%. Also note that these are national averages. Some areas could be more and some could be less. But no way the Medicare approved amount is $50,000. That may be what the facility and physician charge, but as you know, that amount gets greatly reduced.

The interesting part on the above referenced amount is that the hospital side shows an amount that is less than 20% of the total approved amount. This is due to Medicare capping the 20% to $1,600 for outpatient hospital services which is the inpatient deductible. So in this scenario, the patient actually saves Medicare money by having the surgery in the hospital instead of at an ambulatory surgical center.

Right, thats kinda the point. If patient responsibility is 20% he wasn't far off for the total cost of the surgery.

 

[sman]

Right, thats kinda the point. If patient responsibility is 20% he wasn't far off for the total cost of the surgery.

I guess I'm not understanding you. Total cost of the surgery is between $10,621 and $14,347 depending on where it is done. That's a lot more than $2,163.

 

[straightnochaser]

I guess I'm not understanding you. Total cost of the surgery is between $10,621 and $14,347 depending on where it is done. That's a lot more than $2,163.

You know what, you're right. I am (once again) recovering from Covid and the brain fog is real. I can't math today.

 

[goillini52]

You know what, you're right. I am (once again) recovering from Covid and the brain fog is real. I can't math today.

I still have brain fog almost 2 years later.

 

[Kim Mastridge]

It depends how my health is at 65 . If it’s good I’ll select a mapd with low moop . If it’s bad I’ll select a med sup .

If I did that, my luck would definitely change, lol. I am OM all the way. What's a bit of Uber driving?

 

[Yagents]

Hmmm.....the poll shows 2 out of 3 agents would get OM for themselves.

 

[Bryan Smith]

If you read further into the study, you will find they only interviewed 29 brokers and agents. that is hardly a reason to say "MANY" or "MOST Agents" I would choose MAPD hands down over MED SUPP. Way better care, and incentive for the Providers to care and do more for their panel, rather than just FFS shi*

 

[Fisher]

"Way better care" is certainly a subjective statement.

 

[Bryan Smith]

"Way better care" is certainly a subjective statement.

"Way better care" I speak from experience. 12 years in the industry, 1400 + clients active on MAPD plans.