Posted by fallsfall on January 23, 2005, at 9:55:29
Health insurance is such a fun topic.
Because I have been on SSDI for more than 2 years I am eligible for Medicare. I have been covered under my COBRA policy from when I was working (and it was Excellent insurance), but that has run out. So I am now covered under my husband's insurance from his work - but it is very expensive and so far seems to be really crappy insurance. So I am looking for alternatives. I think he'll be able to save a bunch of money if I drop his insurance (he can go to a 2 person family instead of a "family" family).
So, my question is: Is anyone using Medicare to pay for therapy? The brochures say it pays 50%, but that is 50% of their "maximum allowable" figure. And there is something about 5% less but 15% more of that if the doctor does or doesn't accept assignment. And something about Medigap policies covering the coinsurance (does that mean they cover my 50% - but that would be my 50% of the "max allowable", right?). And the real question is: do they limit the number of sessions you can have? I see my therapist 3/week and both he and I feel Very strongly that this is a necessary frequency. His fee is pretty high, and he wants to get his full fee. How can I set things up (or how can he set himself up in Medicare) so that Medicare pays as much as it will pay, and I can pay the rest? I know that some of the arrangements are such that he is prohibited from charging more than 15% more than their "max allowable" fee. He doesn't know much about Medicare. He has been on it occasionally in the past, and is willing to participate as he needs to for me, but pretty much I have to figure out how to do it (and then tell him how without him thinking I'm trying to be controlling...).
Any Medicare experts out there?
poster:fallsfall
thread:446160
URL: http://www.dr-bob.org/babble/social/20050123/msgs/446160.html