W1GUH
11-14-2012, 04:18 PM
Purely informational....no politics are intended here.
Be wary of picking an HMO -- it can cause problems.
What happened is I enrolled in an HMO. Their coverage seemed pretty good and the cost was reasonable, and my doctor was a part of it. What else did I need to know? Medicare stuff, and the difference between a Medicare Supplement and an HMO,that's what.
The literature I had didn't spell out that difference -- I thought both plans offered by the company were supplements. I was dead wrong. The HMO isn't a supplement, but a pretty complete plan. In that situation, Medicare pays what the HMO doesn't. (I'm pretty sure I've got that right).
OTOH, with a Medicare Supplement, the supplement pays what Medicare doesn't.
And...I only had HMO coverage for a month because, as it turned out, my doctor no longer participated in the HMO, and as soon as I learned that, I pretty much had to switch back to Blue Cross.
Tip: When you're selecting a plan and your doctor is listed by the plan as being a participant, it's best to call your doctor's office to make sure of that. This is something I didn't know beforehand. Would have saved LOTS of grief!
So, OK, as of 11/1 I've got Blue Cross, and I thought I was home free. Well, maybe, almost.
Medicare still thinks I have that HMO, and it won't pay what it thinks that would have paid. Don't think this is a real problem, only a processing delay that will be straightened up as the machine chugs through the change, but it was a shock to find it out at the hospital today.
I DO wish that there had been some sort of seminar or conference call where this is spelled out, would've helped a LOT.
BTW, saw the doctor today and I'm doing just as good as ever. Guess I'd rather have that good and insurance a hassle than easy insurance and treatment that's a problem!
Be wary of picking an HMO -- it can cause problems.
What happened is I enrolled in an HMO. Their coverage seemed pretty good and the cost was reasonable, and my doctor was a part of it. What else did I need to know? Medicare stuff, and the difference between a Medicare Supplement and an HMO,that's what.
The literature I had didn't spell out that difference -- I thought both plans offered by the company were supplements. I was dead wrong. The HMO isn't a supplement, but a pretty complete plan. In that situation, Medicare pays what the HMO doesn't. (I'm pretty sure I've got that right).
OTOH, with a Medicare Supplement, the supplement pays what Medicare doesn't.
And...I only had HMO coverage for a month because, as it turned out, my doctor no longer participated in the HMO, and as soon as I learned that, I pretty much had to switch back to Blue Cross.
Tip: When you're selecting a plan and your doctor is listed by the plan as being a participant, it's best to call your doctor's office to make sure of that. This is something I didn't know beforehand. Would have saved LOTS of grief!
So, OK, as of 11/1 I've got Blue Cross, and I thought I was home free. Well, maybe, almost.
Medicare still thinks I have that HMO, and it won't pay what it thinks that would have paid. Don't think this is a real problem, only a processing delay that will be straightened up as the machine chugs through the change, but it was a shock to find it out at the hospital today.
I DO wish that there had been some sort of seminar or conference call where this is spelled out, would've helped a LOT.
BTW, saw the doctor today and I'm doing just as good as ever. Guess I'd rather have that good and insurance a hassle than easy insurance and treatment that's a problem!