kannon
Recycles dryer sheets
Good Morning -
I am a (happily) retired federal worker on FERS. My DW is about to turn 65 so we are at the Medicare decision point. We currently have BC/BS Standard.
I have read a lot of online experiences about FEHB and Medicare and been great source of information.
Right now my plan is to sign DW up for Part A. The question is what to do about Part B. In its simplest terms I thought it be basically a comparison of estimated Part B yearly premium expense (I estimate about $1800) compared to current or expected BC/BS copays/out of pocket expenses for my DW. The assumption if we pay for DW on Part B as primary, then BCBS would be secondary and take care of all the copays,... versus stay solely on BCBS and we continue the copays.
Now the complication. Most of her doctors are with a group and they say they are Medicare Non-Par Status. From reading the fine print this means that they have a Limiting Charge of 115% of Medicare allowable charge.
So, in my small brain, I think this means that Medicare Part B and BCBS would only cover the 100% portion and we still get stuck with the 15%.
For instance, say dr visit was $100 Medicare Allowable Charge. Medicare pays $80 (80%), BCBC pays $20, and we are left with a $15 charge. Am I reading this correctly?
Cause if this the case seems to me I am paying BCBS premiums and still getting stuck with copays,... cause of the Non Par 115% Allowable Charge. Then why pick up Medicare Part B. Maybe time for new medical doctors group.
Appreciate anyone advise on folks who have dealt with this Non Par status.
Thanks
I am a (happily) retired federal worker on FERS. My DW is about to turn 65 so we are at the Medicare decision point. We currently have BC/BS Standard.
I have read a lot of online experiences about FEHB and Medicare and been great source of information.
Right now my plan is to sign DW up for Part A. The question is what to do about Part B. In its simplest terms I thought it be basically a comparison of estimated Part B yearly premium expense (I estimate about $1800) compared to current or expected BC/BS copays/out of pocket expenses for my DW. The assumption if we pay for DW on Part B as primary, then BCBS would be secondary and take care of all the copays,... versus stay solely on BCBS and we continue the copays.
Now the complication. Most of her doctors are with a group and they say they are Medicare Non-Par Status. From reading the fine print this means that they have a Limiting Charge of 115% of Medicare allowable charge.
So, in my small brain, I think this means that Medicare Part B and BCBS would only cover the 100% portion and we still get stuck with the 15%.
For instance, say dr visit was $100 Medicare Allowable Charge. Medicare pays $80 (80%), BCBC pays $20, and we are left with a $15 charge. Am I reading this correctly?
Cause if this the case seems to me I am paying BCBS premiums and still getting stuck with copays,... cause of the Non Par 115% Allowable Charge. Then why pick up Medicare Part B. Maybe time for new medical doctors group.
Appreciate anyone advise on folks who have dealt with this Non Par status.
Thanks