No problem!
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Thatās outrageous. You need to switch insurance companies. Most insurance companies cover annual physicals and mammograms 100% (unless thatās changed).
Iām on Medicare Advantage and itās covered 100% for us.
The only reason I chose Medicare Advantage over regular Medicare is because stand alone Medicare doesnāt cover medications, and we take a lot of medications (most of which are covered 100% by our Medicare Advantage plan). Medications can be really expensive.
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My first biannual mammo was covered. I think it was the followup given its inconclusiveness.
Also, itās only partly the insuranceās fault. The āhospital/facilityā fee is a brand-new way by one of our health providers to fuck us. They lie about the fee, too, when they give you the estimate.
The university, through which our insurance runs, is aware of the issue. Other faculty & staff have been slammed with fees in the 4 figure range.
It is absolutely disgusting.
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Yeah, after last year Iāll be on medications for life. So itāll probably be the Advantage plan for me plus the extra Rx plan.
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YOWZA! Thatās insane!
Look into the MassHealth Medicare plans. Itās been great for my mom so far.
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With Advantage you might not need the extra prescription coverageāitās usually included.
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While I hear that Medicare Advantage plans in MA are pretty good, that is not always the case. Make sure you check that your docs are in network, what they require with respect pre-authorizations, referrals and the like. As a physician, my H sometimes found it hard to it his patients the care they need without going through hoops.
Most MA plans include drug coverage but you may do better with a gap pln/Part G and separate drug plan/Part D. Also, you may want to talk to an medicare insurance broker who can run various scenarios for you.
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Oh, thatās a given. Iāve been my companyās HR Manager for years, and itās what I always tell employees to do before joining or switching plans.
Didnāt know about Part G, but was aware of Part D. I do have a Medicare person to speak to once Iām ready, referred to me by another employee who is starting his retirement process.
Thanks so much!
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Same here . A big NO to Medicare Advantage.
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Uffdah. Hadnāt heard of this shenanigan before. Can you negotiate it substantially down?
I got hit with a $3000 transport fee for a 10 minute, 3 mile trip from one hospital to another. Turns out very few of the transport guys accept any insurance around here (as opposed to emergency hospital-affiliated ambulance transport, generally covered if the hospital is in-network, and even then, just a partial fee).
So when I got the bill I called them, filled to the gills with oxycontin and said itād be a cold day in Hell. She offered to reduce it to $1500 and I said, I have credit card in hand and will pay you $300 to quit the claim.
She took it.
In another case Iād been receiving a daily treatment that my insurance was covering at $1000/day. After the first month, they balked at covering a second month. The specialists Iād been seeing every week put together a very well-researched rebuttal and appeal, and all 4 of them signed it. No Joy.
They (the specialists) convinced me that I really really needed the next monthās worth of treatments, and I negotiated a discount of $600/day, so what the insurance paid $30K for, I got for $12K.
The next course of treatment worked, by the way.
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You probably already know about this, but Massachusetts also has a free option called the SHINE program that links people with volunteer counselors that help people make Medicare decisions. I used this resource about 10 years ago when I needed to quickly relocate my Mom to MA. The counselorās information was a helpful baseline.
Fast forward to the present day. Iāll have been through my own decision-making process before you plan to set out on yours. Feel free to DM me if anything Iāll have learned may be helpful.
How time flies.
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I didnāt, but will note itā¦AND your offer of chatting about options! Thx! Just another thing to deal with as we get older, huh? 
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Glad to be of some help. I only recently went through the process so it is somewhat fresh in my mind.
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Humor ist, wenn man trotzdem lacht.
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And I would like to welcome our new, blue goo overlords:
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Theyāll never find you with that spiffy new name. Maybe I should go anonymous, too 
Too late! 
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Well, Iāll beef hooked!*
*Read that out loud & fast 
Itās an old joke.
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